Tue, 16 May 2017
MediStrategy with Kip Piper Episode 11: Improving Prenatal Care and Birth Outcomes Via Mobile Technology: Interview with Juan Pablo Segura of Babyscripts Summary What if we could eliminate preterm birth by 2027? There’s an app for that. That is the moonshot goal of Babyscripts, a new model in pregnancy management that seeks to improve prenatal care and birth outcomes by supporting both pregnant moms and their physicians. The app has been adopted by several of the nation’s top health systems, including MedStar Health, George Washington University Medical Faculty Associates, Northwestern Medicine, UT Physicians, and Aurora Health. A graduate of Notre Dame’s Mendoza College of Business, Juan Pablo Segura is the Co-founder and President of Babyscripts, the only doctor-delivered digital health tool that employs remote monitoring and big data to detect problems sooner. The innovative Babyscripts technology has been recognized by Startup Health as a ‘Healthcare Transformer’ and by CTIA as a ‘Wireless Lifechanger.’ The venture was also a member of the inaugural GE Consumer Healthcare program. Segura is a sought-after speaker on the future of digital health and consumer empowerment in the healthcare space; he has given presentations at mHealth, HIMSS, WEGO Health, Health Datapalooza, and Health 2.0. Today Segura discusses how the Babyscripts mobile app can improve birth outcomes, more rapidly detect at-risk pregnancies, facilitate patient-doctor communication between office visits, improve patient satisfaction, increase reimbursement for obstetricians, and lower overall healthcare costs. Listen and learn how the Babyscripts team has ‘labored’ to create and test a groundbreaking, evidence-based mobile app available only through obstetricians. Subscribe in iTunes | Stitcher | SoundCloud | Libsyn | RSS Feed Topics Covered [2:25] The nuts and bolts of Babyscripts
[4:38] How the Babyscripts app works for doctors and moms
[8:25] Segura’s motivation to focus on prenatal care
[13:35] How Babyscripts is distinct from other pregnancy apps
[21:18] How Babyscripts functions
[28:16] The process of validating the ROI story
[39:30] Why treating obstetrical care like a commodity does not produce optimal results
[44:52 ] The traction Babyscripts is gaining with health plans, state Medicaid programs, and leading health systems
[58:39] Segura’s best advice for entrepreneurs in the healthcare tech space
Connect with Juan Pablo Segura of Babyscripts Connect with Kip Piper, Host of MediStrategy About MediStrategy and Kip Piper The MediStrategy podcast offers informative interviews with healthcare leaders and insights on hot business and policy issues in Medicare, Medicaid, and health reform. Health executives, policymakers, entrepreneurs, authors, and other influencers share challenges and opportunities in America’s rapidly changing $3.2 trillion health care system. MediStrategy is hosted by Kip Piper, a top expert on Medicaid, Medicare, and health reform. A prominent consultant, speaker, and author, Kip Piper advises health plans, state Medicaid agencies, hospitals and health systems, provider associations, life sciences companies, and investment firms. Subscribe in iTunes | Stitcher | SoundCloud | Libsyn | RSS Feed
Direct download: MediStrategy_with_Kip_Piper__Ep_11_-_Juan_Pablo_Segura_Babyscripts.mp3
Category:Science and Medicine -- posted at: 4:01am EDT |
Tue, 16 May 2017
MediStrategy with Kip Piper Episode 10: Value-Based Purchasing with Healthcare Consultant Nancy Kohler of Sellers Dorsey Summary Savvy consumers seek the best value for their money, evaluating the benefits of a product prior to purchase. Elsewhere in the economy, it seems obvious that we should hold a manufacturer accountable for delivering a quality product. With health care reform, this concept has at last been applied to medical care via the value-based purchasing model. Rather than simply paying fee-for-service which rewards volume, health care consumers, health plans, and purchasers - state Medicaid programs, federal Medicare program, and employers - can hold providers responsible for outcomes. As a consultant with Sellers Dorsey, Nancy Kohler provides assistance in federal and state health policy issues, financial analysis, and project management. Before joining the firm, she played a key role in the implementation and operational aspects of the Statewide Quality Care Assessment for the Pennsylvania Department of Human Services. The initiative provided millions of dollars in revenue to the Commonwealth's many hospitals and modernized Pennsylvania Medicaid hospital reimbursement. Ms. Kohler's comprehensive portfolio of experience includes both large and small scale public health program operations, policy development and fiscal analysis. She spent 20-plus years at KePRO, dedicating the last six years of her tenure as the vice president of public programs. Nancy Kohler has her master’s degree in Health Services Administration and is a Registered Health Information Administrator and Certified Professional in Healthcare Quality. In this episode, she outlines the core characteristics of the value-based purchasing model, the challenges faced by Medicaid in transitioning to value-based purchasing, and the federal and state collaboration key to further reform efforts. Well-versed in how current legislative proposals might affect value-based purchasing, Kohler explores Congress' efforts to repeal and replace the ACA, the fate of MACRA, and HHA Secretary Price’s advocacy for relief from administrative burdens. Subscribe in iTunes | Stitcher | SoundCloud | Libsyn | RSS Feed Topics Covered [2:48] How Kohler got involved in value-based purchasing
[6:47] Goals of value-based purchasing model
[7:36] Core characteristics of value-based purchasing
[11:01] Challenges faced by Medicaid in transition to value-based purchasing
[14:08] The role of the state with respect to value-based purchasing
[20:38] The role of federal collaboration in furthering state level reforms in payment and care delivery
[27:03] Kohler’s work to further value-based purchasing initiatives
[30:37] How proposed legislation to repeal and replace the ACA may affect value-based purchasing
[35:54] The pace of value-based purchasing initiatives
[42:27] The shift of risk to providers
[44:56] How the Medicare Access and CHIP Reauthorization Act (MACRA) fits within payment reform
Connect with Nancy Kohler and Sellers Dorsey Connect with Kip Piper, MA, FACHE, Host of MediStrategy About MediStrategy and Kip Piper The MediStrategy podcast offers informative interviews with healthcare leaders and insights on hot business and policy issues in Medicare, Medicaid, and health reform. Health executives, policymakers, entrepreneurs, authors, and other influencers share challenges and opportunities in America’s rapidly changing $3.2 trillion health care system. MediStrategy is hosted by Kip Piper, a top expert on Medicaid, Medicare, and health reform. A prominent consultant, speaker, and author, Kip Piper advises health plans, state Medicaid agencies, hospitals and health systems, provider associations, life sciences companies, and investment firms. Subscribe in iTunes | Stitcher | SoundCloud | Libsyn | RSS Feed
Direct download: MediStrategy_with_Kip_Piper__Ep_10_-_Nancy_Kohler_Value_Based_Purchasing.mp3
Category:Science and Medicine -- posted at: 3:27am EDT |
Thu, 11 May 2017
MediStrategy with Kip Piper Episode 09: Fighting Healthcare Fraud and Ensuring Medicaid Program Integrity: Interview with Bill Lucia, Chairman and CEO, HMS Summary “Fighting health care fraud is like playing Whac-A-Mole.” Our nation’s $3.2 trillion healthcare system is a complex beast. To ensure its integrity, we must combat a range of issues – from unintentional errors to criminal activity. Today’s guest is an industry leader in leveraging data analytics and the benefit of a national perspective to identify bad actors and ensure that Medicaid is the ‘payer of last resort.’ Bill Lucia is Chairman and CEO of HMS Holdings, the nation’s largest and most successful company dedicated to providing the broadest range of healthcare cost containment solutions to help purchasers, plans, and at-risk providers improve performance. HMS works with 45 state Medicaid programs, 250 health plans, Medicare, large employers, and provider organizations to help contain costs and protect our nation’s healthcare system from fraud, waste, and abuse. Lucia joined HMS in 1996, becoming chairman, president, and CEO in 2009. He is responsible for leading HMS through the evolving healthcare landscape, demonstrating the ability to formulate and implement key strategic initiatives. Subscribe in iTunes | Stitcher | SoundCloud | Libsyn | RSS Feed Topics Covered The mission of ensuring the integrity of nation’s healthcare system by reducing costs and removing fraud, waste, and abuse. The complex nature of the Medicaid system:
How HMS works to ensure program integrity in Medicaid:
How technology, know-how, and analytics are used to:
How pattern recognition is used to detect inaccuracies and fraud in claims:
The significant return on investment from HMS program integrity work:
How to make the case for preventative measures (vs. recovery dollars):
How HMS has built the industry standard with regard to coordination of benefits:
How to leverage advanced analytics:
HMS policy recommendations to Congress and States:
Connect with Bill Lucia and HMS Resources Mentioned HMS Report: Effective Cost Management for Medicaid Connect with Kip Piper, Host of MediStrategy About MediStrategy: The MediStrategy podcast offers informative interviews with healthcare leaders and insights on hot business and policy issues in Medicare, Medicaid, and health reform. Health executives, policymakers, entrepreneurs, authors, and other influencers share challenges and opportunities in America’s rapidly changing $3.2 trillion health care system. MediStrategy is hosted by Kip Piper, a top expert on Medicaid, Medicare, and health reform. A prominent consultant, speaker, and author, Kip Piper advises health plans, state Medicaid agencies, hospitals and health systems, provider associations, life sciences companies, and investment firms. Subscribe in iTunes | Stitcher | SoundCloud | Libsyn | RSS Feed
Direct download: MediStrategy_with_Kip_Piper__Ep_09_-_Bill_Lucia_HMS.mp3
Category:general -- posted at: 4:25pm EDT |