Rick Majzun

Keep our rurals open but if you really want to help get the foreign equity owned GPO that sets the pricing for our hospitals BANNED from our state. Economies of scale are used by Vizient against Oklahoma rural hospitals. If you have 13 tiers, hidden tiers, and tier maxes…that’s not a contract, that a free for all nightmare of a scam we all fell for. Their awful written tiered agreements force our rurals to pay more for the exact same items that our large hospitals pay less for. Example box of gloves a large hospital system in the state will pay 6-8 bucks for a box of 250 exam gloves. That same box for a rural EMT? 24 bucks. There is no price transparency and you are forcing patients who live in rural areas to pay more because of the lack of infrastructure by the corporations serving them to effectively and economically get goods and services to these hospitals. And distributors who whine about the cost of delivering to rural hospitals all while posting BILLIONS in profit every quarter are the first on my 💩 list. Let’s keep our rurals open but let’s make them more profitable so that they can continue to add much needed services and gainfully employ more community members.

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Another important position statement from Association of Healthcare Value Analysis Professionals (AHVAP). As value analysis evolves, it is vitally important to ensure that those who are entrusted with the process understand what is expected of them in terms of professionalism. Please feel free to share this important document.

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Here's a quote from one of the authors of the recent Yale, UofW-Madison, Harvard, U of Chicago, the IRS and Treasury Department study: “We can use our analysis to estimate the effect of hospital mergers,” said Stuart Craig, an assistant professor at the University of Wisconsin-Madison Business School. “Our results show that a hospital merger that raised prices by 5% would result in $32 million in lost wages, 203 lost jobs, a $6.8 million reduction in federal tax revenue, and a death from suicide or overdose of a worker outside the health sector.” The study also showed that because rising health care prices leads firms to let go of workers, a knock-on effect of hospital mergers is that they lead to increases in government spending on unemployment insurance and reductions in the tax revenue collected by the federal government. Read more here. Please. We've said for years that the system is unsustainable. This study shows very clearly that we have reached that point. When rising costs lead to unemployment and suicide, in addition to simply more generalized misery, we've reached the break point, and keeping business as usual fuels this burning pyre of human hope. Unfortunately, we know that almost all carriers have been complicit in these price increases. Yes, mergers help tilt the negotiating power, but when your profitability is proportional to the misery that's created, you're not really motivated to put the fire out. And that's why the carriers happily fuel the burning pyre. And who fuels their growing pile of cash? Employers who have to lay off employees; employees who lose their jobs so that others can still receive health benefits; families that can no longer afford anything. This outcome is not inescapable. Quite the contrary. But it does require having the courage to make different choices.

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"It's not your experience, knowledge, or skills. Your heart is your most important leadership tool." Michael Hyatt Just one of the relevant and thought-provoking insights I gained from reading Jonathan Fisher, MD, FACC new book, Just One Heart: A Cardiologist's Guide to Healing, Health, and Happiness. What happens when a distinguished Harvard-trained Cardiologist shifts his focus to genuine care for our hearts in service of well-being, joy, and health? THIS! 👇 A captivating exploration of our lived experience and how we can enrich our lives with a dedication to the 'Seven timeliness traits of the heart.' Jonathan's work fosters organizational resiliency, and in healthcare, resilience is our middle name. 😉 We understand the importance of waking up daily and recommitting to our calling and its challenges. I urge my fellow healthcare professionals to delve into this book and reflect on its valuable practices and approaches. Bravo Jonathan! It's amazing to watch your journey! ❤️ #wellbeing #organizationalresiliency #healthcare #consumerexperience #caregiverexperience #highperformance

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Mark your calendars! The 2024 Association of Healthcare Value Analysis Professionals (AHVAP) Value Analysis Week is just around the corner. Join us from July 15-19 as we gather healthcare professionals from around the world to explore the latest advancements and strategies in value analysis. Don't miss out! To learn more: https://lnkd.in/eJZSWUVa. #AHVAP2024ValueAnalysisWeek #HealthcareValueAnalysis #HealthcareEvent

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Value analysis is transforming partnerships between health systems and suppliers in health care. In a recent article from The Journal Of Healthcare Contracting, insights from the IDN Insights West panel featuring Cheryl Smith Anderson, DNP, MBA, RN, BSN, system director of Value Analysis at Steward Health Care, and Jimmy Chung, MD, MBA, FACS, FABQAURP, CPE, CMRP, chief medical officer at Advantus Health Partners, sheds light on the pivotal role of value analysis. Cheryl and Dr. Chung discuss their approaches to value analysis and the key components of successful partnerships. From prioritizing patient care outcomes to fostering transparent communication, their insights show the importance of collaboration in driving value for both healthcare organizations and their patients. Read more about how strategic partnerships in value analysis are reshaping the healthcare supply chain landscape: https://lnkd.in/gB7NgJF3

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Independent physicians are the best value in healthcare

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Here's a shocker -- the AHA and the FAH are pushing back against Medicare's mandatory hospital-based bundled payment program. The hospital associations are asking for more time to get ready for a program that will start in 19 months.... It's laughable, of course, but what else should we expect from the agents of the status quo? For those who hadn't kept up, Medicare announced the Transforming Episode Accountability Model several months ago and it's finally going through the end of the rulemaking process. So what's TEAM? A slimmed down version of the Medicare Bundled Payment Model (BPCI and its successor BPCIA) that has been in place for over a decade. There's nothing new about TEAM except that it only covers a handful of inpatient stays and the accountability is reduced to 30 days post discharge instead of 90. Four years ago a dozen or so highly respected leaders in the industry recommended that CMS institute a "DRG+30" across the board. Not just for five DRGs, but all DRGs. And here we are, four years later, and TEAM is set to start in 2026....yes, 2026, not 2025. The first cohort of the original program launched in April 2013, more than 11 years ago. By the time TEAM starts it will have been close to 13 years. Isn't that enough time to get ready Chip Kahn???? All of the published analyses on the Medicare Bundled Payment program showed the same source of savings -- post-acute care. And the savings never negatively impacted outcomes. So it's logical that Medicare makes this mandatory. What's not logical is that it's taken so much time to get to this decision. So let's just get on with it because the taxpayers deserve it and so do Medicare beneficiaries. #TEAM, #BundledPayments, #CMMI

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September 23-25 in Nashville, TN. Mark your calendars! We're covering these topics and more: -Health Care After the Elections: Policy Priorities for the Next Four Years -High-Cost, High-Value Care: Adopting (and Affording) the New Wave of Therapeutics -Whom Can You Trust?: Navigating the Intersection of AI and Misinformation -The Employer Resurgence: New Strategies to Advance Affordability, Accessibility, and Equity -Spotlight on Women’s Health: New Research, Investments, and Care Models -From Pledge to Action: Lessons from Leading Health Equity Champions -The Quest for Commercial Risk: Discoveries on How to Unlock Win-Win Arrangements

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***Partnership Announcement*** Pediatric Resource Group (PRG) is excited to partner with Libman Education, one of the most trusted resources for training of hospital coding, CDI, and HIM professionals, to offer our Pediatric CDI Educational Series. The Pediatric CDI Educational Series has over 35 on-demand videos created by CDI expert pediatricians and geared towards coders, CDI professionals and clinical staff with the following objectives: -Understand inpatient pediatric conditions to identify all query opportunities -Describe documentation’s impact on severity adjustment, quality metrics, expected length of stay (LOS), & hospital payment -Review CDI processes, policies, metrics, and the CDI physician champion role This tool is a great supplement to our "Pediatric by PRG" module in the Pinson & Tang CDI Pocket Guide. #CDI #pediatrics #clinicaldocumentation https://lnkd.in/gewSdrAr

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Edition 3 of "The Surgeon's Record" presented by Commons Clinic. Welcome to the first in a three-part series on the current state of specialty care delivery. The foundation laid here will begin charting a path toward sustainable VBC with a focus on 3 Pillars of Innovation: - Value-based Payment Models - Migration to ASCs - Thoughtful Implementation of Technology Part 1 in this series takes a deep dive into the existing MSK VBC models including why sustainable success has been elusive (flavored by my own experience in CMS' BPCI-A program). The usual features are here too: quick takes on popular topics from the last week, the weekly poll, and a jaw-dropping visual (teaser: it's a "has to be seen to be believed" EOB from an inpatient joint replacement). #medicine #healthcare #health #vbc #valuebasedcare #msk #healthcareinnovation

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Key Strategic Insights = A Successful OP CDI Program The challenge of value-based care starts with a collaborative approach, when launching an Outpatient Clinical Documentation Integrity (OP CDI) program. Here are some key strategic insights to success: 1. Engage with Population Health Understand Pain Points: Begin by understanding the specific challenges faced. This fosters collaboration. Tailored Questions: Use customized questions to facilitate productive discussions and ensure alignment with needs. 2. Effective Software Implementation Manage Patient (Pt.) Volumes: Implement software solutions to efficiently handle pt. volumes. OP CDI Calculator: Utilize a calculator to determine Full-Time Equivalent (FTE) needs. Data Analytics and Reporting: Emphasize the importance of continuous improvement via data analytics. 3. Workflow Creation Establish Robust Workflows: Create strong workflows before integrating reviewers. 4. Collaboration & Communication Promote Strong Collaboration: Encourage robust communication between key stakeholders. Leverage Software: Use technology to reduce physician burnout & streamline communication. 5. Patient-Centered Approach Address social determinants of health (SDOH) & ensure accurate documentation of conditions and care plans. Patient Outcomes: Keep patient care at the center of all doc. & workflow processes. 6. Regulatory Compliance Adhere to Guidelines: Follow regulatory requirements such as CMS guidelines on Hierarchical Condition Categories (HCC) coding to avoid penalties and enhance credibility. 7. Measurable Outcomes Set Clear Goals: Aim for measurable outcomes like improved HCC recapture rates, enhanced RAF scores, better HEDIS measures, and addressing SDOH needs. 8. Stakeholder Engagement Involve All Stakeholders: Ensure that executives, clinicians, and other relevant parties are involved in planning and implementation process. Success Stories Recently, I helped several CDI directors validate their cases for OP CDI programs within Accountable Care Organizations (ACOs). By engaging with population health leadership, we identified key issues such as RAF gaps and HEDIS measures, and tailored processes to address them. For instance, a CDI director I guided successfully identified HCC and HEDIS recapture as their biggest pain points. With strategic solutions in place, they are now ready to implement the project for the 2025 budget yr., aiming to improve their HCC recapture rate by 20%, leveraging data analytics for outcomes and improvement needs. Benefits of Implementing These Strategies Align Risk Stratification: Properly align risk stratification with chronic conditions and healthcare needs. Quality Measures: Improve quality measures and address SDOH. Collaborative Team: Ensure success with a collaborative team supported by technology. Overall, these strategic actions will enhance patient care and operational efficiency. #Healthcare #Leadership #CDI #PatientCare #ValueBasedCare #HealthcareInnovation

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As healthcare costs continue to rise it is imperative for health plans to have a strong network strategy to manage cost of care. At CareCentrix we partner with our health plan clients and provider network to support goals for improved plan and provider performance with patient care at the forefront.

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Why big is bad in healthcare: Some interesting comments here on health system consolidation from Andrew Donahue, FHFMA, CPA, HFMA's director of health finance policy. Keep in in mind that this is someone who's extremely sympathetic to the hospital industry. First, he acknowledges that mergers "can lead to less competition, inferior service and higher prices" and goes on to say that the only driver of hospital mergers is private insurance companies giving better rates to bigger systems. In an accompanying interview on HFMA's "Healthcare Blame Game" podcast, Donahue goes even further: "Community healthy systems do not want to be megasystems...growth is not necessarily the strategic imperative...you lose local control." He talks about "megasystems" laying off local staff and cancelling contracts with local suppliers, both of which can be devastating to communities. "The corporate finger can slip off of the pulse of the local community when you have more bureaucratic layers, channels, and processes to navigate." This is a message that needs to be heard across the healthcare industry. Hospitals exist to serve communities, not corporate offices in distant locations. Corollary message: Private insurers, both for-profit and non-profit, have s***-ified the hospital industry with their contracting practices. #ethicalhealthcare #hippocraticcapitalism #hospitals #healthsystems #monopolies #antitrust

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🚨 40% of Hospitals Are Losing Money! (Source: Kaufman Hall) 🚨 https://lnkd.in/eEenrkWG While many will shrug and say it is not a big deal because it is the smaller hospitals that are unprofitable, but the reality is much more significant. These hospitals often serve as the largest employers in their communities. When a rural hospital closes, it doesn't just impact healthcare; it devastates local businesses, the broader economy, and the health of that community. Moreover, the presence of a nearby hospital is a critical factor for businesses scouting new locations. Companies know they can't attract top talent if the nearest hospital is in the next county or town. Unfortunately, these hospitals are frequently overlooked by vendors, making it harder for them to thrive. At VantageHealth.ai (and our sister company CompliantHealth.com), we are committed to addressing these challenges. Our value-added solutions aim to move hospitals from red to black through improved revenue streams, reduced costs, increased compliance, and enhanced patient engagement. Let's work together to support these vital institutions and ensure they continue to serve their communities effectively. #Healthcare #RuralHealth #HospitalManagement #CommunityImpact #HealthcareInnovation

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🌟We are thrilled to announce our two AdventHealth clinically integrated networks in Florida are merging into a singular, state-wide network.🌟 This strategic move is not just about growth; it's about enhancing the quality of care we provide to every community we serve. As we embark on this journey, I am reminded of a powerful quote: "When the winds of change blow, some people build walls, others build windmills." This resonates deeply with our commitment to evolution and innovation. By embracing change and harnessing the power of unity, we are setting a new standard for healthcare excellence. This evolution signifies our dedication to innovation, ensuring that every patient receives the best possible care. It's a testament to our team's hard work and the trust placed in us by the communities we serve. Here's to a future where healthcare knows no boundaries, and innovation leads the way to better health for all. 💡🏥 #Innovation #populationhealthmanagement #valuebasedcare

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According to the Center for Healthcare Quality & Payment Reform, KS has 26 hospitals “at immediate risk of closure within the next 2-3 years” and 57 hospitals “at risk of closure in the next 6-7 years”. KS is second only to TX in both of these categories of at-risk rural hospitals. When a hospital closes - rural, suburban or urban - it places strain on the rest of the system… and ultimately impacts our ability to care for our communities. This is not an “us” or “them” issue - this is an issue!

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Leadership has to morph into many forms, and being able to adapt to changes for the benefit of the patient should be the focus of all healthcare leaders.

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