Rick Dewhirst

🚨 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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As revenues recover, it's clear that many hospitals are still grappling with rising costs. However, the hospitals that stand out are those embracing technology to drive efficiency and operational improvements, significantly reducing staff burnout. 🌟 Healthcare professionals entered this great profession to care for patients, not to be bogged down with manual tasks. That's why leading hospital systems are implementing comprehensive applications to enhance people, processes, and automation. This approach ensures cost-effective, top-of-license performance, ultimately benefiting both staff and patients. 💼❤️💡🔧 #GetReady #HealthcareInnovation #TechInHealthcare #OperationalExcellence #PatientCare

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As of late, healthcare has become a favored target of hackers. Disruption of operations and patient care is a risk no healthcare entity can afford. Project Balackout Blueprint is a business-led, not IT-led, program that brings together operational leaders to develop a resiliency plan for ensuring minimal or no disruption to patient care or enterprise business functions. Equip your team with clear protocols and communication strategies to respond effectively in any crisis. Don't wait for disaster to strike. Take action today! #hla #proveninsight #pbb

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If you click on the link you will see a report called Expense Distribution. I know this report more than you can imagine. It's based on paid claims. It shows that for this plan half the members were essentially self-insured as individuals. If I was the CEO of this company, you can bet I would make sure the rates my employees were paying for their own care were reasonable. If not, I'd be personally liable. #deerhold #ContractRateExplorer #MRFInsights

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What are the biggest changes you are expecting in the next 12 months? We have been speaking with lots of people and have been to many conferences. What we're seeing is a big push to get OP CDI to the front of the line, along with a huge risk adjustment push. We are also being asked, at the highest rate ever, to perform targeted audits of existing hospital coding staff as well. How about you? What changes are you expecting and/or seeing? Would love to start the conversation. #whyisnorwoodeverywhere #changeisgood #changehappens #riskadjustment #opcdi

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If I asked you to choose between Trader Joe's or Target, which would you choose? It's a silly question, really. Because both offer unique benefits. As major GPOs shift in the market, exclusive agreements are becoming common. But are they truly driving value for health systems and patients? Exclusive GPO contracts limit choice. It's like forcing someone to choose between Trader Joe’s and Target. At Advantus Health Partners, we offer diverse vendor partnerships and PPI contracts, enhancing both economic benefits and patient care. By rethinking exclusivity, we prioritize patients and empower health systems with choice. Ready to supplement your supply chain with value-added partnerships? Contact Advantus today to learn more about our non-exclusive contracts. https://lnkd.in/deiYRgfE #SupplyChainStrategy #GPOExclusivity

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HCA's CEO-to-worker pay ratio over the past 5 years Nashville, Tenn.-based HCA Healthcare CEO Sam Hazen was paid between 254 and 556 times more than the health system's median employee since becoming the health system's chief executive in 2019, according to proxy statements filed with the Securities and Exchange Commission. Sam Hazen has been paid approximately $111 million over the last five years not including stock options, bonuses, and other perks. While CEO of a large health system requires incredible skill sets and knowledge, earning a ratio of 356 to 1 ceo-to-median-worker pay ratio seems on face value to be excessive. How much wealth does one need to live comfortably over a lifetime? Think of all the employees of HCA committed to providing excellent patient care and those who support the care or revenue cycle of the individual hospitals that go into Mr. Hazen's pocket along with shareholders. #CEO, #exorbitantpay, #overpaid, #medianwage, #equity https://lnkd.in/eNQ68Bh8

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When is a company sitting on $300 million of cash (with zero debt) valued at only $168 million to investors? In the current moment, perhaps partially because it's a telehealth company. It’s been bad news following bad news for telehealth between the Optum news, Walmart news, and Teladoc Health letting CEO Jason Gorevic go. But among the most fascinating underreported issues around telehealth right now is the fact that Amwell has a negative enterprise value. It appears the other part of the answer is that, unlike Teladoc, investors don’t control the company: co-CEOs Roy Schoenberg and Ido Schoenberg do. Maybe, just maybe, their long term view of telehealth is the right one. Is AmWell undervalued? Had fun looking into this one, and am sure others have a different perspective. https://lnkd.in/eiEJ27Gh

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Another benefit of health system partnerships between EMS Teams 🤝 Case Management: Understanding Brokered Transportation Medicaid and other programs often employ Non-Emergency Medical Transportation (NEMT) brokers with capitated payment models to manage and finance transportation services for beneficiaries. 📐 The agency pays the broker a predetermined amount for each enrolled beneficiary each month. This amount is agreed upon in advance and does not change based on the actual number of trips taken or services provided. 💰 The broker assumes financial risk because the fixed payment must cover all transportation needs of beneficiaries. If the costs of providing transportation services exceed the capitated payments, the broker absorbs the loss. Conversely, if costs are lower, the broker can retain the surplus. 🚗 Brokers establish contracts with transportation providers, negotiating rates and service levels. They manage a network of providers to ensure coverage and reliability. 💻 Many brokers require prior authorization and leverage their own processes and technology to assign rides to transportation companies. 👍 The agencies like these models because they can better predict and manage its budget for NEMT services because payments to brokers are fixed and not directly tied to the number of trips provided. 👎 However, there is a risk that brokers might limit services to control costs, potentially denying necessary transportation. There is also limited visibility into the ride status, performance, and assignment process for the care coordinator and patient. 💡 As many case management leaders absorb accountabilities for throughput and EMS leaders get more involved in billing processes, the shared understanding of how brokers operate is essential for developing transportation strategies that scale. #RideEconomics

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Want to know what's going on in the SNF market? Read the thoughts of this 11 location SNF provider for a glimpse of what's impacting skilled nursing today on Skilled Nursing News. https://lnkd.in/gzt6rmjp

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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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3 free billing courses for HPNA members! With NCPDs!!

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The California Office of Health Care Affordability has recently approved a requirement that all healthcare providers report their annual operating expenses. If those expenses increase more than 3.5% (eventually lowering to 3%) in a year, that provider will be fined, ironically increasing their expenses. The state claims this regulation is aimed at protecting consumers from high healthcare costs. This is the same State of California that recently raised all healthcare workers' minimum wage to $25 per hour (up from $15.50).  For our health system, that results in a $30 million annual cost increase and a 7.5% increase in our salary costs. This is also the same state that passed an unfunded mandate that requires our system to spend about $1 billion to replace a hospital building that they feel is at risk from damage in an earthquake. And it’s also the same state that increased the cap on medical malpractice lawsuits…and has authorized utility companies to raise their rates 15% per year.  So, with all of these unfunded requirements and policies that dramatically increase providers' costs beyond their control, how exactly does the state suggest that we limit our expense growth to 3% per year?  Healthcare cost inflation has already been running at more than 5% before any of these new requirements took effect. Perhaps if California wants to get serious about reducing the cost of healthcare they might look at the managed care plans. The most recent data I could find from the California Health Care Foundation indicates that California managed care companies made $222 billion in 2020. What direct value did these companies provide to the health of our communities? Meanwhile, hospitals and physicians are providing direct patient care and struggling to survive- especially systems like Kaweah Health that serve a high percentage of Medi-Cal (Medicaid) and Medicare patients.  On a side note, the governor did sign a new managed care organization tax into law this year, which was promised to increase Medi-Cal reimbursements to providers, but all signs suggest that he now intends to use those proceeds (nearly $7 billion) to fill holes in his budget's general fund deficit and will not be providing Medi-Cal rate increases. I would humbly suggest that if the state is genuinely concerned about its residents' cost of living, they might look at the state income tax (highest in the country), its gas prices (highest in the country), the essentially unaffordable housing costs, or countless other factors that will have a larger impact on individuals' pockets than beating up healthcare providers with laws that don't make any sense. #hospitals #california #healthcare

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T.E.A.M. has the potential to be very positive. Blending acute care and post-acute care into 1 bundled payment will ensure accountability in a very high risk part of the care continuum. Since the hospital is controlling the post-acute spending for 30 days, SNF use will drop dramatically in favor of home health at half the cost. It's great to see Medicare CMMI drive innovation with programs like TEAM, GUIDE, PACE, ACO Reach and many others. Good reasons for patients to stop enrolling in Medicare Advantage and keep their traditional Medicare.

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Can payers and providers really be friends? @BenGrabski and @JohnFryer share their perspectives on collaborative value-based care in this new podcast episode from @Lumeris! In this podcast interview, we explore challenges and opportunities in the Medicare Advantage landscape, highlighting the importance of collaborative payer relationships, consumer-centric innovations, and care delivery transformation. Ben and John share valuable insights on leveraging AI, navigating strategic inflection points, and building a win-win model to empower health systems and providers in achieving value-based care. Here are just some of the key takeaways from the discussion: 1. At Lumeris, our North Star is always to improve patient outcomes and provider experience. This will allow us to sustain (and thrive) through multiple market cycles. 2. Many in our industry (our competitors) see changes in risk adjustment as an existential crisis. And they should in those businesses because value-based care isn’t just about coding. 3. We must empower our partners with people, process, and technology (using just technology to solve problems will never be successful). 4. Systems can no longer continue to afford to build new assets and or keep up with their existing physical plant and property within the reimbursement environment that exists today. 5. Building win-win payer-provider relationships is key to success in VBC.

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Let's keep hospice focused first and foremost on the PATIENT. After all, we only get one chance to do it right... "There are six primary trends that are influencing consolidation and professional practices: regulatory complexity. technology and integration, private equity ownership. demographics, economies of scale and consumer expectations,” Henderson said. “So many of these things that we see that are influencing health care consolidation need to be pointing toward the patient." #patientsfirst #hospicecare #youonlygetoneshot https://lnkd.in/gbbgV-YF

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COTA, Baptist Health South Florida, and PreciseDx Announce Collaboration on the AI-Enabled Breast Cancer Recurrence Risk Assessment, PreciseBreast™ NEW YORK--Today, COTA, PreciseDx and Baptist Health South Florida announced a collaboration to assess and validate the performance of the artificial intelligence (AI) -enabled PreciseBreast™ (PDxBr) test that predicts the likelihood of invasive breast cancer (IBC) recurrence. “AI has the potential to augment human learning and improve the accuracy and precision of cancer diagnostics and treatments,” said C. K. Wang, M.D., chief medical officer, COTA. “It is critical that we evaluate these tools against the current standard of care to validate their efficacy and build trust in AI and new technologies.” As long-term collaborators, COTA and Baptist Health South Florida will analyze the performance of PreciseDx’s clinical risk tool using curated real-world data. They will compare the results of PreciseBreast™ to traditional pathology reviews and to 21-gene assay results to validate its performance. If the validation study is successful, Baptist Health South Florida will offer this AI-enabled testing to patients with IBC with the goal of expanding access to innovations in cancer care. Additional benefits include access to results in 48 hours and an 80% reduction in cost. Current pathology practices are manual and often subjective. The PreciseBreast™ test is designed to improve clinical decision-making with AI-derived insights that give physicians and patients a clear understanding of the risk of recurring IBC. “AI has allowed us to take a giant leap forward in the accuracy, affordability and accessibility of tools to better understand and treat breast cancer,” said Gerardo Fernandez, M.D., co-founder and chief scientific officer of PreciseDx. “Access to COTA’s best-in-class, real-world data that provides comprehensive insights into the cancer journeys of diverse patient populations will power more advanced and accurate AI learnings.” "This collaboration underscores our commitment to advancing cancer diagnostics with the latest AI-driven solutions,” said Manmeet Ahluwalia, MD, MBA, FASCO, deputy director, Fernandez Family Foundation Endowed Chair in Cancer Research, chief of medical oncology, and chief scientific officer of Miami Cancer Institute, part of Baptist Health South Florida. “By combining state-of-the-art technology with real-world evidence, we are working to not only enhance our diagnostic precision but also improve accessibility that may ultimately empower both patients and physicians with timely, actionable insights.” #realworlddata #rwd #oncologyresearch #breastcancer #healthcareai

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Transform your hospital's financial health with Coker! A critical access hospital achieved a $9.4M turnaround in just 15 months using these strategies: • Redesigning the chargemaster • Enhancing revenue cycle performance • Negotiating better payer contracts Combine these with Coker’s interim CFO leadership, self-funded benefit plans, and improved billing practices to reduce denial rates, increase clean claim rates, and manage finances effectively. Let's thrive together! #HealthcareFinance #HospitalManagement #CokerSolutions

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