What If Health Care Went BANANAS? (as in The Savannah Bananas)

Prepare to voyage Beyond the Stethoscope with us, as we reminisce on season 3's highlights and look to season 4's promising future. From inspiring conversations with awe-inspiring guests to heartwarming news stories and thrilling travel plans, our podcast has been a journey worth reliving. Brace yourselves for an exciting ride through the unchartered territories of the future of healthcare, where disruptors are on the rise and AI, virtual care, and M&A activities are all set to change the game.

This episode, we also put a spotlight on Kroger's successful model of serving healthcare right where the people are.

Join us in celebrating the spirit of Christmas, reflect, unwind, and soak in the magic of the season. Remember to stay tuned till the end for a special bonus surprise that we promise, you won't want to miss!

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Get set to untangle the intricacies of health insurance with us and our esteemed guest, Matt Usher. We promise you a guided tour through escalating out-of-pocket maximums, specialty medication costs, and their implications on the affordability of health insurance plans. We shed light on why employers need to consider alternative plans to lessen the financial strain on employees. Moreover, we analyze the latest shifts in the health insurance industry, such as the Humana / Cigna merger, and what they mean for the future of health insurance in businesses.

Brace yourself for an insightful ride into the pulsating world of health insurance, with a special emphasis on the industry's recent mergers stimulated by the competitive prescription benefit management market. Tune in and increase your knowledge about how the Biden administration might influence these mergers. We also present invaluable advice for both employers and employees on how to evaluate their plans, comprehend the market they're dealing with, and become smarter health care consumers. Our discussions on the significance of self-funded arrangements and the power of making informed decisions about where to seek care serve as potent strategies to save money for everyone involved in the plan. This episode is a perfect opportunity to arm yourself with the understanding needed to confidently navigate the health insurance market.

You can find Matt on LinkedIn or on his website.

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Are you ready to unravel the labyrinth of insurance trends in the small business sector? We've got you covered! We welcome insurance broker Matt Usher to our show who shares his knowledge on an array of topics. From understanding premium hikes, exploring alternative solutions for businesses against increasing costs, to the innovative designs like HSA plans in the post-COVID era, we leave no stone unturned. And that's not all; stay on the line to hear more from Matt on HSA out-of-pocket maximums in our upcoming episode.

As we traverse the complex terrains of healthcare costs, we shed light on how insurance companies master the tightrope walk between profitability and providing quality care. We dissect the budding trend of reference-based pricing and how it could metamorphose employers' health insurance offerings. In a riveting section, we address the steep cost of specialty medications in employer healthcare. From financial assistance programs to international sourcing, we showcase potential solutions to counteract the soaring costs of specialty medications. This exchange is a crucial one, as we delve deep into the current and future scenarios of healthcare costs and insurance. So, lend us your ears for these vital conversations that promise to enlighten and empower.

You can find Matt on LinkedIn or on his website.

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Get ready to navigate the changes coming with the 2024 Quality Payment Program (QPP) in a fascinating discussion with expert guest (and regular co-host), Aaron C Higgins. Brace yourself as Aaron charts a course through the complex maze of MIPS Value Pathways (MVPs) that clinicians will have to opt in for, and simplifies their workings. We'll also illuminate the "new" population health measures, calculated automatically through claims data, decreasing the administrative burden for clinicians. Take note, the nomination window isn't opening until summer, so use 2024 as a transition year to gear up for mandatory participation in 2028.

We'll plunge into the realm of certified EHR technology (CEHRT) changes and what it means for Alternative Payment Models (APMs) and Accountable Care Organizations (ACOs). Be aware! CMS has moved to a new numbering system for CEHRT versions and ONC is now holding the reins, deciding what is considered a valid version for QPP participation. Keep your eyes peeled for the requirement of 100% CEHRT usage in APMs and don't miss any updates. As we head towards 2025, we'll discuss the impending requirement for APM participants to report on promoting interoperability. Lastly, we delve into the changes in the incentive payment for QPs, and the potential financial perks for existing QPs compared to non-QPs.

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Are you ready to master the CMS Quality Payment Program changes for 2024? Buckle up as we, your co-hosts Jason Crosby and Aaron Higgins, equip you with the necessary knowledge to navigate these changes. We unpack the crucial amendments, including participation in traditional MIPS, alternative payment models, and the MIPS value pathways. We also delve into the changes that didn't make the cut, and provide an in-depth understanding of the performance expectations for the four categories of QPP: quality, cost, improvement activities, and promoting interoperability. 

As the conversation continues, we shed light on the adjustments to the Promoting Interoperability category for the 2024 reporting period and introduce you to the MIPS Value Pathways Program (MVP).  We also discuss how MVP will be influencing traditional MIPS participation. Gain insights on how these changes can be strategically navigated for an optimal performance and a reduced administrative burden.

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Ever wondered why so many physicians are leaving their profession? What if we told you that 63% of them are experiencing symptoms of burnout and over 117,000 have quit in the past year alone? Join us, your hosts Aaron Higgins and Jason Crosby, as we unpack the harsh realities of physician burnout and the alarming rise in cyber attacks in the healthcare industry. Our conversation takes us on a journey through recent news headlines as we shed light on these issues with a surge of anxiety-inducing statistics. We also explore how technological advancements such as AI could potentially lighten the administrative load on healthcare providers, thereby reducing stress levels and keeping more doctors in the profession.

But the problems don't stop there. Did you know that an astonishing 88% of healthcare organizations report an average of 40 cyber attacks in the past year? We delve into the costly repercussions of these attacks, highlighting their disruptive impact on operations and potential consequences on patient care. As we sound the alarm on the need for enhanced cybersecurity measures, we also share actionable tips on how organizations can protect themselves. The future of healthcare is a complex web of challenges and opportunities, and we're here to guide you through it. So, buckle up and stay tuned for our next episode where we'll dive into the 2024 final rule and its implications on MIPS and QPP. This is a conversation you won't want to miss!

News Articles Discussed:

https://www.beckershospitalreview.com/cybersecurity/hospital-cyberattack-costs-patient-care-disruptions-up-9-things-to-know
https://www.beckershospitalreview.com/cybersecurity/30-most-common-passwords-of-2023.html
https://www.kevinmd.com/2023/11/the-crisis-of-physician-burnout-and-the-promise-of-technology.html
https://www.beckershospitalreview.com/digital-health/where-health-systems-stand-on-ai-adoption.html

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Are you ready to take stock and contemplate gratitude? We're doing exactly that in the latest episode of Beyond the Stethoscope. Join us, Jason Crosby and Aaron C Higgins, as we muse over the last year - the highs, the lows, the triumphs, and the challenges. We're sharing our gratitude for our families, the exceptional team at SHP, and you, our dedicated listeners who inspire us to keep going. 

As we wind down the year, we're excited about the enlightening episodes coming your way. We'll be discussing the QPP Final Rule for 2024 - a topic crucial for those keeping an eye on MIPS. Finally, we'll conclude the season with a thought-provoking conversation with Matt Usher, SHPs insurance broker. We'll be addressing the 2024 health plan challenges from the viewpoint of both the employee and employer. This episode will be for everyone who interacts with healthcare. Don't miss this opportunity for insight and growth on Beyond the Stethoscope. Tune in!

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What happens when you mix the expertise of Coastal Vascular and Vein Center's CEO Craig Kilgore with the turbulence of the post-pandemic private practice landscape? You get a dynamic and insightful exploration of the challenges and opportunities facing private practices in this transformative era. From the consolidation of payer landscapes to the evolution of volume levels, and the constant struggle with staffing, Craig offers his perspective, grounded in his extensive experience across IT, finance, and executive administration. 

Craig goes beyond just identifying the problems: he offers tangible strategies for fostering growth, harnessing innovation, and engaging physicians and staff within a practice. Drawing from his own experience, he outlines the merits of owning property and diversifying business strategies to build a resilient and successful private practice. But it's not all rosy – Craig also shares his concerns about the declining interest among physicians in private practice and the ongoing struggle with staff retention. This episode is more than a conversation; it's a masterclass in navigating the choppy waters of private practice in a post-pandemic world. So, ready to get some invaluable insights? Of course, you are! Let the conversation begin.

Craig M. Kilgore, CEO - Coastal Vascular & Vein Center
(e) craig.kilgore@coastalvvc.com
(p) 843-577-4551

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Strap yourselves in as we embark on an insightful journey with Craig Kilgore, the captain steering the ship at Coastal Vascular and Vein Center. Craig's ascension from the tech-savvy IT manager and CFO at Holston Medical Group to the high echelons of Charleston ENT and Allergy, and now his leadership role at Coastal Vascular and Vein Center is a story that's as compelling as it is inspiring. We traverse the tumultuous landscape of independent medical practice, grappling with challenges in staffing, IT, and more. Plus, Craig dissects the influence COVID has had on private practices, providing us with a unique perspective on the shifting healthcare scene.

As we venture into the second half of our enlightening exchange with Craig, prepare to soak up some pearls of wisdom on leveraging professional networks and associations. Reflecting on his tenure at Holston Medical Group, Craig sheds light on its transformation into an Accountable Care Organization (ACO), providing us with a blueprint for smaller practices to emulate. The secrets to successful contract negotiations, the art of maximizing contracts, and the science of efficient revenue cycle management - all these and more await you. If you're an independent medical practice aiming to expand or diversify your revenue streams, hitch a ride with us on this exhilarating journey with Craig Kilgore.

Craig M. Kilgore, CEO - Coastal Vascular & Vein Center
(e) craig.kilgore@coastalvvc.com
(p) 843-577-4551

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Curious about what the latest headlines in the health sector mean for you? Join us for a vital conversation with Jason Crosby & Aaron Higgins where we dissect the implications of the proposed HHS crackdown on information sharing and explore its potential to revolutionize patient data flow across different care settings. We delve into the consequences of non-compliance, especially for hospitals & practices participating in MIPS, offering insights that providers and other stakeholders will find incredibly enlightening.

In addition, we reflect on the first anniversary of the 988 suicide and crisis hotline, evaluating its impact and the challenges it faces. Our discussion uncovers the urgent need for more local resources for the hotline and the strides it has made in advancing mental health initiatives.

We also discuss the open enrollment of the ACA health plans. What are the things to be on the lookout for going forward as more people become eligible for these plans.

Wrapping up, we share a sneak peek into our upcoming interview with Craig Kilgore.

With subject matter that impacts us all, this episode is a treasure trove of essential health sector insights. Don't miss it!

Headlines:
Jason: https://www.fiercehealthcare.com/payers/open-enrollment-aca-exchanges-set-begin-here-are-5-trends-watch

Aaron: https://www.healthcareitnews.com/news/new-information-blocking-rules-hhs-could-cost-noncompliant-providers-thousands

Aaron: https://www.cnn.com/2023/10/31/health/988-potential-mental-health-study/index.html

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