The Change Healthcare Podcast
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Change Healthcare is a leading healthcare technology company, focused on accelerating the transformation of the healthcare system through the power of the Change Healthcare Platform. We provide data and analytics-driven solutions to improve clinical, financial, administrative, and patient engagement outcomes in the U.S. healthcare system. Learn more at changehealthcare.com.
Available episodes
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May 5, 2022
Let’s Talk Interoperability: Consent and Data Segmentation
With the new CMS and ONC regulations firmly in place, individual access is taking off. But there are still some tricky issues to address around consent and data segmentation. In this episode of the Let’s Talk Interop podcast, our panel explores how technology can support consent capture and revocation as well as consent sharing. They also dive into the work our industry is doing to create standardized ways to segment sensitive data so that patients can safely access their own data and caregivers can access data when needed.
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Apr 15, 2022
Capitol Connection: Post-Pandemic Healthcare Policy
As our public health emergency (hopefully) winds down, federal and state governments are reshaping healthcare policy. To gain clarity we sat down with Ceci Connolly, CEO for the Alliance of Community Health Plans to discuss federal and state healthcare policy trends around Medicaid, mental health, preauthorization and value-based care.
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Feb 25, 2022
Let’s Talk Interop: Straight Talk on TEFCA
Get to know the newly released Trusted Exchange Framework and Common Agreement (TEFCA): what it is, what it does, and how it might impact nationwide interoperability.
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Jan 28, 2022
Innovation: Strategies for Moving Enterprise Imaging to the Cloud
While crossing professional paths over many years, health IT leaders Eric Lacy and Jim Schreiner became good friends—and learned advocates for the transition of enterprise imaging to the cloud. From their perspectives, informed by a radiology practice and a hospital setting respectively, they offer advice and optimism on what lies ahead on the path to the cloud. Tracy Byers, Senior VP and General Manager of the enterprise imaging business for Change Healthcare leads the conversation.
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Jan 11, 2022
A New Approach to Alcohol Treatment
Mike Russell is the co-founder and CEO of Monument, an online treatment platform for those looking to change their relationship with alcohol. In this episode, Change Healthcare’s Anuj Desai talks with Mike about how his own experience drove him to create a new approach to alcohol treatment. Mike tells Anuj how his company was born and how technology has enabled an alternative care mode
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Jan 4, 2022
Enterprise Imaging in the Cloud: Adoption and Outlook
For healthcare providers, the potential of cloud technology intrigues, yet adoption has proven difficult.
Nowhere is this more evident than in imaging, which has a legacy of aging, on - premise applications that interact with every point of care. Faced with unscalable solutions and limited alternates, many providers’ have stalled their initiatives.
Today’s enterprise cloud imaging solutions offer new hope. Here we discuss what’s next for cloud based medical imaging, outlining drivers and barriers to adoption.
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Dec 17, 2021
Payer Government Mandates: And the Survey Says...
We recently asked payers across the country about the No Surprises Act. What do they think about it? How are they preparing for it? How do they feel it will affect their business? In this inaugural episode of our government mandates theme — which we plan to record quarterly, or as critical updates become available — our panelists reflect on payers’ survey responses.
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Dec 3, 2021
Let’s Talk Interop: Moving Toward Electronic HEDIS Measures
Join our presenters as they discuss the history and future of HEDIS reporting. Listen in to discover how existing pain points, regulatory agencies, and environmental factors are influencing the transition from claims-based to clinical-based measures.
Today’s panel includes: Genevieve Morris, senior director, clinical interoperability strategy at Change Healthcare; Robert Connely, vice president, business development, provider networks, clinical networks at Change Healthcare; Eric Whitley, independent health informatics consultant
Here’s what they chatted about:
* Why HEDIS was first established, how it’s evolved over the years, and where it’s headed
* How COVID-19 has affected the healthcare data landscape
* Moving from claims-based to clinical-based measures: Key considerations
* How market influences will inform the future of HEDIS and healthcare data
* What career path Genevieve would choose if she could go back 20 years
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Dec 2, 2021
SDoH: Advancing Individual-level Data to Drive Better Care
As a “free-range” child in the late ‘60s and early ‘70s, Dr. John Halamka rode his bicycle to the dumpsters of defense contractors, pulling out the integrated circuits they had thrown away. By age 14, he had gained an advanced understanding of technology, however his passion lied in biology and life sciences—which led to a “crazy idea”: “What if I made a career that brought together technology and service to patients?” Roughly a half century after his novel notion, Dr. Halamka joins Change Healthcare’s Tim Suther to share stories and lessons from the leading edge of incorporating social determinants of health (SDoH) and individual data into healthcare.
On today’s show, Dr. John Halamka joins Tim Suther to discuss gaps that exist between what we know about SDoH and individual-level data in healthcare, and how organizations are incorporating individual-level data to drive better care outcomes.
Today’s panel: Dr. John Halamka, president, Mayo Clinic Platform; and Tim Suther, senior vice president, data solutions at Change Healthcare.
Here’s what they chatted about:
* Why is the real-world healthcare experience still decidedly mixed despite knowledge that social determinates affect up to 80% of health outcomes?
* Lessons from the front lines of healthcare, including what works and what doesn’t.
* How we end up with incorrect or ineffective healthcare data, and the need for alternate sources of data.
* Incorporating social determinants into predictive algorithms, and where these algorithms are most likely to fail.
* Why “innovation without risk” is an unrealistic goal, and how organizations can approach innovation instead.
Why healthcare organizations need to make data security a priority, along with an approach Mayo Clinic uses to protect patient data.
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Nov 18, 2021
What Can Research Tell Us About COVID-19 Breakthroughs?
In today’s episode, Tim Suther is joined by Dr. Mark Cullen, who’s been at the forefront of population health for decades—even before it was a recognized field. Listen in as Tim and Dr. Cullen discuss the collaborative effort that has gone into the COVID-19 Research Database, and what the resulting research and analysis can tell us about vaccine effectiveness, breakthrough infections, social determinants of health (SDoH), and booster vaccines.
Today’s panel includes: Dr. Mark Cullen, consultant in population health and the Founding Director of the Stanford Center for Population Health Sciences; and Tim Suther, senior vice president, data solutions at Change Healthcare.
Here’s what they chatted about:
* What data can tell us about COVID-19 vaccine effectiveness and breakthroughs, and what it can’t.
* What’s behind vaccine hesitancy and where we go from here.
* How social determinants of health (SDoH) and pre-existing conditions have affected infection and mortality rates.
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Oct 17, 2021
Infrastructure, Budgets, and other Critical Public Health Policy Issues in the Balance
The US Government is poised to make groundbreaking federal and state policy decisions. Special guest Matt Salo, executive director of the National Association of Medical Directors, joins us to discuss the latest congressional action on the infrastructure package, challenges of current budget reconciliations, and Medicaid expansion consideration. We also explore critical state health and health tech topics including the growing data privacy and security policy efforts, state public option models, COVID vaccine hesitancy, how Medicaid programs have addressed public health needs, and what’s next for telehealth policy in states.
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Sep 27, 2021
Value-Based Care Innovation — Payers, Providers and Tech Collaborate to Drive Outcomes Pt.2
Analytics are key to success in value-based care. That’s because analytics deliver data-driven insight into exactly what it takes to achieve desired patient outcomes for any given episode of care. With that insight, payers and providers can collaborate to move more smoothly from fee-for-service to fee-for-value, to create logically bundled payment programs, and to produce insight-driven results. So learning more about VBC analytics will help you reap more of VBC’s potential benefits.
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Sep 24, 2021
Value-Based Care Innovation — Payers, Providers and Tech Collaborate to Drive Outcomes Pt.1
Analytics are key to success in value-based care. That’s because analytics deliver data-driven insight into exactly what it takes to achieve desired patient outcomes for any given episode of care. With that insight, payers and providers can collaborate to move more smoothly from fee-for-service to fee-for-value, to create logically bundled payment programs, and to produce insight-driven results. So learning more about VBC analytics will help you reap more of VBC’s potential benefits.
Presenters:
Summerpal Kahlon, MD, VP Value-Based Payment at Change Healthcare
Kyle Kroening, Product Manager, NetworX Product Suite at Cognizant
Jennifer Mann, Senior Manager, NetworX Product Management Team at Cognizant
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Aug 10, 2021
Cost Transparency: Driving Better, More Informed Care Decisions
Would you order something online but not expect to know the cost until after the item is delivered? The answer is probably, no! For years, healthcare costs have been a mystery, not revealed until after services were completed. Now, with the shift to cost transparency in healthcare, consumers are acquiring the tools to get advanced pricing on healthcare services. Two important federal regulations are helping to drive this new normal.
In this episode, host Ed Domansky talks with Mike Peresie about the opportunities and challenges payers face in implementing price transparency in healthcare. Mike is the senior vice president and general manager of the Medical Network business at Change Healthcare.
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Jun 17, 2021
Delivering a Retail-Style Experience Through Healthcare’s Digital Front Door
Consumers expect digital access to providers to be on par with their online retail experiences. After all, they're footing the bill for healthcare under their high-deductible health plans. And o providers today need a “digital front door” that attracts and retains patients, and ultimately drives revenue. Today’s show brings together healthcare leaders from Adobe, Microsoft, and Change Healthcare to discuss this new normal, and what providers need to know to be successful with a digital-front-door strategy.
Today's panel features Ivy Portwood, principal marketing manager at Adobe; Tracy Picon, senior director with Microsoft’s U.S. Health and Life Sciences group; Tom Swanson, heads of Adobe’s Health and Life Sciences strategy and marketing; and Patrick Leonpacher, business development and operations executive with Change Healthcare.
Here's what they discussed:
* Why digital front door matters
* Patient self-help capabilities
* Components of a digital front door
* How…
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Jun 16, 2021
Squeezing Paper Costs Out of the Healthcare Ecosystem
Paper checks comprise about one-third of all payments from health plans to providers. They’re accompanied by printed remittance information, which adds to the costs of printing, mailing and depositing checks. How can healthcare convert more payments from paper to electronic formats? In part one of a two-part series, host Brian Andrews, along with colleagues Dan Pay and Mark Zurline, discuss new technology that simplifies payment processing and posting.
Brian Andrews is Change Healthcare’s senior vice president of provider network development. He joins Dan Pay, vice president of strategy and management operations; and Mark Zurline, senior director of payments product management, in this compelling discussion about the latest advances in payment processing.
They discuss:
* The financial scale of healthcare’s paper-check problem
* Why paper checks persist in healthcare
* Takeaways from converting paper claims to electronic
* Inside the National Payments Connector (NPX)…
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Jun 8, 2021
Health IT Innovation Targets HIPAA’s Complexity
HIPAA sets a floor rather than a ceiling for how patient privacy works state by state. Human factors also add complexity to policy under the law in areas such as clinical trials and substance abuse treatment. Today's guest David Finney is joined by Deanne Kasim and Arien Malec to explore how efficient exchange of personal data, proven in existing technology and innovative networks, offers the promise of information sharing at reduced cost.
David Finney is co-founder and partner of Leap Orbit. Deanne Kasim is executive director of health policy at Change Healthcare. Arien Malec is senior vice president of product development at Change Healthcare.
Here's what they discussed.
* Forms of data use authorized by HIPAA
* HIPAA’s patchwork of privacy protections
* Patient authorization’s role in HIPAA
* Information that requires patient authorization
* HIPAA’s de-identified data standard
* Technology for documenting patient privacy directives
* A complicating factor in a…
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Jun 4, 2021
Vaccine Credentialing and the Healthcare Experience
Today 37% of the U.S. is vaccinated. But how do you verify that? What vaccine was given? How do you schedule follow ups? What about vaccinations for other diseases? Vaccine credentialing is one answer, but healthcare credentials issued by different organizations need to be consistent, interoperable, private, and secure. On today’s show, Ramesh Raskar, PhD, and Kris Joshi look at the present and future of healthcare credentialing, the challenges, and the opportunities for population health.
Today’s panel features Ramesh Raskar, PhD, founder of the PathCheck Foundation; and Kris Joshi, executive vice president and president of Network Solutions at Change Healthcare.
Here's what they discussed.
* U.S. vaccine hesitancy compared to other countries
* Issuing and using vaccine credentials
* Integrating credentialing into the public health infrastructure
* Preparing for outbreaks and booster-shot programs
* Considerations for interoperability and the consumer experience
* L…
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May 27, 2021
Getting Health Policy Legislation Over the Finish Line
Can states build models of health policy innovation supported by federal investment? Early efforts are under way to bring health plans, providers, and regulators together, with an emphasis on innovation. State of Reform’s DJ Wilson joins Deanne Kasim and panelists Angela Evatt, Steve Brennan, and Matt Keppler to discuss the components driving this approach among emerging federal and state legislation.
Today’s special guest is DJ Wilson, founder and CEO of State of Reform. DJ joins Change Healthcare’s Deanne Kasim, executive director of health policy; Angela Evatt, director of state health policy; Steve Brennan, Wester Region senior manager of state health policy; and Matt Keppler, Central Region senior manager of state health policy.
They discussed:
* Policy takeaways from Biden administration’s first 100 days
* Public health investment opportunities in upcoming infrastructure legislation
* The post-pandemic outlook for value-based care
* Where states are working wit…
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Apr 12, 2021
The Evolution of Clinical Interoperability
After years of slow to no progress, clinical interoperability is being propelled forward by consumer and competitive market pressures, and an array of federal mandates. On today’s show, host Charles Pelton talks with Genevieve Morris about the evolution of clinical interoperability, where it started, where we are today, and where the industry is headed.
Genevieve Morris is Sr. Director of Clinical Interoperability Strategy at Change Healthcare. She previously worked as a healthcare IT and policy consultant and advisor, and worked on the development of regulations at the U.S. Office of the National Coordinator for Health Information Technology. Charles Pelton is an independent industry analyst and event host.
They review:
* The impact of “information blocking” rules
* Policy or technical challenges: which is the inhibitor?
* Standardizing core healthcare data
* What data remains to be standardized
* How the federal standards-setting process works
* When real-time he…
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Apr 8, 2021
The Capitol Connection: The National Interoperability Policy Agenda
An ONC brief finds healthcare made significant progress on data sharing. But that connectivity is largely between EHRs. Today’s panel draws a distinction between simple EHR data sharing and truly interoperable healthcare services that are usable and extensible via FHIR across myriad vendor, payer, and provider solutions. Lisa Bari, interim CEO at the Strategic Health Information Exchange Collaborative, joins our Change Healthcare panel to look at progress across the national interoperability policy agenda.
Our panel: Lisa Bari, interim chief executive officer at the Strategic Health Information Exchange Collaborative and Change Healthcare executives Deanne Kasim, executive director of Healthcare Policy; Arien Malec, senior vice president of Product Development; and Genevieve Morris, senior director of Clinical Interoperability Strategy.
They talk about:
* The latest on interoperable health data and health information exchanges (HEI)
* Use cases for public health data and acces…
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Apr 6, 2021
Taking Clinical Decision Support Beyond PAMA’s Mandate
The Protecting Access to Medicare Act (PAMA) ties imaging reimbursement to using clinical decision support (CDS) to help ensure medical necessity. But why stop there? On today’s show, Dr. Ryan Lee with the Einstein Healthcare Network in Philadelphia shares how Einstein has gone beyond compliance to embrace a broad and collaborative use of CDS.
Dr. Ryan Lee is an associate professor of radiology at Thomas Jefferson University and leads radiology, quality, and safety programs at the Einstein Healthcare Network in Philadelphia. Greg Mogel is the chief medical officer for CareSelect at Change Healthcare.
They discuss:
* CDS's impact on compliance, cost, and quality
* Substituting medical evidence for anecdotal judgment
* Going beyond radiology
* Lessons learned about the keys to CDS success
* Determining the best study, the wrong study, or no study
* Streamlining preauthorization for commercial insurers and Medicare
* Applying CDS to pediatric cases
* Reducing unnecess…
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Feb 22, 2021
The Capitol Connection: Healthcare Policy Shifts
Today Jen Covich Bordenick, CEO of the eHealth Initiative, helps us assess the Biden administration’s ambitious 100-day agenda for combating COVID-19. She joins Change Healthcare’s Deanne Kasim, Angela Evatt, and Steve Brennan to discuss how COVID-19 is now central to everything happening with healthcare policy legislation and executive orders at the federal and state government levels.
Our panel: Deanne Kasim is executive director of Healthcare Policy, and Angela Evatt and Steve Brennan are senior managers of State Health Policy at Change Healthcare. They’re joined by Jen Covich Bordenick, the CEO of the eHealth Initiative.
Topics discussed on today’s show:
* Progress on vaccine distribution and related public health issues
* Vaccination appointments and the healthcare digital divide
* Legislation to address disparities in access to care
* Momentum for permanent waivers expanding telehealth access and payment
* The potential for “asynchronous” remote care cove…
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Feb 16, 2021
How to Emerge From the Pandemic Stronger Than Before
Just 14% of organizations emerge from an economic downturn in better shape than they were before the slump, according to a recent study by the Harvard Business Review. But the study also found that companies that adopted a “progressive focus” will outperform rivals during and after a downturn.
On today’s podcast, Kevin Brooks and Jeanette Flom consider the role of digital transformation as a strategy to help organizations emerge from the downturn stronger and better prepared for the future of healthcare.
Today's panel: Kevin Brooks is senior vice president of marketing at Change Healthcare. Jeanette Flom is senior vice president of client engagement at AVIA.
Kevin and Jeanette cover:
* Digital transformation and the COVID-19 pandemic
* Unlocking digital strength in an economic downturn
* Three strategic pillars to improving digital patient experiences
* Increasing back-office efficiency with digital innovation
* The differences between digital projects and a digital…
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Jan 25, 2021
The Policy Connection: Healthcare Policy and the Road Ahead for States
While a new administration addresses federal policy for the pandemic, vaccines, and more, the policy implementation remains largely with the states. Today’s guest is Hemi Tewarson, visiting fellow leading state health policy research at the Margolis Center for Health Policy at Duke University and former director of the National Governors Association Center for Best Practices Health Division. She discusses what changes to expect for healthcare policy, and how the states and industry can prepare.
Today’s panel features Deanne Kasim, executive director of Healthcare Policy at Change Healthcare; Arien Malec, SVP of Research and Development at Change Healthcare; and Hemi Tewarson, senior policy fellow at the Margolis Center for Health Policy at Duke University.
Here's what they discussed.
* The policy burden on states and how the federal government can help
* Policy issues put on hold during the pandemic that remain to be addressed
* The collision between surging demands and de…
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Dec 21, 2020
The Capitol Connection: A Post-Election Discussion with Gov. Howard Dean
With the 2020 election in the rear-view mirror, what’s next for healthcare policy? Divided government at the federal and many state levels, and ballooning deficits, complicate the pandemic response even as a national vaccination program rolls out. Deanne Kasim invited Gov. Howard Dean, MD, former chairman of the Democratic National Committee, to join her in a panel discussion and share his views on what might come next for health policy.
Disclaimer: The views and opinions expressed by Governor Dean in this podcast are those of his own and do not purport to reflect the opinions, views, or official policies or positions of Dentons or Change Healthcare.
Today’s panel features Deanne Kasim, executive director, Health Policy; Angela Evatt, senior manager, Health Policy; and Steve Brennan, Senior Manager State Health Policy, for Change Healthcare. They were joined by Gov. Howard Dean, Senior Advisor, Public Policy, to the global law firm Dentons.
Here's what they talked about:
* El…
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Dec 18, 2020
Making Member Communications Meet Today’s Consumer Expectations
The way health plans communicate with members today is strikingly similar to how they communicated 10, 20, even 30 years ago: mostly on paper via U.S. mail. Why are member communications largely stuck in the past while most other industries have aggressively shifted to digital engagement? A recent Harris Poll study of healthcare consumers found 71% of consumers now want their health plan to connect with them digitally, and that number will only grow as a result of the pandemic.
On today’s show, Phillip Cardona and Sally Love Connally discuss what payers need to do to bring member communications into the digital age, while meeting regulatory compliance and other business challenges unique to healthcare.
Phillip Cardona is strategy executive on the Payer Growth Program team at Change Healthcare. Sally Love Connally is senior vice president and general manager of Member Communications at Change Healthcare.
Here’s what they chatted about:
* How health plans are falling short of r…
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Dec 17, 2020
Getting Healthcare Claims Paid Right, With Less Waste
A source of inefficiency in U.S. healthcare is the process for detecting and correcting inaccurate insurance claims payments. Traditional approaches, based on claims auditing, use a “pay and chase” process to recover improper payments. On today’s program, Change Healthcare’s Phillip Cardona and Mike Spellman discuss alternatives to pay-and-chase, including an innovative approach that helps payers and providers work together to catch errors early, reduce administrative overhead, and improve payment accuracy.
Phillip Cardona is strategy executive for Change Healthcare’s Payer Growth Program. Mike Spellman is a senior director for Payment Accuracy Solutions at Change Healthcare.
Phil and Mike discuss:
* Contrasting traditional payment integrity and proactive payment accuracy programs
* How primary and pre-submission claims editing work with retrospective payment integrity reviews
* Efficiencies gained from identifying claims coding and payment errors earlier
* Why pro…
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Dec 17, 2020
Trends in Electronic Payments and the Impact on Provider Revenue
Research indicates the more methods a provider offers patients for remittance, the more likely the provider will be paid quickly. Why, then, have providers proven reluctant to embrace one of the newest and innovative methods of payment: virtual cards? On today’s show, Phillip Cardona and Bill Barbato reveal what virtual cards are, how they help providers get immediate payment of approved claims, why providers have been reluctant to embrace them, and why that reluctance might be fading.
Phillip Cardona is strategy executive for the Payer Growth Program at Change Healthcare. Bill Barbato is general manager and vice president of Payment Solutions at Change Healthcare.
Here's what they dug into:
* Payment options defined, pros and cons
* The link between payment options and bad debt
* How electronic payment speeds payer reimbursement
* Virtual cards defined
* How virtual cards work
* Where virtual cards fit in the array of provider payment options
* Why virtual cards hav…
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Dec 14, 2020
Bridging the Consumer Experience Divide
A special edition of the Change Healthcare Podcast
Today we're bringing you a live forum with the CEOs of HFMA, the Healthcare Financial Management Association, and AHIP, America's Health Insurance Plans.
Today's live forum is about Bridging the Consumer Experience Divide, where Matt Eyles, the CEO of AHIP, and Joe Fifer, the CEO of HFMA, join Change Healthcare’s Bill Krause to discuss how "consumer-first collaboration" can benefit all healthcare stakeholders.
People often focus on the competing business interests of health insurers and providers, but both are striving to achieve the same goals: to make healthcare accessible, affordable, and high quality. And today, payers and providers increasingly agree that these goals can't be achieved without it making it easier for consumers to digitally engage with the healthcare system and gain a more informed and active role in their healthcare decisions.
We brought these industry leaders together for a live forum to discuss how health i…
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Dec 7, 2020
AI Poised to Transform Payer-Provider Relationships
Digital technology is making claims processing more efficient and cost effective—and that is changing how payers and providers collaborate, as well as their relationships. Today Phillip Cardona and Mike Peresie discuss how payers and providers are starting to use AI to analyze electronic medical record (EMR) data, increase claims processing automation, and streamline workflows, all with the potential to fundamentally transform the payer-provider relationship. They also cover the latest AI capabilities, what’s coming next, and how to prepare for the fundamental business shifts that AI can spark.
Phillip Cardona is strategy executive for Change Healthcare’s Payer Growth Program. Mike Peresie is senior vice president and GM of Medical Network at Change Healthcare.
Phil and Mike discuss:
* How AI's impact on claims processing can change payer-provider relationships
* Using AI to analyze EMR data to find revenue opportunities and cost savings
* “Intelligent transactions”…
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Nov 30, 2020
It’s Time to Rethink Coordination of Benefits
Up to 1 in 5 insured are covered by more than one healthcare plan. It’s no secret that one plan will often pay more claims than it’s obligated to while another never gets the bill. Health plans typically solve for this problem through provider audits and other post-payment activities, when better coordination of benefits (COB) up-front can prevent the improper payment altogether. But what does “better coordination” mean? Today Phillip Cardona and David Bachert reveal the secrets and impact of better COB.
Phillip Cardona is strategy executive for Change Healthcare’s Payer Growth Program. David Bachert is director of Payment Accuracy for Change Healthcare.
Here's what they covered:
* Why health plans pay should direct their attention to COB
* How coordination of benefits (COB) differ from third-party liability (TPL)
* Nuances of COB by state and plan type
* How plans can monitor for other primary coverage
* The trouble with “pay and chase” and payment recovery…
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Nov 23, 2020
Strategies to Defend Against Ransomware Attacks
Ransomware attacks against hospitals are proliferating, in part because the attackers understand the consequences of compromising healthcare finances, patient privacy, and patient safety. With well over 60 known ransomware attacks against hospitals and health systems this year, healthcare leaders need to be thinking about what they can do to protect themselves better. On today’s show, Bob Hoover speaks with John Zuziak about the latest healthcare IT strategies that can help mitigate ransomware attack risk.
Today’s show panel features Bob Hoover, VP of Change Healthcare Consulting, and John Zuziak, practice director, IT Risk Management at Change Healthcare.
Here’s what they discussed:
* Why ransomware attacks targeting hospitals are increasing
* Reasons why hospitals are vulnerable to attack
* Hospitals and health systems that were attacked this year
* How ransomware compares with other cybersecurity threats
* How risk assessment differs for hospitals vs. other busine…
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Nov 16, 2020
Digital Transformation of Healthcare in a COVID-19 World
Healthcare's digital experience has lagged other industries. Then came the pandemic. Overnight, digital engagement became a safer way for consumers to find, access, and pay for medical care. Today’s panel looks at how better access to telehealth, and other recent advancements, convinced stakeholders how effective virtual healthcare delivery can be, and how that experience might foreshadow permanent market changes.
Today's panel features Change Healthcare's Natalie Lawrence, director of Business Development, and Zayan Khadri, product manager on the Digital Consumer Experience team.
Here are the issues they discussed:
* How the COVID-19 crisis pushed healthcare organizations to prioritize digital transformation
* The role of telehealth in the future of healthcare
* Why “touchless” experiences for processes such as patient check-in are now crucial
* Whether pandemic-induced virtual healthcare delivery will become permanent
* How healthcare organizations can make routine…
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Nov 9, 2020
CommonWell’s Paul Wilder on Interoperability, Healthcare Policy, and the Pandemic
Healthcare interoperability gained increased urgency as a result of the pandemic. The need for public health measures, such as virtual care and contact tracing, showcased progress but also revealed gaps that must be closed. On today’s show, Arien Malec and Deanne Kasim speak with Paul Wilder, executive director of CommonWell Health Alliance, about how interoperability can drive innovation to close these gaps, mitigate compliance risks, and improve capabilities for stakeholders and the consumer experience.
Today's panel: Change Healthcare’s Arien Malec, SVP of R&D; Deanne Kasim, executive director, Health Policy; and Paul L. Wilder, executive director of CommonWell Health Alliance.
Here's what they explored:
* The nationwide imperative for universal access to health data for patients, providers, and payers
* Data interoperability and access gaps that emerged during the pandemic
* How CommonWell's partnership with Carequality facilitates health data interoperability and port…
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Nov 2, 2020
Rebuilding Consumer Confidence, with special guest David Betts of Deloitte Consulting
Consumer expectations for a seamless digital health experience, coupled with healthcare's response to the COVID-19 pandemic, are accelerating the pace of the industry's digital transformation. On today's show, experts from Change Healthcare and Deloitte Consulting review the results of Deloitte research on COVID-19's impact on the healthcare consumer, along with Harris Poll research that reveals what today's consumer wants in a digital healthcare experience.
On today's show, Rick Preston moderates a discussion with panelists David Betts, principal for Life Sciences and Healthcare at Deloitte Consulting, and Bill Krause, vice president and general manager of Digital and Consumer Experience for Change Healthcare.
This show was produced as part of the Change Healthcare/Deloitte webinar series, The New Healthcare Essentials: Consumer Engagement, Interoperability, Virtual Care, and the Remote Workforce, which explores the four factors every healthcare organization must address to sustain…
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Oct 26, 2020
The Capitol Connection: 2020 Year-End Outlook
The election, the COVID-19 crisis, and a Supreme Court case challenging the Affordable Care Act have healthcare leaders on alert. What comes next? On today’s show, Change Healthcare’s Deanne Kasim and Angela Evatt take a look at the current policy landscape through the end of the year, and catch us up on what’s pending in Congress, with Washington regulators, and in the states; and how some of these issues might play out.
Today’s panel features Deanne Kasim, executive director, Health Policy, and Angela Evatt, senior manager, Health Policy, for Change Healthcare.
They run down:
* The stalled rescue package—and whether there will there be action in the lame duck session
* Legislation to enable greater flexibility for data exchange
* Whether temporary waivers allowing expanded use of telehealth will become permanent
* New regulations pending with OMB
* Status of the final CMS Price Transparency Rule for Payers
* Medicare Advantage developments and the possibility…
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Oct 19, 2020
The Outlook on Electronic Prior Authorization, with special guest April Todd of CAQH
It’s no secret that achieving fully electronic prior authorization is a challenge, but the potential upside is tremendous—to the tune of $454 million in savings, according to the 2019 CAQH Index Report. On today’s show, Andrew Johnson meets with our special guest from CAQH, April Todd, to shed light on areas around prior authorization that remain the most challenging, the benefits of transitioning to an automated workflow, and efforts underway to speed adoption of electronic prior auth.
Today’s panelists are Andrew Johnson, vice president of Electronic Prior Authorization Solutions for Change Healthcare, and April Todd, senior vice president for the CAQH, a non-profit alliance creating shared initiatives to streamline the business of healthcare.
They unpack:
* The purpose and role of the CAQH CORE (Committee on Operating Rules for Information Exchange)
* Why prior authorization is a challenge for payers and providers
* Update on alignment between industry standards bod…
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Oct 12, 2020
Bringing Clinical Decision Support to Imaging to Assure PAMA Compliance
The Protecting Access to Medicare Act (PAMA) requires providers to consult a clinical decision support mechanism when ordering advanced imaging tests. While the CMS has extended the PAMA compliance deadline to Jan. 1, 2022, some providers–such as St. Charles Health System–are wasting no time to ensure compliance. Samantha Waldrop and Elizabeth Zobel join Nick Geyer to share how St. Charles implemented imaging clinical decision support (CDS), including their goals, challenges encountered, their approach, and the results.
Nick Geyer, product marketing manager at Change Healthcare, leads a discussion with Samantha Waldrop, applications analyst at St. Charles Health System, and Elizabeth Zobel, senior customer success strategist at Change Healthcare.
Here what they talked about:
* Overview of PAMA
* Requirements around imaging Clinical Decision Support (CDS)
* Impact of PAMA on St. Charles
* How St. Charles evaluated imaging CDS options
* Why St. Charles decided to work wi…
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Oct 5, 2020
Transitioning Enterprise Imaging to the Cloud, with special guest Ken Buechele, vice president of Information Technology at Bronson Healthcare Group
Bronson Healthcare Group is about 18 months along in its transition of enterprise imaging to the cloud. With nearly two years of experience under its belt, Bronson’s Ken Buechele now has much to review and share with other healthcare IT leaders. Today Ken circles up with Tomer Levy to share Bronson’s cloud transition story, including why Bronson is making the shift, challenges and successes experienced along the way, where Bronson is taking its cloud journey next, and Ken’s strategic advice for IT leaders who are evaluating a transition.
Today’s episode features Tomer Levy, vice president of Global R&D and Enterprise Imaging for Change Healthcare, and Ken Buechele, vice president of Information Technology for Bronson Healthcare Group.
Topics they cover include:
* Where enterprise imaging sits within Bronson’s IT and patient engagement strategies
* Why Bronson is transitioning enterprise imaging to the cloud
* The current stage of Bronson’s transition
* Short- and…
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Sep 14, 2020
The Path to Prioritizing Cybersecurity in Healthcare
Technology is only half the battle when it comes to cybersecurity measures for healthcare organizations. The remainder is awareness. Phil Alexander joins John Zuziak on today’s show to dig into common gaps in security awareness and their implications. Phil and John examine the elements of a successful security awareness program, including how to gain buy-in; setting goals; identifying wins; communicating progress and successes; and ultimately making security awareness a part of the organization’s culture.
This conversation features John Zuziak, director of the Security and IT Risk Management Practice for Change Healthcare, and Phil Alexander, CISO for North Mississippi Health Services.
Here’s what they report on:
* The need to emphasize security awareness in healthcare
* Tailoring security awareness training by job function
* Topics to include in security awareness training
* Gamifying security awareness
* Making security awareness training work on a lean budget
*…
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Sep 7, 2020
Electronic Data Interchange in the Era of COVID-19
EDI turns 55 this year. Unlike other information technologies from 1965, EDI continues to play a crucial role in healthcare. Few can speak to EDI’s history, continual evolution, and contemporary relevance like Sheryl Miller, executive vice president for Advanced Data Systems. On today’s show, Sheryl shares the surprising role of EDI as a backbone for the COVID-19 telemedicine surge, how her company uses EDI, why EDI’s use cases are growing, and more.
Today’s show is hosted by Serrah Linares, vice president of Partner Sales for Change Healthcare, and features Sheryl Miller, executive vice president for Advanced Data Systems.
Topics they cover:
* A brief history of EDI
* How EDI revolutionized healthcare IT, and why it continues to drive innovation
* Why EDI’s use cases evolved as a result of the pandemic
* EDI as a backbone for the COVID-19 telemedicine surge
* How COVID-19 is impacting healthcare revenue cycle management
* How ADS is using EDI to help providers…
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Aug 31, 2020
The Policy Connection: Tracking Pandemic Recovery by State, with special guests from the National Conference of State Legislators
Victories and challenges abound across U.S. states in their efforts to overcome the pandemic. We invited two special guests from the National Conference of State Legislators to provide a deep dive into the current and emerging state policy trends around Medicare, Medicaid, and telehealth. Haley Nicholson and Emily Blanford field key questions from Deanne Kasim and Arien Malec on the latest state actions, where legislative friction remains, and what’s next in state policy decision making.
Insights on this episode come from Deanne Kasim, executive director of Health Policy for Change Healthcare; Arien Malec, SVP of Research & Development for Change Healthcare; Haley Nicholson, senior policy director of Health & Human Services for the National Conference of State Legislators; and Emily Blanford, program principal for the National Conference of State Legislators.
Their deep dive covers:
* How states are preparing for the increase in demand for Medicare and Medicaid services
* Fore…
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Aug 24, 2020
Value-Based Care Transformation in the Midst of a Pandemic, with special guest John Wendling, CEO, Parkland Community Health Plan
Parkland Community Health Plan’s 2020 priority: transition to value-based healthcare. But a pandemic wasn’t in the plan. On today’s show, Bob Hoover talks with Parkland’s CEO John Wendling and consultant Joe McIntire to learn how, despite one of the most disruptive healthcare events in history, Parkland has been able to stay on track and meet its strategic goals. Their conversation reveals keys to collaboration and communication that enable the team to avoid delays, overcome complexities, and remain agile.
This episode features Bob Hoover, vice president of Change Healthcare consulting; John Wendling, CEO of Parkland Community Health Plan; and Joe McIntire, senior manager for Change Healthcare consulting.
Here's what they covered:
* Parkland’s goals to support patients
* Why Parkland is prioritizing these goals
* How COVID-19 influenced Parkland’s value-based care strategy
* Factors that drove Parkland to insource certain functions and change its business process…
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Aug 17, 2020
Insights from the Harris Poll 2020 Consumer Healthcare Experience Research
Finding, accessing, and paying for healthcare requires so much work that half of consumers have avoided seeking care, according to the 2020 Change Healthcare - Harris Poll Consumer Experience Index, a national study of 1,945 consumers. These findings and more—many of which should cause serious concern for healthcare stakeholders—are covered on today’s show, with special guest Tom Swanson from Adobe. Also covered: what stakeholders can do to meet consumers’ expectations and gain a competitive edge.
Swanson joins show host Bill Krause to review the research, discuss what consumers say are the challenges to finding, obtaining, and paying for care, and unpack fresh digital strategies that can help providers give their patients exceptional experiences.
Bill Krause is VP and GM of Connected Consumer Health for Change Healthcare. Tom Swanson is head of Industry Strategy and Marketing for Health and Life Sciences at Adobe.
Here are the topics they tackled:
* Key findings from the…
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Aug 10, 2020
What’s Next for Telehealth, with special guest Ann Mond Johnson, CEO of the American Telemedicine Association
No event in recent history demands telehealth like the coronavirus pandemic. Today’s episode features one of the country’s leading telehealth experts, Ann Mond Johnson, CEO of the American Telemedicine Association (ATA). G. Shah and Carolyn Wukitch join Ann for a lively discussion on one of the hottest topics in healthcare IT today: telehealth—including its evolving definition, applications, innovations, potential obstacles and public policies—and what it all means for payers, providers, and policymakers.
G Shah, VP of Healthcare Platform and Marketplace for Change Healthcare leads the conversation with Ann Mond Johnson, CEO for the American Telemedicine Association; and Carolyn Wukitch, SVP of Network and Financial Management Solutions for Change Healthcare.
They cover:
* How COVID-19 is changing the definition of telehealth
* Whether the new face of telehealth is here to stay
* Tips for providers and payers when adopting telehealth services
* Ways to scale teleheal…
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Aug 3, 2020
The Policy Connection: Return to the Workplace, with Special Guest Dr. David Shulkin, 9th Secretary of the Department of Veterans Affairs
It’s evident to Dr. David Shulkin that the path to safely reopening businesses is not exclusively guided by local, state, and national government. Employers, together with government and health systems, play pivotal roles. On today’s show, Deanne Kasim joins Arien Malec to lead a compelling discussion with Dr. Shulkin, the 9th Secretary of the Department of Veterans Affairs. Dr. Shulkin draws on his deep experience in the public and private sectors to provide advice for employers working on their reopening plans.
Today’s episode features Deanne Kasim, Executive Director of Health Policy for Change Healthcare; Dr. David Shulkin, the Ninth Secretary of the US Department of Veterans Affairs, and Arien Malec, SVP of Research & Development for Change Healthcare.
They dissect:
* Lessons the U.S. has learned about managing COVID-19
* Challenges health systems must still address
* How employers can work with government and public health authorities to reopen businesses safely…
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Jul 6, 2020
How a Newly Minted CISO Approaches COVID-19 Security Risks
Responding to security and privacy challenges in the age of COVID-19 is a tall order—and it’s even more complicated if you’re just starting a new role as a chief information security officer (CISO). Meet Steven Ramirez, who became Chief Information Security Officer for University of Louisville Health in January. He met with John Zuziak to share his story of a COVID-era indoctrination by fire, discuss the changing risk management landscape, and reflect on cybersecurity issues facing every healthcare CISO.
Today's panelists are John Zuziak, Cyber Security Practice Director for Change Healthcare Consulting; and Steve Ramirez, CISO for University of Louisville Health.
They discuss:
* The career track that led to a CISO role
* Balancing regulation, cyber threats, and patient safety
* How COVID-19 changed Steve’s 90-day plan
* Ways to use resources, including existing security assessments, to define initial goals
* The pandemic's impact on the University of Louisville He…
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Jun 15, 2020
Ten Security Control Objectives for Every Healthcare IT Contract, with Randall Frietzsche, CISO of Denver Health
Cybersecurity is only as strong as the security of an organization's vendors. Randall Frietzsche, chief information security officer (CISO) of Denver Health, a level one trauma center in Denver, has his organization's information security assessments down to a science. On today’s show, Randall joins Change Healthcare’s John Zuziak to share how Denver Health conducts security assessments, and how Randall's team assesses new vendors and monitors for vulnerabilities.
Today's panel: John Zuziak, Change Healthcare's Security and IT Risk Management Practice director; and Randall “Fritz” Frietzsche, MS, CISSP, CHPC, C|EH, C|HFI, ISSA distinguished fellow, and enterprise chief information security officer (CISO) at Denver Health, Denver, Colo.
Here’s what they talked about:
* Frameworks for building security programs and assessments
* Assessing security risk with third-party vendors
* Creating a risk management policy
* Conducting risk stratification analysis
* Assigning…
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Jun 12, 2020
The Capitol Connection: A Quarterly Healthcare Policy Update with Special Guest Mary Grealy, President, Healthcare Leadership Council
Welcome to the Capitol Connection, a quarterly update on what's happening on Capitol Hill and in various state legislatures around healthcare policy. Our special guest today is Mary Grealy, President of the Healthcare Leadership Council. The HLC is a coalition of chief executives from all disciplines in U.S. healthcare. It’s the exclusive forum for healthcare leaders to develop policies, plans, and programs to achieve a 21st century system that makes affordable, quality care accessible to all Americans.
Your hosts for today’s show are Deanne Kasim, Executive Director of Health Policy at Change Healthcare, and Angela Evatt, Senior Manager of State Policy Strategy at Change Healthcare.
Here's what the panel included in this quarter’s Capitol Connection:
* Background on the HLC
* The latest information on federal and state policies in response to COVID-19
* The next relief package: thoughts and priorities
* What’s next for Congress this summer
* Will states’ relaxed…
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Jun 8, 2020
ACHE CEO Deborah Bowen and Carrie Owen Plietz, FACHE, Share Healthcare Executives’ Perspectives on the Impact of COVID-19
The American College of Healthcare Executives (ACHE) has been advancing leaders and healthcare management excellence for 85 years. We invited ACHE President and CEO Deborah Bowen, FACHE, and Carrie Owen Plietz, FACHE, ACHE Chairman-Elect, EVP and COO, WellStar Health System, to give us their advice for how leaders can respond effectively to patient, community, and business concerns around the pandemic, from the standpoint of the industry’s preeminent professional society.
Today’s panel:
Host: Navesh Kandiyil, MD, MBA, FACHE, Change Healthcare
Guests: Deborah Bowen, FACHE, CAE, president and CEO of the ACHE; and Carrie Owen Plietz, FACHE, EVP and COO, WellStar Health System, and ACHE Chairman-Elect
Here’s how the conversation went.
* ACHE backgrounder
* Inside the hot spots
* Lessons providers are learning from inside the hot spots
* Inside the cold spots
* What’s working, what’s not
* How ACHE is responding
* The impact on payer-provider collaboration
* S…
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Jun 1, 2020
The Nexus of COVID-19, Telehealth, and High-Quality Care Delivery
The pandemic tipped telehealth from a disruptive technology into the mainstream, according to the AMA. We invited John Jesser, President of Clinical Solutions at Amwell, to tell us what the surge in telehealth looks like from the vantage point of a global telehealth leader; the implications for consumers, providers, payers, and digital health innovators; technical, operational, and regulatory barriers that remain; and what telehealth might look like and how it might change after the pandemic.
Joining Amwell’s Jesser is Jonathan Parks, VP of Business Development at Change Healthcare. Here’s what they discussed.
* Was the telehealth industry prepared for the pandemic?
* Positives, negatives, lessons learned by telehealth providers
* How well are telehealth vendors, health systems, employer groups, and health plans working together?
* A telehealth entry point for hospitals and health systems
* Opportunities to make telehealth a more seamless, omnichannel experience for pat…
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May 26, 2020
HFMA CEO Joe Fifer Shares Provider Perspectives on the Impact of COVID-19
As CEO of the Healthcare Financial Management Association, Joe Fifer sits at the epicenter of COVID-19’s financial impact on providers. Many of the HFMA’s 56,000 members were hit hard by the pandemic, and the HFMA has been working overtime to support them through the crisis. On today’s show, Fifer joins Change Healthcare EVP Thomas Laur for a C-suite discussion on the unprecedented challenges revenue cycle professionals now face, how providers are coping, and what can be done to help foster a faster recovery.
They discussed:
* COVID-19’s one-two punch
* How HFMA members are taking on their top priorities
* A bright spot among the financial damage
* Will telehealth change workflows forever?
* How and when providers can get back to the office
* HFMA’s guidance to members
* HFMA’s financial outlook on U.S. healthcare
* Unemployment’s implications for healthcare
* The rapid increase of self-pay
* What the new normal will look like
* The indelible mark…
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May 18, 2020
AHIP CEO Matt Eyles Shares Payer Perspectives on the Impact of COVID-19
From his vantage point as CEO of America’s Health Insurance Plans (AHIP), Matt Eyles has a unique perspective on myriad challenges payers, their members, and their provider networks face during the COVID-19 pandemic; and what our post-pandemic future might look like. In this episode, Carolyn Wukitch, SVP and GM of Network and Financial Management at Change Healthcare, talks with Eyles about these topics and more, including:
* Challenges health plans face during the pandemic
* Engaging members with underlying health issues
* Acceleration of telehealth––today and tomorrow
* Planning for 2021 amid immense uncertainty
* Supporting providers on the front line
* Helping the newly unemployed
* Removing cost barriers to treatment
* The impact of Medicaid member increase
* COVID-19's impact on provider networks
* COVID-19 testing and reopening the economy
Episode Resources
* Matt Eyles' bio
* Carolyn Wukitch's bio
* AHIP website
* AHIP COVID-19 FAQ
* AHIP…
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May 5, 2020
The Policy Connection: COVID-19 Testing and Surveillance Policy Proposals
Government officials are weighing testing, tracing, and isolating the public while pondering how and when to restart the economy. As a former ONC leader and current HITAC member, Change Healthcare's SVP of product R&D Arien Malec is watching the COVID-19 policy proposals currently in play.
On today's episode, Arien is joined by Deanne Kasim, executive director of Health Policy at Change Healthcare, for a wide-ranging discussion of COVID-19 testing and surveillance policy proposals. Here’s what they hit upon.
* What American healthcare needs to accommodate effective COVID-19 surveillance
* Takeaways from the Duke-Margolis report on a national surveillance system
* Proposals for getting people back to work during COVID-19
* Social distancing and lockdowns while waiting for a vaccine
* Proposed strategies and global practices for controlling the spread of disease while reopening the economy
Episode Resources
* Arien Malec’s bio
* Deanne Kasim’s bio
* A New Strate…
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May 4, 2020
Becker’s Editor-in-Chief Molly Gamble on the New Normal Facing Providers
Few people are better situated to help us understand the tangled web of issues facing providers today than Becker’s Hospital Review Editor-in-Chief Molly Gamble. Beyond the capacity and supply problems triggered by the pandemic, hospitals and health systems are peering over the edge at some very real existential threats.
On this episode, Kelley Blair, senior vice president and GM of Health System Services at Change Healthcare, connected with Gamble to talk about what she has seen, experienced, and reported for Becker's Healthcare readers over the past six weeks. Topics that they hit on:
* Takeaways from conversations with providers in the 10 hardest-hit states
* Novel challenges facing the healthcare system as it moves into recovery
* New ways in which health systems are communicating with patient populations
* How payers can support providers during the pandemic
* Managing solvency in the face of declining patient volumes
* The role of data in helping hospitals assess…
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Apr 20, 2020
Cybersecurity During and After a Pandemic
Healthcare IT teams had to move quickly when social distancing requirements shuttered offices, and large numbers of employees started working from home. Suddenly the question was: How does an organization safely continue operations during a pandemic? What are the new business continuity, cybersecurity, and privacy considerations? What immediate actions should be taken?
On today's show, John Zuziak, Change Healthcare's Security and IT Risk Management Practice Director, talks "cybersecurity in our new world" with Eric Decker, CIO; Peter Jabrucki, CISO; and LeMar Ward, Business Continuity and Disaster Recovery manager, all with Independent Health, a not-for-profit health plan headquartered in Buffalo, New York.
These IT leaders discuss how and why they've been preparing for a crisis such as this one, and what actions they've taken to manage the new requirements and new risks posed by having a substantial workforce rapidly "lift and shift" from on-site to remote teams.
Here's what they…
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Mar 23, 2020
Creating New Healthcare Solutions: Solving the Build vs. Buy Conundrum
Start-ups and mid-sized companies are innovating new IT solutions to solve challenges in the healthcare industry. One of the issues these development teams face is deciding whether to build all functionality in house, or focus on their strengths and integrate best-of-breed functionality where possible–speeding time to market in the process.
In this podcast, Aakarsh Sethi, product manager at INFINX Healthcare, walks us through his company’s thought process as they brought an innovative patient-access solution to fruition, solving their build vs. buy conundrum in the process.
Here’s what Aakarsh discusses with Gautam “G” Shah, vice president of Platform and Marketplace at Change Healthcare, on today's show.
* Questions to ask when developing out a new HIT solution
* Balancing product purpose with end-user needs
* The “build vs. buy” decision
* APIs as building blocks for innovation
* The difference between APIs and APIs with broad connectivity
* Understanding…
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Mar 2, 2020
The 2020 Industry Pulse Report: Key Insights
For the past 10 years, Change Healthcare and the HealthCare Executive Group (HCEG) have commissioned the Industry Pulse Research Report, an annual effort to "take the pulse" of the healthcare industry. The insights gleaned from this year's research reflect responses from 445 payer and provider leaders, 80% of which are director level or above.
To dig into the results, show hosts Rich Levin and Grant Evans met with Ferris Taylor, executive director of the HCEG; market researcher Michael Brousseau, of Insight Dynamo; and David Gallegos, senior vice president of Consulting Services at Change Healthcare. Here's what the panel discussed:
* The history and purpose of the Industry Pulse
* Research methodology and respondent breakdown
* Industry maturity of consumer-centric strategies
* How provider fragmentation and a focus on acute patients limits insight into the full consumer population
* Payers or providers: Who should provide cost/quality data to consumers?
* Building the r…
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Mar 1, 2020
One App to Manage All Your Medical Bills, and the APIs that Power It
Healthcare consumers are frustrated by the mix of medical bills they receive from multiple providers. Rachel Mertensmeyer started RexPay® to help consumers understand, manage, and pay all those medical bills in one place, through a simple smartphone app. But what consumers don't see when they use the app is something working behind the scenes: the Change Healthcare API & Services Connection, which helps power the solution.
On today's show, Serrah Linares, vice president of Partnerships at Change Healthcare, chats with Rachel about why she created the RexPay app, and how it’s helping consumers and providers make short work of managing their medical bills.
Here's what they talked about:
* The 36 medical bills that led to RexPay app
* Why the app is named after Rex the rescue dog
* How providers and consumers use RexPay
* The pressing need for a solution like RexPay
* Awards, accolades, and grants earned by RexPay to date
* How APIs bring RexPay and Change Healthcare tec…
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Dec 21, 2019
Minimizing Out-of-Network Risk
Unchecked out-of-network (OON) charges can result in high surprise bills for patients and high costs for payers. One reason: The cost for out-of-network care is often well above national averages and norms. It's crucial for payers to protect their members from larger deductibles and out-of-pocket limits by minimizing the risk associated with OON care. And in doing so, payers can also improve employer savings, administrative and medical cost savings, and appeals processes.
On today’s show, Mary Canobbio interviews Anna Bash, claims manager at third-party administrator Employee Plans, and discusses how a claims repricing network can help reduce excessive expenses and protect members by discounting OON claims in collaboration with providers.
Here's what they dug into:
* The impact of political instability on the healthcare market
* How a small percentage of OON claims can lead to increased premiums
* Generating savings through OON risk mitigation
* The impact of OON claims on…
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Nov 27, 2019
Benefits of a Comprehensive Out-of-Network Strategy
While many out-of-network (OON) providers charge reasonable prices for their services, insurers must also cope with excessive OON charges, which undermine members’ financial security and fuel rising healthcare costs. What percentage of these claims should be paid, and how can insurers better protect their members from debilitating balances?
On today's show, Marcus James, Senior Vice President of Claims and Membership for Arkansas BlueCross BlueShield, joins Nanci Ziegler, Vice President of Strategic Clients at Change Healthcare, to discuss what goes into developing a successful OON strategy, how a comprehensive approach can benefit members and providers, and why payers should take a hard look at their current OON approach.
Here's what they covered:
* Non-par providers and what defines an out-of-network claim (01:18)
* Two growing problems: surprise balance billing and ER pricing at walk-in clinics (02:23)
* Why balance billing vs. paid-in-full OON claims is a lose/lose propo…
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Nov 25, 2019
Everything You Dare to Ask About Healthcare Interoperability
Healthcare interoperability: Where is the industry at today, where is it going, what's new, what's coming, and most important–what do payers, providers, and vendors need to do in order to participate in healthcare's interoperational future?
These questions and more are fielded on today's show by Jitin Asnaani, former Executive Director of CommonWell Health Alliance; Kashif Rathore, VP of Interoperability at Cerner; and Nicole Antonson, VP of Identity and CommonWell Services at Change Healthcare.
Covered on today's broadcast:
* Why we're all students of interoperability (03:58)
* Meaningful Use Stage Two, the need for an interoperability alliance, and the birth of CommonWell (09:08)
* Promoting the free exchange of information: Why Cerner became a founding member of CommonWell (16:04)
* Interoperability: What's in it for providers? (21:40)
* The greatest barriers to interoperability for providers (26:54)
* How clinical interoperability exchange can help drive better out…
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Nov 21, 2019
Reinventing Healthcare for the Digital Age
Using digital technology to attract, engage, and serve consumers; deliver exceptional experiences; and earn loyalty is old hat for many U.S. industries. Healthcare, however, remains woefully behind the times when it comes to delivering contemporary digital experiences to consumers.
But that’s changing, and fast. On today's show, experts from Adobe, Microsoft, MDSave, and Change Healthcare have a robust discussion about why healthcare lags behind, the impetus to move quickly, the risks of not doing so, what the personalized patient experience looks like, and much more. It's a must-hear for any payer or provider.
Here’s what the panel debated:
* The digital healthcare experience imperative (04:52)
* A new notion: the “Orchestrated Digital Journey” (21:27)
* Price transparency and its connection to patient satisfaction and collections (25:29)
* What a personalized patient experience looks like (31:44)
* How we can help patients improve their experience while lowering…
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Sep 27, 2019
Characteristics of Successful Alternative Payment Models
Value-based care seeks to improve care quality while reducing cost, and does so, in large part, through the use of innovative alternative payment models. But for payers, transitioning from volume-based payment (i.e., fee-for-service) to value-based alternatives is easier said than done.
On today's show, Mark Berg of McKinsey & Company's Healthcare Innovation group join's Change Healthcare's Rob Capobianco to talk about the steps payers need to take to succeed with value-based care and APMs, and the seven characteristics of successful alternative payment models—the topic of a recent McKinsey report.
Here's what they covered:
* What does McKinsey & Company do and who are their clients (03:47)
* The importance of having organizational systems in place to scale value-based models (07:57)
* Value-based payment as a core strategy for medical cost control, and the role of primary care practices (11:16)
* Value-based care pain points and the importance of stakeholder engagement (1…
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Aug 29, 2019
Getting A Second Opinion on Healthcare with Senator William Frist
Senator William Frist, a former U.S. Senate Majority Leader and nationally recognized heart and lung transplant surgeon, has launched a new podcast called A Second Opinion. The podcast's mission: rethinking American healthcare. We invited Sen. Frist to join Deanne Kasim, Senior Director of Federal Health Policy Strategy at Change Healthcare, to discuss healthcare innovation, policy, technology, leadership, medicine and, of course, the Senator's new podcast. Here's what they covered.
* Why use a podcast to tackle America’s healthcare problems? (00:56)
* The intersection of public policy, medicine, healthcare, innovation, and entrepreneurship (03:57)
* Defining social determinants of health: what they are and why they’re important (07:24)
* How the Nashville Health initiative determined the top three health issues for the city and how the community is tackling them (10:16)
* The most comprehensive set of data on social determinants of health in the U.S. (14:58)
* Four pr…
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Jul 30, 2019
Alternative Payment Models and Value-Based Care: There’s a Framework for That
Aparna Higgins' career has been focused on value-based payment. More than ten years ago, while she was at Booz-Allen, she co-led the design of the Medicare Hospital Value-Based Purchasing report to Congress. It was one of the first programs recommended to the CMS that defined how hospitals could be assessed and rewarded for care quality. The report’s recommendations were implemented when the CMS was authorized under the Affordable Care Act to implement the program.
More recently, as an executive at AHIP (America’s Health Insurance Plans), Aparna led organizational efforts on payment and delivery system reform, included examining and identifying industry-wide best practices in the design and implementation of Alternative Payment Models (APMs), and the core quality measures collaborative. She’s spent most of her career thinking about incentives, incentive design, and how to assess and reward performance.
These days Aparna is the founder and CEO of Ananya Health Innovations. She…
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Jun 10, 2019
Inside the Hospital in the Home Trend
"Hospital in the Home" is emerging as a frequently discussed concept in the medical community. Programs that allow patients to receive hospital-level of care in their homes have shown to be safer, less costly, and result in better patient outcomes. As a result, Hospital in the Home programs are gaining traction as an alternative option to acute inpatient stays.
To better understand the opportunities, benefits, and challenges of Hospital in the Home programs, we invited two of the nation's pioneers and leading experts on the matter to join us on the Change Healthcare podcast: Dr. Bruce Leff, Director for The Center of Transformative Geriatric Research at Johns Hopkins University School of Medicine; and Dr. Allyson Kreshak, emergency medicine physician and Assistant Medical Director at UC San Diego Emergency Department.
Both helped innovate and steer Hospital in the Home programs for their respective hospital systems,and are optimistic that in-home hospital care can become the new sta…
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Jun 4, 2019
Effective Strategies to Help Improve Medicaid Member Engagement
Effective Medicaid engagement strategies encourage member populations to take a more active role in their healthcare. Done well, member engagement can help payers improve population health and plan performance. But that's easier said than done. Indeed, member engagement is one of the biggest challenges faced by plans and providers.
While there's no silver bullet to maximizing enrollee engagement, there are several proven strategies and practices that can help address mitigating factors such as social determinants of health, wellness motivators, and ineffective member communications.
We invited Natalee Fowler, a nationally recognized expert on Medicaid member engagement, to share some of her favorite techniques for helping payers better engage members. Natalie covers the common challenges, unpacks the buzzwords, and provides a roadmap for a contemporary communication strategy that can help payers raise the bar for engagement.
On today’s show, we discuss:
* The biggest challenges…
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Feb 6, 2019
Change Healthcare Introduces Payment Blockchain Proof-of-Concept at HIMSS ’19
Blockchain offers significant potential for transforming healthcare processes, but few concepts have moved from just a vision to a stage where true benefits can be realized. That’s about to change. At HIMSS, Change Healthcare will be introducing a new Payments Blockchain proof-of-concept (PoC) which was developed by our provider payments team. The re-engineered payment process is powered by a distributed ledger, and is designed to reduce the disparate entries that exist in today’s disconnected and legacy payment processes. The Payments Blockchain PoC kicks open the door for a streamlined, smart, and secure payment process that payers and providers can only dream about today.
On today’s show, we interview the Change Healthcare and Digital Asset team that’s come together to build this new Payments Blockchain. On the panel: Gopi Devalcheruvu, the vice president of technology for Change Healthcare; Vinod Nair, the director of product management for Change Healthcare; and Dan O’P…
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Feb 5, 2019
"CPR" for Healthcare
It’s no secret that healthcare costs are out of control for consumers. But what can get lost in the shuffle is how these costs affect employers, who want their employees to be covered with better healthcare.
Some could argue that healthcare cost-containment is one of the most important pillars of the healthcare equation, and that employers can be a key factor in bending this cost curve. Yet it’s worth noting that since 2013, premiums for employer-sponsored healthcare coverage for families have escalated more than 22%, to reach almost $20,000 per year on average.
This upward trend has renewed interest from employers in alternative payment models. The nonprofit Catalyst for Payment Reform (CPR), which provides guidance into the efforts of employers to drive increased healthcare value, is helping close that gap. And as some companies now opt to go directly to providers—bypassing health plans and cutting out the middleman—they certainly could benefit from an expert perspective.…
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Dec 11, 2018
Mandatory Bundled Payment Models Are Coming: What You Need to Know
Representatives from CMS just announced a policy shift regarding mandated alternative payment models.
HHS Secretary Alex Azar said the administration would “revisit” mandatory models that it had previously abandoned in cardiac care, noting the time had come for “exploring new and improved episode-based models in other areas, including radiation oncology.”
To understand the impact this policy shift might have on payers and providers, Patrick McGuigan, Producer of Episode Intelligence, connected with Dr. Andrei Gonzales, who leads the product development efforts for Change Healthcare’s value-based payment solutions.
In this interview, they discuss:
* What CMS is introducing and why it’s generating so much news [00:23]
* What this means for commercial health plans [02:40]
* What health plans should be doing now to prepare for this change [04:46]
* How providers are reacting to this news, and how they can prepare for a future that includes mandatory payment models […
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Oct 10, 2018
How Payers and HIT Analytics Can Help Primary Care Physicians Improve Care Quality
Primary care physicians (PCPs) are in the best position to coordinate patient care, because they understand their patients' unique needs. But knowing which specialists can deliver the most effective care when a referral is required can challenge even the most experienced PCP.
That's because PCPs rarely have insight into the costs and quality of care delivered by other providers. Lacking this evidence, they have no alternative but to base referrals on personal experience, professional recommendations, doctor ratings, and patient requests.
This is changing, however, thanks to a new approach called “episode intelligence.” Using HIT analytics, episodes of care are analyzed to identify physicians and facilities that can deliver the most effective care throughout a course of treatment.
One innovative organization using episode intelligence is Tandigm Health, a value-based healthcare company supporting primary care physicians. Heading Tandigm’s effort is Director of Informatics Tony…
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Aug 31, 2018
AHIP CEO Matt Eyles on Value-Based Care and Evolving Healthcare IT
The rise of value-based care and the ongoing evolution of healthcare technology are just two of the many topics the new CEO of America’s Health Insurance Plans (AHIP) says are front and center on his upcoming agenda.
AHIP’s Matt Eyles takes a deep dive on those subjects and more while speaking with Rob Capobianco, the head of the Change Healthcare value-based-care analytics team, as part of the Change Healthcare Episode Intelligence podcast series.
Matt has more than two decades of healthcare experience in both the private sector and in government. Before joining AHIP, he held senior executive positions at Coventry Health Care, Inc., and Wyeth, and has been a consultant to some of the largest global and U.S. healthcare companies and organizations.
Matt began his career at the Congressional Budget Office where he worked on many issues, including healthcare, budget policy, and regulatory policy.
Rob and Matt cover a wide range of topics, including:
* The biggest differences in…
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