Episode 128: Unlocking Healthcare Payer Data | How DataRise is Changing the Game
Coffee with Coker
Discover how Coker’s DataRise platform is transforming healthcare strategy through powerful data-driven insights. In this episode of Coffee with Coker, Mark Reiboldt interviews Nick Newsad, VP of Innovation at Coker, to explore how DataRise is helping hospitals, health systems, and physician groups make smarter business decisions. DataRise offers unmatched access to: Commercial reimbursement rates across every U.S. market Physician and medical director compensation benchmarks Malpractice premium data, Form 990 records, and more From contract negotiations to fair market value justification...
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Digital Pioneers: Digital Transformation
Coffee with Coker
In this episode of Digital Pioneers, host Michael O'Toole explores how digital transformation is reshaping healthcare by addressing one of its most persistent challenges: improving patient experience in real time. Joining the conversation is Bryan Graven, Executive Director and CIO of Waterbury Health and Eastern Connecticut Health Network. Bryan shares how his health systems implemented an innovative text-based patient feedback system to proactively address concerns before discharge—enhancing satisfaction, boosting star ratings, and improving Press Ganey scores. Key takeaways: How...
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Digital Pioneers: Transforming Healthcare with Virtual Nursing
Coffee with Coker
Welcome to the first episode of Digital Pioneers, a healthcare podcast series presented by Coker, where we explore groundbreaking technological innovations reshaping the healthcare landscape. In this episode, host Michael O'Toole dives into the transformative world of Virtual Nursing with special guests Stacey McGriff and Grant Reed from Piedmont Healthcare. Discover how Piedmont Healthcare implemented a virtual nursing program across its 23-hospital network in just over a year, addressing critical challenges like staffing shortages and improving patient and nurse satisfaction. Key...
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Episode 125: How to Lead IT Transformations in Community Health
Coffee with Coker
In this episode of Coffee with Coker, Gabriel Harry, Vice President at Coker, and Tim Harper, Senior Manager at Coker, sit down with Gary Noseworthy, CEO of Community Health Access Network (CHAN), for an in-depth conversation about CHAN's efforts to modernize health information technology in community health centers. They dive into the collaborative projects they've worked on, reflecting on both the obstacles and successes they've encountered. The discussion covers key topics such as vendor selection strategies, the critical role of strategic partnerships, and the importance of individual...
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Episode 124: How is artificial intelligence revolutionizing the healthcare sector?
Coffee with Coker
In this episode of Coffee with Coker, Mark Reiboldt, EVP at Coker, and Vinson Do discuss the impactful role of AI in the business side of healthcare. They delve into how AI is transforming claims processing, medical coding, and healthcare reimbursement. The conversation highlights real-world examples, such as the AI implementation at Community Medical Centers of Fresno and Mass General Brigham, which have shown significant improvements in reducing denials and enhancing coding accuracy. Ethical considerations and future prospects for AI in healthcare are also examined. 00:25 The Role of AI in...
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Episode 123: Decoding Modifier 25: Navigating Documentation and Billing in Healthcare
Coffee with Coker
This episode of Coffee with Coker delves into the complex and nuanced topic of Modifier 25, a coding nuance critical for healthcare professionals to understand for billing and documentation. Hosts Erika and Jaci unpack the definition, significance, and proper application of Modifier 25, emphasizing its opinion-based nature and the importance of clear, detailed documentation. They provide examples from healthcare scenarios, including preventive visits, urgent care, and procedures like cerumen removal, discussing the implications for billing and compliance. The conversation highlights how...
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Episode 122: Understanding Annual Wellness Visits for Healthcare Organizations
Coffee with Coker
In this episode, the discussion focuses on annual wellness visits, IPPE, and their implications for healthcare organizations. The conversation covers the requirements, coding, documentation, and common audit findings related to annual wellness visits. The speakers emphasize the importance of proper documentation, the use of resources, and a team approach to ensure compliance and successful reimbursement. · Jaci Kipreos and Erika Fisch discuss annual wellness visits (00:18) · Medicare's yearly benefit...
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Episode 121: How Non-Provider Staffing Trends Affect Physician Enterprise Performance
Coffee with Coker
In this insightful podcast for leaders of physician enterprises, we delve into the dynamic landscape of staffing trends within the healthcare sector. The discussion kicks off with a comprehensive exploration of both physician and non-provider staffing trends, providing valuable insights into the evolving workforce dynamics. The conversation then navigates through the intricate factors that contribute to staff turnover, shedding light on the challenges faced by physician enterprises in retaining their crucial personnel. Episode Synopsis The podcast guides leaders in analyzing their...
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Episode 120: Using Generative AI to Streamline Patient Navigation and Communication with Converse Health
Coffee with Coker
Chris Torregosa interviews Louis Sallerson, the CEO of Converse Health, about their generative AI assistant for orthopedic surgery clinics. Podcast Information Follow our feed in , , , , or your preferred podcast provider. Like what you hear? Leave a review! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. · Please email us: · Connect...
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Episode 119: Navigating Patient Demand and Physician Shortages
Coffee with Coker
In this podcast episode, we delve into the critical topic of patient access and operational throughput. With growing demand for medical services and a looming physician shortage, it's essential to reframe patient access as a pivotal aspect of healthcare production, not merely patient satisfaction. Episode Synopsis Join us as we discuss current patient access challenges, highlight key focus areas for effective management, and explore the differentiation between patient access and operational throughput, emphasizing role clarity, optimizing staff utilization, and improving communication....
info_outlineBrandt Jewell and Taylor Cowart join Mark Reiboldt to discuss the latest news for site neutrality. Hospitals have historically benefited from the Outpatient Prospective Payment System (OPPS), the reimbursement mechanism for Hospital Outpatient Departments (HOPD) facility fees, in comparison to their private practice peers functioning under the Medicare Physician Fee Schedule.
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Episode Synopsis
The procedures performed in a freestanding clinic versus an HOPD received 75% less reimbursement. Hospitals were highly incentivized to acquire independent sites, switch the designation to HOPD and begin increasing their reimbursement for the same procedures. This strategy caused HOPD billings to effectively double over the last decade.
Both Medicare and its beneficiaries were under pressure to find a solution.
Between 2018 and 2020, the Centers for Medicare and Medicaid Services (CMS) updated the OPPS rate and proposed to phase in a 60 percent reduction over two years. They believe site neutral payments will give patients more options for their care.
Alternatively, hospitals predicted a massive loss under the site neutral payments into the millions for many organizations. The American Hospital Association (“AHA”), the Association of American Medical Colleges (“AAMC”) and various other private groups took up arms against CMS, arguing that hospitals should receive additional reimbursement as it is inherently more expensive to run HOPDs based on the standards they are required to uphold.
Extras
Another Blow for Hospitals: The Ongoing Battle of Site Neutral Payments
Bonus Episode: Three Key Objectives from the 2019 State of the Union Address