Beyond the Stethoscope: Vital Conversations with SHP

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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Navigating the shifting landscapes of healthcare in a post-COVID world is no walk in the park. Our insightful guest, Damien Scott, CEO of Emmanuel Medical Center, unpacks this maze with us, illuminating pressing issues like the generational divide among physicians, skyrocketing staffing costs, and the dire need for expanding autonomy for nurse practitioners and PAs. We also delve into the vital role of programs like Mercer Medical School and MCG in steering medical professionals towards rural areas, and strategies to break free from the reliance on travel agency staff.

But that's not all. We also dive deep into how we gauge the quality of healthcare in our communities. Damien shares his expertise about rating systems like CMS 5-Star and the undeniable value of patient feedback. He offers his perspective on the advantages of providing services like outpatient OBGYN services five days a week, and the conundrum of striking a balance between offering such valuable services and maintaining financial viability. We also take a moment to appreciate the power of a balanced board and the incredible team they've built over the years. So tune in and get enlightened!

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Are you intrigued by the dynamics of rural healthcare leadership? Join us as we navigate the complexities of this critical role with a proven and seasoned executive at the helm of rural hospitals in Swainsboro, Georgia. Damien Scott, a CEO with a clinical background, walks us through his interesting journey from physical therapy to hospital administration, while also providing insights into the scientific and clinical challenges his team regularly encounters. He candidly discusses the hurdles he has crossed transitioning from a hands-on role to an administrative one, and shares his experience with the financial and business aspects of running a hospital.

Mike Scribner and Jason Crosby discuss with Damien how he has made a significant impact in rural healthcare with his unique initiatives. His passion for providing quality care shines through as he discusses the creation of the React Team and the Emanuel County Resource Centre. Delving into the philosophical, Damien explores the question of who should bear the brunt of uncompensated care. We explore how the balance between constituents and hospital direction shapes the outlook of rural healthcare. Join us on this enlightening journey, shedding light on the realities of healthcare leadership in rural settings.

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Are you ready to embark on a new journey with 'Beyond the Stethoscope: Vital Conversations with SHP'? We're kicking off our third season with a bang! Join us, your hosts Aaron C. Higgins and Jason Crosby, as we celebrate our first podcast anniversary and revel in crossing over 1,000 listens. Looking back, we've had a spectrum of engaging interviews and explored a variety of formats, but this season, we have a truly impressive lineup of guests to introduce.

We're starting this season off with a deep dive into the latest developments in the healthcare industry. We'll discuss Costco's unexpected step into healthcare and explore how a Mark Cuban-sponsored study on price transparency reveals some big discrepancies. Then we look into the future...of our podcast! This season, we shift our focus to feature conversations with CEOs of successful, independent practices and hospitals. We can't wait to introduce you to some of our upcoming guests: Damien Scott, CEO of Emmanuel Medical Center in Georgia, Kelly Mackin-Marble, CEO of Oswala Medical Center in Wisconsin, and some more stellar "in the trenches" guests.

Get ready for a season filled with enlightening discussions and invaluable insights. Let's go beyond the stethoscope together!

News Articles:
Jason's News: Mark Cuban-backed study finds price discrepancies in hospital services
Aaron's News: Costco Enters the Healthcare Market with Partnership with Sesame

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In this episode, Aaron Higgins and Jason Crosby share articles about how our providers and children are burning out, and the new cyber security rules and requirements for healthcare facilities that are being prepared by the Biden administration.

Then, we are joined by Sean Cavanaugh, CCO / CPO Aledade. Previously he served as Deputy Administrator and Director of the Center for Medicare @ CMS. In this special 2 part series, you’ll hear his viewpoint related to today’s independent primary care physician, the impact of Value Based Care (VBC), and how Aledade supports their practices for success in their ACO.

Sean can be found:
LinkedIn
Twitter @dc_cavanaugh

Learn more about Aledade:
Website
Twitter @AledadeACO

The transcript of our conversation can be found on our website.

News Items
Jason's News Item
Aaron's News Item


Credits

Production Assistance & Editing: Nyla Wiebe
Scripting by: Aaron C Higgins
Show Notes & Transcription: Aaron C Higgins
Social Media Management: Jeremy Miller & Nyla Wiebe
News Co-Hosts: Aaron C Higgins & Jason Crosby
Interview co-hosts: Mike Scribner & John Crew
Show Producers: Mike Scribner & John Crew

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In this episode, Jason Crosby and Aaron Higgins provide a quick overview of the PFS Final Rule that released at the end of October.

Then Jason talks with Joe Ebberwein. Joe is the Co-founder and Chief Financial Officer of Corstrata, a technology-enabled care management solution focused on improving outcomes for wound and ostomy patients. We gain data-oriented insight into this often-neglected area of care and how Corstrata is working on solving this care gap; then, they discuss how virtual care and telehealth are viable solutions for any provider to utilize.

News Item - PFS 2023 Final Rule 15 Takeaways

Register for the Nov 15th QPP Webinar

Joe & Corstrata can be found at:

Corstrata.com, Twitter, Facebook, LinkedIn

Transcript of the interview

Credits

Production Assistance & Editing: Nyla Wiebe

Scripting by: Aaron C Higgins

Show Notes & Transcription: Aaron C Higgins

Social Media Management: Jeremy Miller & Nyla Wiebe

News Co-Hosts: Aaron C Higgins & Jason Crosby

Interview hosts: Jason Crosby

Executive Producers: Mike Scribner & John Crew

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Production © Strategic Healthcare Partners, LLC.
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On today’s episode, Jason shares an article about how Mark Cuban is expanding his low-cost pharmacy project. And Aron shares about how charging for digital messages may be on shaky ground.

Jason sits down with our guest Steve Adams. A Certified Professional Coder Instructor with InGauge Healthcare Solutions with more than 20 years-experience with training others how to code in all arenas of care. Steve dissects the coding changes for 2023 in the Final Rule, including E&M, new G-codes, and screening reimbursements.

Aaron 's news: https://www.beckerspayer.com/policy-updates/mychart-message-fees-live-on-unstable-ground.html

Jason's news:

https://www.beckershospitalreview.com/pharmacy/mark-cuban-cost-plus-partners-with-2nd-pbm-hints-at-insulin-market-entry.html

Transcript

Credits

Production Assistance & Editing: Nyla Wiebe

Scripting by: Aaron C Higgins

Show Notes & Transcription: Aaron C Higgins

Social Media Management: Jeremy Miller & Nyla Wiebe

News Co-Hosts: Aaron C Higgins & Jason Crosby

Interview hosts: Jason Crosby

Executive Producers: Mike Scribner & John Crew

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Send an email contact@shpllc.com

Production © Strategic Healthcare Partners, LLC.
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With the recent CMS updates about provider enrollment, we felt that we needed to bring you some timely information about these changes. We sat down with Raquel Grizzard SHP’s Provider Enrollment expert. She has been working in Provider Enrollment since 2014 and has seen her fair share of changes, but none as dramatic as this all at once.

We discuss DMEPOS, CHOW Filing, changes to the 8550, the new specialists that have been added, and more. Join Raquel Grizzard as she shares her insight and tricks of the trade for all things Provider Enrollment.

Credits

Production & Editing: Nyla Wiebe
Show Notes & Transcription: Aaron C Higgins
Social Media Management: Jeremy Miller
Hosts: Jason Crosby & Aaron C Higgins
Executive Producers: Mike Scribner & John Crew

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Production © Strategic Healthcare Partners, LLC.
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Welcome to the Season 3 Teaser Trailer for "Beyond the Stethoscope: Vital Conversations with SHP"! In this teaser, hosts Aaron C. Higgins and Jason Crosby give you an exciting glimpse of what's coming up in the new season. Get ready for engaging discussions, the latest healthcare headlines, insightful interviews, and a touch of healthcare humor. 

What to Expect in Season 3: 

• Discover the success stories of Practice Administrators who have overcome challenges and found innovative solutions. 
• Gain inspiration from Hospital CEOs and CFOs as they share how they've turned obstacles into opportunities. 
• Hear firsthand accounts from Physician clients about the transformative impact of SHP's services on their practices. 
• Explore the world of data-driven healthcare through insights from clients who have utilized SHP analytics. 
• Stay ahead in the healthcare landscape with expert discussions on the latest trends and topics. 
• Stay updated on the 2024 Quality Payment Program changes through our dedicated segment. 

 "Greatest Hits" Repeats: 

Before Season 3 kicks off, enjoy memorable moments from some of our past episodes. Every week in September, before Season 3 starts, relive thought-provoking discussions that made you laugh, ponder, and connect. 

Stay Connected with SHP: 

• Explore all podcast episodes, resources, and more on our website https://shpllc.com/podcasts. 
• Subscribe to "Beyond the Stethoscope: Vital Conversations with SHP" on your preferred podcast platform. 
• Share the podcast with colleagues, friends, and fellow healthcare enthusiasts to spread knowledge and inspiration. 

Mark Your Calendars: 

Get ready for a brand-new season of "Beyond the Stethoscope: Vital Conversations with SHP." Season 3 is on its way October 11, 2203, so stay tuned for more enlightening episodes that empower and educate. 

Thank you for joining us for this Season 3 teaser episode. We're excited to have you onboard for another round of insightful conversations and vital discussions. Stay curious and stay connected with Strategic Healthcare Partners! 

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In our last episode part of this 4 episode series, as well as last for Season 2, Jason Crosby and Aaron Higgins discuss the leadership style of the Yellow Tux himself, Jesse Cole, and how his passion and energy is share across Banana Land.

In continuing of the series highlights, they recall case studies by their very first guest last season, Scott Regan, and how the leader can directly walk in the shoes of their patients.  With the detailed insight into the game experience, further discussion on the culture comparisons highlight this last episode.

So, put on your yellow tux, grab a Slippery Banana, and listen in as they wrap up the season with highlights of the differences in culture and opportunities in creating fans of the provider setting.


Credits

Production Assistance & Editing: Nyla Wiebe

Scripting by: Aaron C Higgins

Show Notes: Aaron C Higgins

Social Media Management: Jeremy Miller & Nyla Wiebe

Co-Hosts: Aaron C Higgins & Jason Crosby

Show Producers: Mike Scribner & John Crew

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Tweet @ us on Twitter
Follow on Linkedin
Send an email contact@shpllc.com

Production © Strategic Healthcare Partners, LLC.
All rights reserved.