The #HCBiz Show!

The #HCBiz Show!

A practical podcast on the business of healthcare w/ hosts Don Lee and Shahid Shah. The premise behind #HCBiz is that we can't "just innovate". Sure, you may have a great idea, an all-star team and execute flawlessly, but if you don't understand the complex dynamics of the healthcare business you'll never get traction. We'll identify the issues that impede change, explain why they exist and find ways to work with them, through them, or around them. In short, we'll help you create space for innovation in healthcare through technology (HealthIT | HIT | Digital Health) and workflow. We'll also explore health policy, administration and the psychology behind it all. Finally, we help you align your ideas to business incentives, market them to healthcare leaders and get the sale. Check out all of our podcasts, videos and blog posts here: http://thehcbiz.com/ Produced by Glide Health IT LLC in partnership with Netspective Media.... Show More

Episodes

February 26, 2021 50 min

As of 2015 the Office of the National Coordinator for Health IT had awarded $548 million in grants to states to establish health information exchanges (HIE). I have no doubt hundreds of millions of dollars more have been invested in various ways since then. So, when faced with one of the most daunting healthcare data challenges of our time in the COVID-19 vaccine rollout, surely, we turned to the HIEs first. Right? Not so much, acc...

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CMS Direct Contracting is coming fast, is very nuanced, and full of grey. In a nutshell, 50% of Medicare patients are in Medicare Advantage (i.e., value-based care) and 50% are still Medicare fee-for-service (FFS). Direct Contracting is CMS’ bold play to quickly move many of the remaining Medicare fee-for-service (FFS) patients into value-based care.

If you’re a doctor who takes care of Medicare fee-for-service (FFS) patients, th...

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The pandemic has exposed many weaknesses in our healthcare and public health systems, and our disjointed public health data infrastructure is certainly one of them. Like much of our healthcare data, public health data tends to be manually compiled, Excel-reliant, and lacking in critical detail needed to make good decisions. Today we talk with Prashant Natarajan, VP of Healthcare Life Sciences and Health Insurance at H2O.ai about re...

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The pandemic has had a tremendous impact on the business of healthcare.  With states canceling elective procedures and people deferring care for fear of being exposed to the virus, hospital and medical practice revenue is down. On the flip side, many health plans are sitting on a mountain of premiums that aren’t being spent because of this deferred care, possibly leading to rebates in some cases and a ton of uncertainty in pretty m...

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The CMS Patient Access Rules are coming. And they’re easy to cheer for. We’re giving patients their data and that’s a huge win! We all love that!

But what we don’t love is when FraudulentHealthcareApp.com collects patient data and sells it to the highest bidder to support targeted marketing, or whatever other nefarious act they can come up with. Well, the health plans don’t get to pick and choose which apps they connect to. What if...

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This podcast features the Selling to Health Plans panel discussion at the Digital Health Growth Summit, moderated by our very own Shahid Shah, with panelists Vijay Bhatt, Deputy CTO, Harvard Pilgrim Health Care, and Bill Friedman, Vice President of Sales, Zipari.

The panel covers some of the most important digital health technologies that health plans are interested in and how digital health startups can get health plan executives ...

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The business of healthcare is consensus-driven and permissions-based. As we’ve seen time and again on this show, this culture slows innovation, stretches sales cycles, and inspires institution-first thinking. Ultimately, it’s responsible for the high costs and lousy user-experiences we’re all trying to fix.

What if healthcare went from a culture of consensus and permission to one of openness and experimentation? That’s what we’re g...

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Many digital health startups rely on sales prospecting to generate new leads. That works to a point but doesn’t scale because each deal takes a long time, and good healthcare salespeople are hard to find. Today we’re talking with Bryan Loomis, a Digital Health Growth expert and mentor, about how to design, build and execute a growth plan that generates leads in a more sustainable way.

 

We discuss:

 

  • Bryan’s PAGE Methodology (Purpo...
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    Get ready for a cold dose of reality. On this episode, we’re talking with Neil Carpenter, VP of Strategic Planning at Array Advisors and former health system Chief Strategy Officer, about how health systems think. This behind the scenes look at health system strategy, decision-making, and purchasing tells you much of what you need to know as a startup/vendor trying to sell into this market. You won’t like everything you learn, but ...

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    For many healthcare startups and established vendors, partnering with payers is a crucial part of their business plan. And as we know, selling in healthcare is hard. It’s even harder when you don’t understand how these large corporations work. What do they want? How do they set priorities? How do they make purchasing decisions? How long does that process take? The list goes on, and if you’re strategizing without this knowledge you’...

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    There’s a lot of talk about addressing physician burnout, but little practical advice about what to do. The path to action lies first in understanding the many sources of burnout, and then separating them into those that we can impact, and those we cannot.

    There’s a class of burnout factors that are intrinsic to being a physician. Simply put, it’s a hard job, and it's demanding in both a physical and mental sense. But this i...

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    Many private organizations have stepped up to provide support as we deal with the pandemic. Surescripts, for their part, repurposed clinical direct messaging infrastructure to help health systems communicate critical information from the frontlines to federal agencies. It’s a great story of a private organization rapidly transitioning to fill a need.

    What we’d like to explore, and what we think you will most benefit from hearing, i...

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    It may seem cliché to say payers need to be more like Amazon, but the analogy provides fundamental, and surprisingly actionable insights for the health insurance industry.

    Think about your experience with Amazon (or Google or Zappos, or any other organization that provides a phenomenal customer experience). Whether they're helping you find the right product, or streamlining the purchase, or dealing with a delivery problem, or a...

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    On this episode, we discuss the HealthIMPACT Fall Forum coming up September 30th – October 2nd, 2020. Shahid Shah, our co-host and the HealthIMPACT Forum Chair, tells us it’s a “No BS and No PowerPoint” event that’s intended to be more of a conversation than a series of presentations. The goal is to get healthcare leaders together and facilitate a conversation amongst peers about the work they’re doing in the real world.

    We also ta...

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    On this episode we talk with Dr. Vivian Lee about her new book, The Long Fix: Solving America’s Health Care Crisis with Strategies that Work for Everyone. Dr. Lee offers a fresh perspective that will strengthen your understanding of the issues facing America’s healthcare system. And while she acknowledges that our government must play a substantial role in driving systemic change, she points out how each of us as individuals, clini...

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    Patient Centricity is a buzzword that’s easy to throw around, but difficult to realize. The notion itself is straightforward… build your product or service around the patient who it is intended to help. Talk with them. Incorporate their input. Understand their needs, desires, and goals. It’s so straight-forward that today’s guest tells us this is no “ah-ha” moment for healthcare, but more of an “ah-duh”.

    Why do other industries do ...

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    Payers already face a formidable challenge when it comes to internal data management. After years of consolidation in the industry, many payers have a collection of legacy systems cobbled together to run their operations. This makes data management difficult for things like claims, provider directories, and member demographics. And those are just “the basics”.

    Now, as quality measurement evolves and payers experiment in value-based...

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    In a growing crowd of national health information networks, eHealth Exchange is one of the oldest and most connected in the U.S.. Notably, they are the primary way healthcare organizations connect with federal agencies such as the Social Security Administration (SSA), Department of Defense (DOD), and the Department of Veterans Affairs (VA). In addition, they're connected with 75% of all U.S. hospitals, more than 60 regional and...

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    Everything you’re trying to accomplish comes down to one thing… getting people to do stuff. Behavioral economics, in its simplest terms, is the study of how and why people decide to do what they do (or don’t do). Whether you’re trying to sell, get users to adopt a new system or workflow, or make your staff feel comfortable coming back to work during a pandemic, understanding behavioral economics will greatly increase your chances o...

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    Public health vs. the economy is a dangerously false dichotomy. We can protect our people AND get back to work if we accept reality and embrace science. You already know you should wear a mask, wash your hands, and practice social distancing. As we begin to go back to work and spend time with our extended families and friends, Remote Patient Monitoring (RPM) tools present an additional layer of protection that could allow us to do ...

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