199: Why can't providers and plans just get along?

Producers' note: We know a lot of organizations have been and are being affected by the major cyberattack of Change Healthcare systems and resulting outages. We won't be addressing it in this episode, but if you have questions or are looking for more information please go to https://www.unitedhealthgroup.com/changehealthcarecyberresponse.

The relationship between health plans and providers has always included an element of friction, but lately, it seems like the temperature is rising. And you've probably noticed – public contracting disputes increased by 69% between 2022 and 2023.

That's why, in this episode, host Abby Burns invites Advisory Board experts Max Hakanson and Eileen Fennell to discuss why the state of affairs seems to be getting worse, how key flashpoints are fanning the flames, and what each stakeholder says they need to see from their partners in order to mend the relationship. Plus, Advisory Board digital health expert Ty Aderhold makes a cameo appearance to help answer the question: Is AI the solution here?

Links:

• 7 things we want to fix in 2024 (and how to get there)
• A new era of payer-provider relationships
• The new era of provider enablement
• AI in healthcare: Insights from 10 C-suite executives

2024 Raising the Value Bar Summit

A transcript of this episode as well as more information and resources can be found on radioadvisory.advisory.com.

Corporate entities like health plans, retail companies, and PE firms have aggregated large, diverse portfolios of care delivery assets over the past decade – with one notable exception: no one was buying hospitals.

But in January, venture capital firm General Catalyst bucked that trend and announced its intent to acquire Summa Health, a 3-hospital health system in northeastern Ohio. What are they thinking? And what could this mean for the industry?

In this episode, host Rachel (Rae) Woods and co-host Abby Burns invite Advisory Board's health system expert Vidal Seegobin to unpack the details of the story, interpret General Catalyst's ambition, and share what they'll be watching in the coming months.

Links:

• Radio Advisory's financial impact playlist
• Survey insights: 6 priorities for health system strategists in 2024
• Ep. 193: Is health system growth still possible?
• Ep. 123: Is private equity health care's bad guy?

The Hospital Benchmark Generator

Improving detection of ATTR-CM: Insights from experts

A transcript of this episode as well as more information and resources can be found on radioadvisory.advisory.com.

Artificial intelligence has been rocking industries across the world, and healthcare is no exception. But what impact will it have exactly on physicians? Health systems? Data sovereignty?

In this episode, host Rachel (Rae) Woods passes the microphone to Eric Larsen, President Emeritus of Advisory Board and President of TowerBrook Advisors. In this conversation, Eric sits down with Dr. John Halamka, President of the Mayo Clinic Platform, to demystify how the industry should think about generative AI across all of healthcare.

Links:

• Ep. 185: AI adoption: why you can't afford to "wait and see"
• Ep. 180: Tom Lawry on why AI has a PR problem
• Lessons from the C-suite
• AI in healthcare: Insights from 10 C-suite executives

Learn more about Advisory Board Sponsorship

Learn more about Advisory Board's 2024 Revolutions in Specialty Care Summit

A transcript of this episode as well as more information and resources can be found on radioadvisory.advisory.com.

Headlines about the future of surgery often focus on robots in the operating room– but innovation in surgical care and operations goes beyond robotics. In reality, the solutions to surgery leaders' problems – like inefficiency and dwindling margins – may be less futuristic than you'd think.

In this episode, host Rachel (Rae) Woods invites Advisory Board experts Isis Monteiro, Miles Cottier, and Paul Trigonoplos to discuss what is next for the future of surgery, and what it will actually take for health systems to make surgical care profitable again. They discuss innovations in the OR, opportunities to improve efficiency, and why it might be time to think differently about the future of surgery.

Links:

• Mentioned in the interview (15:00): Open source code that optimizes operating room efficiency
• Ep. 142: The dire state of hospital finances (Part 1: Hospital of the Future series)
• Ep. 193: Is health system growth still possible?
• General surgery service line outlook – 2023
• [Webinar on Feb. 27] How health systems are preparing for the future of surgery

Use the Market Scenario Planner tool

Learn more about Advisory Board's 2024 Revolutions in Specialty Care Summit

A transcript of this episode as well as more information and resources can be found on radioadvisory.advisory.com.

The data doesn't lie: site-of-care shifts are accelerating. Health systems rely on surgical volumes as a major revenue driver, but as more procedures take place outside of the hospital, systems are not necessarily positioned to capture the shift in volumes – or revenues. So, what should health systems do?

To answer that question, host Abby Burns talks with Advisory Board experts Nick Hula and Sebastian Beckmann. They discuss why health systems need to transition from a "defensive" to "offensive" approach to capture shifting volumes and identify service- and market-level factors systems should consider when putting this mindset shift into action.

Links:

• Site-of-care shifts: The next savings opportunity for health plans?
• Ep. 193: Is health system growth still possible?
• 5 trends (re)shaping site-of-care shifts
• What's happening with joint replacement volumes?

Learn more about Advisory Board's on-demand courses

Learn more about the Advisory Board Fellowship at: advisory.com/fellowship

A transcript of this episode as well as more information and resources can be found on radioadvisory.advisory.com.

We've all seen headlines about decreasing quality in U.S. healthcare. In an industry battling with workforce shortages, rising health needs, missed prevention, workplace violence, and rising healthcare needs, it's no wonder quality is falling and adverse events are rising. The fact is: in 2024, the patients are not all right.

In this episode, host Rachel (Rae) Woods talks with Advisory Board equity expert Darby Sullivan about the state of clinical quality. Following that, we hear from Dr. David Baker, Executive Vice President for Healthcare Quality Evaluation and Improvement at The Joint Commission, to discuss why patient quality is declining and what the industry can do to improve it. In the conversation, they discuss how we define and measure clinical quality, what leaders can do to improve outcomes, and more.

Links:

• The Joint Commission
• How to tackle the 4 root causes of stagnating clinical quality
• 4 ways to 'fire-proof' your quality efforts
• Is clinical quality declining? A look at the data — and what you can do.

Learn more about Advisory Board's on-demand courses

How UPMC improved interdisciplinary care for metastatic breast cancer and geriatric patients

A transcript of this episode as well as more information and resources can be found on radioadvisory.advisory.com.

Between high labor costs, inflation, workforce shortages, and a host of other challenges, the past couple of years have been some of the most straining financial times for health systems in recent memory. Though the tides may be starting to turn, it is critical that health systems do not get complacent. How can health systems prepare to grow in the midst of an optimistic yet volatile landscape? Paradoxically, the growth path for health systems is actually to shrink.

That’s why, in this episode, host Rachel (Rae) Woods invites Advisory Board health systems expert Vidal Seegobin, and quantitative insights expert Larry Watts to discuss why heath systems might have to first shrink in order to grow and prepare themselves for the future. Throughout the conversation, they discuss why leaders need to look past the optimism of short term relief, and why hospital-based health systems need to start working smarter and not harder.

Links:

• [Tool] Market Scenario Planner
• Ep. 147: Pursuing growth in today's financial landscape
• [Rerun] The dire state of hospital finances (Part 1: Hospital of the Future series)
• Survey insights: 6 priorities for health system strategists in 2024
• Ep. 161: Unwavering purpose, the creation of Ballad Health

3 reasons to prioritize comprehensive sleep services

Need a quick answer to a healthcare question? Ask Advisory! Whether it's about where the market is headed, or how to navigate our website our team of experts are just a call or email away. Visit ask.advisory.com or email ask@advisory.com to learn more.

A transcript of this episode as well as more information and resources can be found on radioadvisory.advisory.com.

Last week, in the first part of our series on what CEOs need to pay attention to in 2024, we discussed several of the seismic changes that have emerged in the healthcare industry. In particular, we discussed where care is delivered, and how the healthcare industry is shifting from hospital-first care delivery to vertically integrated ecosystems.

In part two of our series, host Rachel (Rae) Woods welcomes back Advisory Board experts Natalie Trebes, Prianca Pai, and Sharon Yuen to discuss two other seismic shifts: who delivers care and how it’s paid for. In the conversation, they discuss how care team roles are shifting in a world of generative AI, how treatment economics are evolving in the new era of bespoke care, and more.

Links:

• Ep. 191: What CEOs need to know in 2024 (Part 1)
• Bold predictions for healthcare in 2024
• Ep. 189: A preview of Advisory Board's 2024 research
• 11 Things CEOs Need to Know in 2024

Improving detection of ATTR-CM: Insights from experts

Learn about Advisory Board Sponsorship at advisory.com/sponsorship

A transcript of this episode as well as more information and resources can be found on radioadvisory.advisory.com.

As we step into 2024, there is no denying that the healthcare industry is vastly different than it was 5 years ago, 1 year ago, maybe even one month ago. As the immediacy of the pandemic has ebbed, several other seismic changes have emerged that promise to transform the core of the healthcare industry. Understandably, healthcare leaders are concerned about the pressures they face today and those that lie ahead in 2024.

That's why, in part 1 of a two-part series on what CEOs need to know in 2024, host Rachel (Rae) Woods invites Advisory Board experts Natalie Trebes, Prianca Pai, and Sharon Yuen to unpack these seismic changes and discuss how leaders should be preparing for the future.

Links:

• Bold predictions for healthcare in 2024
• 11 Things CEOs Need to Know in 2024
• Ep. 189: A preview of Advisory Board's 2024 research
• Ep. 145: Part 1: What CEOs need to know in 2023

Learn about Advisory Board Sponsorship at advisory.com/sponsorship

Advisory Board On-Demand Courses

A transcript of this episode as well as more information and resources can be found on radioadvisory.advisory.com.

Every year, Advisory Board receives thousands of questions from healthcare leaders about what's happening in the industry and how their organizations should respond. The team who answers these questions is called AskAdvisory – and today we're giving listeners a behind-the-scenes look at how these experts help leaders answer their most pressing questions.

In Part 1 of this episode, host Rachel (Rae) Woods invites some of our AskAdvisory colleagues to answer some of the questions they've received this year. Then, in Part 2, Rae invites Chris Phelps, lead producer of the Radio Advisory team, to give listeners an inside look on how we make Radio Advisory.

Links:

• The board’s guide to 5 AI challenges
• The Hospital Benchmark Generator
• Low-acuity fast track
• Market Scenario Planner
• National site-of-care shift maps
• Ep. 159: Ozempic, Wegovy, and our questions on weight management drugs
• Ep. 172: Build a value-based enterprise: Live from 2023 Value-Based Care Summit
• Ep. 145: Part 1: What CEOs need to know in 2023
• Ep. 146: Part 2: What CEOs need to know in 2023
• Encore: Revisiting our conversation on building ethical AI systems
• Ep. 173: 4 ways to prevent a physician shortage [Bonus content]

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A transcript of this episode as well as more information and resources can be found on radioadvisory.advisory.com.