104 episodes
Value-Based Care Insights Lumina Health Partners
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- Business
Value-based care isn’t the “future of health care delivery,” it has already arrived. But value-based care is only the starting point of this conversation. We must also examine how we can bring more value to health care by increasing efficiencies, reimagining how financial performance is measured, and so on.
Of course, realizing this level of transformation isn’t easy.
That’s why we created the Value-Based Care Insights Radio Show – to empower health care organization leaders like you with the actionable guidance and strategic knowledge you need to optimize performance, as well as meet the
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Strengthening Payer-Provider Partnerships in Medicare Advantage Plans
As Medicare Advantage enrollment rises and traditional Medicare enrollment declines, collaboration between payers and providers becomes essential. However, these relationships have historically been fraught with challenges and various administrative complexities. In this episode of Value-Based Care Insights, we explore the critical need for effective payer-provider partnerships. SueEllen Carroll, Managing Director at AArete, and Darren Ghanayem, a seasoned expert in healthcare and IT. SueEllen and Darren Ghanayem join us to share their insights on building trust between payers and providers and strategies for improving governance. Gain insights into fostering contract collaboration, improving patient care, and reducing the administrative burden often associated with Medicare Advantage contracts.
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Leveraging Data to Guide Discussions on Provider-Payer Contracts
As healthcare providers engage in payer contract negotiations, understanding their contractual reimbursement rates compared to their market has never been more crucial. In this episode of Value-Based Care Insights, we sit down with Damon Morse, an expert in rate analyses to discuss the challenges healthcare providers face with payer contract negotiations, and the strategies required to level discussions. Gain insights into how thorough analysis and strategic positioning can ensure fair reimbursement for provider organizations and support organizational growth.
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The Provider’s Playbook for Medicare Advantage Plans
Medicare Advantage has been the subject of significant attention lately among provider organizations due to its distinctive demands that influence traditional practice operations norms. In this episode of Value-Based Care Insights, we sit down with Sarah Hartley, an expert in health information management, and discuss some of the hurdles with new Medicare Advantage contracts, along with the efforts needed to align providers and patients. Gain insights into the administrative challenges, diverse strategies for effective patient data management, and the essential cultural shift required to promote collaboration between provider organizations and payers.
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Building an Integrated Ambulatory Network: Forty-Five Years of Medical Group Strategy
Forty-five years after a Chicago hospital pioneered an integrated network strategy, the healthcare landscape has undergone a significant shift towards prioritizing preventative care. In this episode of Value-Based Care Insights, Jeffry Peters, an expert on medical group strategy, along with Michael Antoniades, President of the University of Chicago Medicine, explore the groundbreaking challenges and strategies that revolutionized healthcare delivery, and how they are still being tackled today. Gain insights on the evolving focus towards preventative care, the measures used to evaluate healthcare delivery, and the pivotal role of primary care in bolstering the entire healthcare ecosystem.
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A Physician Leader’s Journey: Strengthening Culture as a Catalyst for Growth
Within the healthcare industry, effective organizational culture requires building trust, nurturing collaboration, and positioning leaders to drive strategic and impactful change. In this episode of Value-Based Care Insights, we sit down with Dr. Eric Velazquez, Professor of Medicine at Yale, alongside Doug McKinley, a clinical psychologist and leadership coach. Together, they explore the challenges and opportunities of strengthening the workplace culture in order to improve organizational effectiveness, financial performance, and overall patient care. Gain insights on the importance of vision alignment, a healthy culture, team collaboration, and the delicate balance between “steering the ship” and delegating responsibility.
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Unraveling the Impact of Behavioral Health on Patient-Centric Care
Behavioral health is pivotal for overall patient well-being, yet healthcare providers are just beginning to recognize the significance of lifestyle factors and social determinants in delivering this sort of whole-person patient-centric care. In this episode of Value-Based Care Insights, host Dan Marino sits down with Dr. Matthew Burg, a clinical health psychologist at Yale, to explore how social determinants and behavioral medicine are addressing the clinical needs of patients. Gain insights into the challenges and opportunities involved in integrating behavioral health into patient care, in prioritizing quality outcomes over services, and in recognizing the importance of preventative measures to establish a more comprehensive patient-centric care delivery system.
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