Coffee with Coker
As healthcare business consultants, we are committed to helping healthcare organizations and professionals navigate the healthcare industry. Our discussion will focus on current events in the healthcare industry and how leaders in healthcare organizations can effectively overcome challenges.
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Episode 128: Unlocking Healthcare Payer Data | How DataRise is Changing the Game
05/05/2025
Episode 128: Unlocking Healthcare Payer Data | How DataRise is Changing the Game
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 and new market expansion, DataRise delivers real-time, actionable intelligence that healthcare organizations can use to benchmark, plan, and grow. Whether you’re evaluating a joint venture, planning a new service line, or negotiating payer contracts, this is a game-changing tool designed to give you the upper hand. : https://datarise.cokergroup.com/?utm_source=youtube&utm_medium=podcast&utm_term=episode-128&utm_content=unlocking-healthcare-payer-data-how-datarise-is-changing-the-game &utm_campaign=performance-transformation
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Digital Pioneers: Digital Transformation
03/18/2025
Digital Pioneers: Digital Transformation
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 real-time patient feedback drives service recovery in hospitals The role of technology in bridging gaps between patients and healthcare providers Lessons from Waterbury Health’s successful implementation and adoption strategy If you're a healthcare leader looking for practical tech solutions to enhance patient care, this episode is packed with valuable insights. Don’t forget to subscribe for more conversations with trailblazers in digital healthcare innovation!
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Digital Pioneers: Transforming Healthcare with Virtual Nursing
03/11/2025
Digital Pioneers: Transforming Healthcare with Virtual Nursing
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 takeaways: · How virtual nursing supports bedside staff and enhances patient care. · Insights into Piedmont's rapid implementation and scaling process. · Real-world advice for healthcare leaders considering virtual nursing. Whether you're a healthcare leader, technology enthusiast, or just curious about the future of healthcare, this episode is packed with valuable insights. Don’t forget to subscribe for more episodes featuring trailblazers in digital healthcare innovation!
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Episode 125: How to Lead IT Transformations in Community Health
10/28/2024
Episode 125: How to Lead IT Transformations in Community Health
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 assessments for health centers. Gary also shares how CHAN's team has grown and evolved, offering insights into the transformative impact of their initiatives. He looks ahead to CHAN’s future, envisioning an expansion of participating health centers and exploring new business opportunities. 00:32 Background on Community Health Access Network (CHAN) 02:08 Vendor Vetting and Selection Process 09:48 Implementation and Unique Requirements 12:00 Project Success and Team Contributions 15:18 Challenges and Lessons Learned 29:47 Future Growth and Strategic Partnerships 34:38 Conclusion and Closing Remarks 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook:
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Episode 124: How is artificial intelligence revolutionizing the healthcare sector?
07/09/2024
Episode 124: How is artificial intelligence revolutionizing the healthcare sector?
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 Healthcare 00:53 Introducing Vinson Do and AI's Impact 01:51 Understanding Artificial Intelligence 04:43 AI in Claims Processing 11:37 AI in Medical Coding 16:32 AI in Healthcare Reimbursement 23:14 Ethical Considerations and Future Prospects 30:53 Conclusion and Final Thoughts 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook:
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Episode 123: Decoding Modifier 25: Navigating Documentation and Billing in Healthcare
04/30/2024
Episode 123: Decoding Modifier 25: Navigating Documentation and Billing in Healthcare
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 insurance companies' interpretations can vary, impacting the application of Modifier 25. Further, they explore the challenges healthcare providers face in ensuring their documentation supports the use of Modifier 25, pointing out common pitfalls and offering guidance on best practices. This discussion underscores the vital role of accurate coding and documentation in healthcare billing and the ongoing need for education and dialogue among practitioners. 00:32 Diving Deep into Modifier 25 01:49 Understanding the Definition and Application of Modifier 25 05:33 Exploring Real-World Scenarios and Challenges with Modifier 25 08:33 Navigating Documentation and Billing Challenges 15:04 Specific Cases and Auditing Insights 27:36 Concluding Thoughts and Future Topics 29:54 Engaging the Audience and Closing Remarks Links to other resources: AMA | Reporting CPT Modifier 25 ( Podcast covering Medicare Annual Wellness Visits ()
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Episode 122: Understanding Annual Wellness Visits for Healthcare Organizations
03/14/2024
Episode 122: Understanding Annual Wellness Visits for Healthcare Organizations
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 for beneficiaries called annual wellness visits (01:25) · Initial Preventative Physical Exam (IPPE) and annual wellness visits (02:32) · Difference between annual wellness visits and preventative physical exams (05:34) · Resources for understanding annual wellness visits (08:06) · Common audit findings for IPPE and annual wellness visits (14:16) · Handling patient refusal to answer questions during the visit (18:57) · Separate coding for additional services during the visit (22:58) · Screening EKG and its requirements (25:12) · Importance of a team approach to ensure proper documentation and billing (28:58) · Checking with your MAC for additional requirements or recommendations (32:52) · Next episode to cover the 25 modifier (34:55) Extras · (https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/preventive-services/medicare-wellness-visits.html) · (https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html) · (https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf) · (https://edhub.ama-assn.org/steps-forward/module/2757861) 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook:
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Episode 121: How Non-Provider Staffing Trends Affect Physician Enterprise Performance
01/16/2024
Episode 121: How Non-Provider Staffing Trends Affect Physician Enterprise Performance
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 physician enterprises with a data-driven approach, offering practical strategies to create staffing targets aligned with the unique characteristics of their practices. As the discussion progresses, listeners gain actionable solutions to common staffing challenges, including addressing salary increases in a declining market and handling healthcare turnover amidst current market conditions. The podcast also explores staff retention tactics and best practices essential for physician enterprise success. The latter part of the podcast delves into the impact of various technologies on staffing for physician enterprises, exploring the integration of AI and workforce automation. The discussion concludes by highlighting the crucial link between staffing, ROI, and the overall functionality of physician enterprises, providing valuable insights for leaders navigating the intricate landscape of healthcare management. · Physician and non-provider staffing trends (2:05) · Factors contributing to staff turnover (4:20) · How to analyze your physician enterprise using a data-driven approach (4:50) · How certain practice characteristics impact staffing levels (6:30) · Create staffing targets that make sense for your practice (7:22) · Solutions to staffing challenges (8:14) · Addressing salary increases in a declining market (8:30) · How to handle healthcare turnover in the current market (11:02) · Staff retention tactics (13:39) · Best practices for physician enterprise success (16:35) · Critical issues plaguing independent medical practices (20:12) · Embracing new trends and adjusting to patient expectations (21:30) · Other technologies affecting staffing for physician enterprises (23:45) · Addressing AI and workforce automation for your practice (25:00) · How staffing impacts the ROI and functionality of the physician enterprise (26:40) Extras · () · () · () 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook:
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Episode 120: Using Generative AI to Streamline Patient Navigation and Communication with Converse Health
12/07/2023
Episode 120: Using Generative AI to Streamline Patient Navigation and Communication with Converse Health
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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook: Episode Synopsis Throughout the interview, Louis shares his passion for the healthcare industry and dedication to improving medical practice operations using generative AI. The heart of their product is communication, and their goal is to streamline patient navigation and communication for orthopedic surgeons. Click to listen to the episode. Extras
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Episode 119: Navigating Patient Demand and Physician Shortages
11/02/2023
Episode 119: Navigating Patient Demand and Physician Shortages
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. The episode also delves into trends in patient access management, including the role of Advanced Practice Providers and the strategic integration of technology to enhance access. Patient access has never been more vital, as patient demand is projected to exceed provider supply. We offer practical strategies for healthcare organizations to excel in patient access and operational throughput. · Patient access and throughput in healthcare (0:11) · Patient access and physician shortages in U.S. healthcare (4:37) · Streamlining patient access and scheduling (9:20) · Patient access and appointment metrics (12:01) · Improving patient access and organizational performance (15:52) · Improving medical practice efficiency (20:15) · Improving patient access in healthcare (26:16) · Improving patient access and reducing no-shows (32:03) Extras · (https://cokergroup.com/overcoming-obstacles-with-performance-improvement-for-critical-access-hospitals/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-119-navigating-patient-demand-and-physician-shortages&utm_content=patient-access&utm_campaign=physician-services&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=solution) · (https://cokergroup.com/quantifying-patient-access-utilize-data-to-identify-improvement-opportunities-and-monitor-performance/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-119-navigating-patient-demand-and-physician-shortages&utm_content=patient-access&utm_campaign=physician-services&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=solution) 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook:
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Episode 118: How Provider Compensation Design Impacts Performance
09/21/2023
Episode 118: How Provider Compensation Design Impacts Performance
This episode delves into the complex world of compensation design within the healthcare industry, focusing on traditional hospital/employed provider models. We explore the common pain points experienced by clients of all types when incentivizing strategic goals. Episode Synopsis Join us as we discuss the various considerations hospitals and health systems face, including concerns about provider compensation spending and fair market value. We also examine incentive structures designed to foster growth and meet strategic objectives, all while ensuring that compensation plans remain competitive in the challenging recruitment landscape. But it's not just about the financial aspect. We'll also explore how compensation design can be a powerful tool, acting as a 'carrot' to drive productivity and achieve organizational goals. And when compensation design isn't enough, we'll delve into the other factors influencing low provider productivity. Tune in for an insightful conversation on the critical intersection of compensation design and healthcare strategy. · Aligning physician incentives with organizational goals (4:25) · Designing physician compensation models (8:54) · Analyzing audio transcript for insights (14:39) · Redesigning physician compensation models (19:48) · Designing and implementing fair and equitable compensation (26:30) · Physician compensation model design (33:37) · Provider compensation and performance improvement (37:15) Extras · (https://cokergroup.com/episode-111-the-intersection-of-provider-compensation-and-value-based-reimbursement/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=podcast&utm_marketing_tactic=awareness) · (https://cokergroup.com/case-study-provider-compensation-misalignment/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=case-study&utm_marketing_tactic=solution) · (https://cokergroup.com/compensation-best-practices-for-physician-enterprises/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=white-paper&utm_marketing_tactic=solution) · (https://cokergroup.com/compensation-methodology-best-practices-true-up-payments/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness) 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook:
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Episode 117: How to Be Successful with Revenue Cycle Management
08/17/2023
Episode 117: How to Be Successful with Revenue Cycle Management
The speakers will break down various areas they review when evaluating the revenue cycle and give examples of how they evaluated and helped clients achieve success around revenue cycle improvement. They will discuss some of the key pitfalls and areas where physician enterprises struggle, and offer advice, regardless of type and size, to consider as you optimize your revenue cycle processes and performance. Episode Synopsis In the context of revenue cycle management, it's essential to emphasize that the scope extends far beyond the billing office alone. The notion of "outsourcing the revenue cycle" often requires clarification, as it commonly refers to selectively outsourcing certain components, like billing or specific front-end operations. It's rare for an organization to entrust the entirety of its revenue cycle, spanning from initial patient intake and service provision to claims processing, payment reconciliation, collection endeavors, and comprehensive follow-up, to an external entity. This podcast episode delves into the intricacies of this comprehensive revenue cycle management process. · Opening Introduction (0:11) · Key pitfalls and areas to avoid when evaluating the revenue cycle (1:02) · The interaction between each functional area (6:05) · Why are we seeing more and more issues occur (9:28) · How to diagnose billing and billing issues (12:13) · Solutions and recommendations (18:37) · What do the leaders and managers think of the reports? (24:26) · Sustainability measures to help with implementation (27:40) · Using dashboard reporting for key performance indicators (33:16) · Question the status quo on revenue cycle management (38:07) Extras · · · 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook:
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Episode 116: Introducing Physician Enterprise Performance Improvement (PEPI)
07/20/2023
Episode 116: Introducing Physician Enterprise Performance Improvement (PEPI)
This series aims to help physicians and practice administrators enhance their financial and operational performance across various domains. Episode Synopsis In this podcast series designed for physicians and practice administrators, our speakers will provide a deep dive into the reasons behind this series. They will emphasize the significance of performance improvement in healthcare organizations and specifically focus on physician enterprise performance improvement. Listeners will gain insights into how organizations can effectively evaluate their performance in relation to expectations, goals, and targets. Building upon these fundamental concepts, our speakers will explore the creation of a framework for achieving high performance. They will discuss practical methods for developing a data-driven culture that permeates throughout the organization, from leadership to staff to providers. Throughout the series, we will cover a range of important domains, including revenue cycle management, operational efficiency, physician compensation, and quality outcomes. By addressing these crucial topics, we aim to provide physicians and practice administrators with valuable strategies and knowledge to enhance performance and drive success in their healthcare practices. Extras · · · 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook:
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Episode 115: How Does the Physician Compensation Roadmap Look
06/22/2023
Episode 115: How Does the Physician Compensation Roadmap Look
Alex Kirkland joins Mark Reiboldt to discuss the state of physician compensation and what the future may hold. Hospitals have competed for physician market share in the post-pandemic world, and the influx of private equity investment alongside rising costs has pushed the survey data approach of funding physician compensation models to unsustainable levels. Episode Synopsis Many external factors have impacted physician compensation over the past several years. The extensive list includes pandemic-era volume reductions, volatile survey data, Medicare Physician Fee Schedule changes, rising inflation, and the list goes on! If there is any constant, it is that change is inevitable. With so much uncertainty, how can healthcare systems possibly plan for the future in terms of a sound physician compensation strategy? The answer lies in understanding expected shifts in the physician workforce, and the need for a nimble compensation structure that can adapt to market forces. Extras · · · · 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook:
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Episode 114: An Abundance of Options: A Survey of Current Alignment Trends for Physician Enterprises
05/25/2023
Episode 114: An Abundance of Options: A Survey of Current Alignment Trends for Physician Enterprises
Justin Chamblee presented this webinar for the American Health Law Association. He analyzes the current state of the healthcare industry and take an objective look at options for physicians/physician enterprises, assessing some of the positives and drawbacks from each and what it may mean for the future. 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook: Episode Synopsis In the not-too-distant past, the majority of physicians were in private practice. Then, the market experienced a shift wherein a number of physicians chose to be hospital affiliated, with either private practice or hospital affiliation seemingly being the only options. In recent years, the market has shifted again. Private equity money has created options for physicians that have not existed in the past, entities like VillageMD and Privia Health are rapidly developing employment models providing additional options, and health systems are assessing the financial viability of maintaining their physician enterprises in the legacy state, looking for future potential alternatives. Learning Objectives Survey the evolution of alignment options for physicians/physician enterprises over the past several decades. Dive deep into the current market, looking at current alignment trends and the positives/drawbacks from each. Ponder what the current alignment options may mean for the future of the healthcare industry. Extras · · · · ·
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Episode 113: Clinical Co-Management Arrangements
03/09/2023
Episode 113: Clinical Co-Management Arrangements
Jana Sizemore joins Mark Reiboldt to discuss clinical co-management arrangements as an alternative alignment model for healthcare organizations and physician groups. Clinical co-management allows physician groups to align with hospitals and health systems without becoming employed or implementing a professional services agreement. 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook: Episode Synopsis Primarily used with surgical specialties, a hospital will partner with independent physician groups to support or grow the service line. While each situation is unique and different, Jana highlights why hospitals should consider a clinical co-management agreement, how they differ from other forms of alignment, and when to use the co-management structure. Retaining autonomy and independence is a big selling point for independent physician groups considering clinical co-management. The physicians can affect changes to the service line that would improve quality outcomes and patient care at the hospital by developing the service line and improving staff and patient satisfaction. Extras · · · ·
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Episode 112: Announcing the 2023 E/M Impact Calculator
02/23/2023
Episode 112: Announcing the 2023 E/M Impact Calculator
Jaci Kipreos, Alex Kirkland, and Matt Jensen join Mark Reiboldt to discuss the evaluation and management coding section changes and announce the update to our popular E/M Impact Calculator. What does your organization need to do to address these changes? 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 with us on LinkedIn: · Follow us on Twitter: · Follow us on Instagram: · Follow us on Facebook: Episode Synopsis Alex, Jaci, and Matt present what the road map looks like and what prompted CMS to give a directive. Outpatient changes started in 2021, and the inpatient changes were effective on January 1, 2023. Their advice is to treat 2023 as a preparation year, measuring high volume codes and conducting operational reviews by the provider to determine if the documentation will meet the new guidelines. These changes will also affect your compensation plans because there are material changes to the wRVUs. The impact calculator estimates the potential economic impact your organization may face with a partial listing of changing codes. Please note that the results of the calculations include the national Medicare reimbursement impact based on the volume input. As such, the calculation results are meant for planning purposes only and do not represent an estimation of value. For a more in-depth assessment of your providers’ payment calculations and how this may affect your commercial and other payers, please contact us to speak with one of our physician compensation experts. Extras · · · ·
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Episode 111: The Intersection of Provider Compensation and Value-Based Reimbursement
01/19/2023
Episode 111: The Intersection of Provider Compensation and Value-Based Reimbursement
Justin Chamblee joins Mark Reiboldt to discuss value-based reimbursement and provider compensation. He recently presented this topic at the MGMA conference with the goal of answering questions that naturally arise when considering the intersection of value-based reimbursement and provider compensation. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis Government programs initially led value-based reimbursement (VBR) initiatives, but commercial payers are making the shift. CMS proposes to expand access to ACOs, modernize coverage for behavioral health services, colon screening, and dental services. There are also new and exciting value-based care programs being announced outside of CMS. Justin and Mark look ahead at the value-based care initiatives on the horizon, and how these programs should intersect with provider compensation. Learning Objectives Further understanding of how value-based reimbursement is manifesting itself in the market Answer questions that naturally arise when considering the intersection of value-based reimbursement and provider compensation Equip attendees with practical steps to further align their provider compensation strategies with current reimbursement environment Extras
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Episode 110: How Upcoming Billing and Coding Changes Influence Healthcare Economics
12/01/2022
Episode 110: How Upcoming Billing and Coding Changes Influence Healthcare Economics
Beth Balcom, Brandt Jewell, Alex Kirkland, and Richard Romero presented this webinar for the American Health Law Association. Our team will cover upcoming billing and coding changes affecting healthcare organizations in three areas: coding and compliance, operations, and finance. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis Upcoming billing and coding changes will affect healthcare organizations in three areas: coding and compliance, operations, and finance. Our team will cover these areas as they discuss how billing changes will impact physician practice operations and economics, including provider compensation and fair market value considerations. Learning Objectives Understand the financial impact of critical changes within the Medicare Physician Fee Schedule proposed rule and what they may mean from a valuation perspective. Discuss the operational implications and considerations resulting from the Medicare Physician Fee Schedule proposed rule. Provide an overview of the expected coding changes and associated compliance considerations. We recommend you speak with your key stakeholders about performing three actions to prepare for the upcoming changes which go into effect on January 1, 2023: Develop a coding communication plan that considers tools and checklists to help front-line resources acclimate to the changes Audit current EHR scheduling templates to ensure they consider the changes Conduct a chart audit to verify the accuracy of coding and documentation If Coker Group can assist you with developing a plan or implementation for any of the above, please get in touch with us to schedule a free consultation to discuss the specific needs of your client(s) or organization. Book Your Free Consultation ---> Extras
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Episode 109: Is Your Advanced Practice Provider Compensation Strategy Successful?
10/13/2022
Episode 109: Is Your Advanced Practice Provider Compensation Strategy Successful?
Alex Kirkland and Matt Jensen join Mark Reiboldt to discuss the results of our inaugural advanced practice provider strategy and oversight survey. The survey contains insight from 60 organizations employing 3,067 advanced practice providers and represents 4,356 physicians and 28 states. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis Advanced Practice Providers (APPs) are at the forefront of healthcare delivery. They directly impact organizational goals, such as patient access, care coordination, care outcomes, and population health initiatives. A straightforward APP compensation framework that recognizes market rates, specialization, and experience is essential to an organization's success in retaining and growing its APPs. Aligning APP compensation models with physician compensation model structures promotes team cohesiveness and enables providers to maximize their unique value to meet strategic goals and objectives. Do you want to learn more about APP strategies and oversight? Listen to the episode and learn how APP strategies and oversight are changing. Extras
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Episode 108: What is the Precision Experience for Medical Professionals?
09/29/2022
Episode 108: What is the Precision Experience for Medical Professionals?
Jack Liu and Dr. Hamlet Benyamin join Mark Reiboldt to discuss the shift from a one size fits all approach to precision medicine which is individualized to each person. Dr. Benyamin defines precision experience as the unique experience a person needs as they enter the healthcare workforce. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis How do we assess the barriers and processes for the healthcare workforce so we can deliver better care for everyone? Covid-19 shed light on the healthcare delivery process, particularly within the patient and provider dynamic. Precision experience is essential to all aspects of the healthcare delivery process, from physicians and advanced practice providers to supporting staff. Healthcare can use the insights as a jumping-off point to leap forward and improve processes that have been problematic for years. An opportunity arises from a crisis to improve the system for the people it serves. Click to listen to the episode and learn more about the precision experience for healthcare. Extras
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Episode 107: How will Split/Shared Visits Change Between APPs and Physicians?
09/15/2022
Episode 107: How will Split/Shared Visits Change Between APPs and Physicians?
Alex Kirkland and Chris Marrs join Mark Reiboldt to discuss changes to the split or shared billing between advanced practice providers and physicians. Alex and Chris encourage healthcare organizations to understand these changes and update processes before the changes take effect in 2024. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis A split/shared visit, defined as “an E/M visit in a facility setting that is performed in part by a Physician and an NPP who are in the same group,” is billed based on which provider performed the “substantive portion” of the service. For non-critical care split/shared visits in 2022, a “substantive portion” is considered “all or some portion of the history, exam or medical decision-making key components of an E/M service.” However, for critical care visits in 2022 and all applicable visits beginning January 1, 2023, a “substantive portion” is more specifically defined as greater than 50% of the time spent on the encounter. If the physician spends more than 50% of the time with the patient, CMS will reimburse the visit at 100%. However, if the advanced practice provider spends more than 50% of the time with the patient, they will reimburse the visit at 85%. The provider attached to the service will also receive the wRVU credit for those professional services. Listen to the episode and learn how these changes could impact how your providers are reimbursed and compensated for their professional services. Extras
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Episode 106: Developing a Data-Driven Culture
09/01/2022
Episode 106: Developing a Data-Driven Culture
Brandt Jewell joins Mark Reiboldt to explain the management principles for developing a data-driven culture. Brandt walks through examples of utilizing data to manage staff and engage providers as leaders, mentors, and champions with common group-level objectives. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis Data validation is essential to gain buy-in and consensus from all stakeholders, particularly providers. Sharing data with providers and staff establishes consistent communication and dissemination of information. When developing a data-driven culture, you should: Simplify the data to focus on key metrics and actionable information Provide clear and actionable direction regarding how daily responsibilities of all roles can impact the metrics Communicate performance expectations to meet operational objectives Build realistic near and long-term goals Use consistent metrics across the group to avoid making exceptions A strategic direction coupled with a shared vision, aligned incentives, operational support, and peer accountability through data and communication will develop a high-performing culture. Extras
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Episode 105: Why do I need cyber liability insurance?
08/11/2022
Episode 105: Why do I need cyber liability insurance?
Jeffery Daigrepont interviews Dan Stewart, the president of Jackson Health Tech Advisors, one of our partners providing cybersecurity advisory services. Dan has been in the healthcare information technology and services industry for more than 30 years, with the last ten years focused on cybersecurity risk management and mitigation services. That includes a Cyber Liability Insurance Services program we will discuss today. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis The last two years have seen a new era of cyber-attacks with increased hacker sophistication, a propensity to pay in ransomware cases, and a geopolitical environment that has upended the cyber insurance market in general, particularly in healthcare. In 2020, healthcare-related cyber-attacks increased by more than 55%, of which ransomware attacks comprised 28% of the total. According to Cybersecurity Ventures, in 2021, the US healthcare system lost $21 billion caused by ransomware attacks alone. Covid-19 further exposed the weaknesses in healthcare cybersecurity systems as the industry was forced to institute or expand telehealth services and remote working functions rapidly. These factors caused significant losses for the insurance carriers that were providing cyber insurance resulting in several major market changes that are affecting healthcare providers. Extras
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Episode 104: Determining the Value of Non-Competes and Restrictive Covenants in Healthcare
07/28/2022
Episode 104: Determining the Value of Non-Competes and Restrictive Covenants in Healthcare
Richard Romero joins Mark Reiboldt to explore non-compete and other restrictive covenants in the healthcare industry. Richard explains the purpose and the value of these restrictive covenants. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis There are three types of restrictive covenants: non-compete agreements, non-solicitation agreements, and non-disclosure agreements. Depending on who you ask, these covenants can be a tool to protect the business or perceived as a way to limit a physician’s ability to choose their employer. No matter how they are perceived, if a restrictive covenant does not protect a legitimate business interest, it may be unenforceable. The law does not prohibit ordinary competition. Extras
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Episode 103: What is a Security Risk Analysis, and Why Do I Need One?
06/30/2022
Episode 103: What is a Security Risk Analysis, and Why Do I Need One?
DeAnn Tucker and Roz Cordini join Mark Reiboldt to explain the need for a security risk analysis within healthcare organizations. Many organizations are missing one critical component when performing a security risk analysis. Learn what elements organizations usually miss and how to conduct a security risk analysis properly. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis Did you know Health and Human Services requires an annual security risk analysis? If a breach of information occurs, OCR will request the last 2-3 years of security risk analyses to verify your organization has performed the analysis and taken steps to implement the remediation plan. Aside from the requirement, performing a security risk analysis also safeguards electronic protected health information (ePHI) by identifying potential vulnerabilities before a criminal exploits them. Click to listen to the episode. Extras
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Episode 102: How do you Align Provider Compensation with Health System Goals?
06/09/2022
Episode 102: How do you Align Provider Compensation with Health System Goals?
Alex Kirkland and Andy Sobczyk join Mark Reiboldt to explore a prevalent provider compensation trend. As health systems continue to acquire private practices, they also inherit differing compensation structures with each acquisition. Alex and Andy unpack the concept of provider compensation misalignment. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis Many healthcare provider practices lack an overarching provider compensation philosophy that aligns the health system's goals with the incentives for the providers. While there are many reasons this occurs, the solution is the same: develop a compensation philosophy for your organization to govern the compensation plans. Alex and Andy use a physician compensation scatterplot (see page 5 of the case study) to illustrate how a decentralized compensation approach contributes to misalignment and variability. Click to listen to the episode. Extras
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Episode 101: What are Cash Balance Plans?
05/19/2022
Episode 101: What are Cash Balance Plans?
Mark Massey, a vice president with the Southern Medical Association Services, Inc., joins Mark Reiboldt to explore the concept of cash balance plans for medical practices. Mark explains cash balance plans, who is a prospect for cash balance plans, and how they work. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis A Cash Balance plan is a type of retirement plan that allows business owners to contribute over $200,000 per year in many cases. Contribution limits are based on the age of the owner. The plan is entirely employer-funded, and the plan clearly defines the contribution/benefit formula for participants. A Cash Balance Plan takes advantage of a business expense that an owner can keep, deduct from profits, and let grow tax-deferred. Owners can fund a sizable portion of retirement savings using money they would have paid in taxes. Click to listen to the episode. Extras
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Episode 100: How Could Artificial Intelligence Improve the Patient Experience?
04/21/2022
Episode 100: How Could Artificial Intelligence Improve the Patient Experience?
Jeffery Daigrepont interviews Dr. Neil Baum, an early pioneer in the healthcare IT industry. They discuss patient care ethics and how artificial intelligence impacts the provider-patient dynamic. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis As healthcare technology has evolved, healthcare providers are spending less time focusing on the patient, and more time focusing on their computer or tablet screens. The rise of telemedicine has furthered that barrier, putting a screen between the provider and the patient and removing empathy from the patient visit. For this reason, Dr. Baum and Jeffery believe artificial intelligence will never replace the provider-patient interaction. A patient entrusts a healthcare provider with sensitive, personal information, and in turn, the provider connects with the patient, providing personalized care. In which instances do you think artificial intelligence could take over and improve the patient experience? Extras !
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Episode 99: How Have Hiring and HR Trends Influenced the Healthcare Industry?
03/25/2022
Episode 99: How Have Hiring and HR Trends Influenced the Healthcare Industry?
Lee Perrett and Richard Ballard join Mark to talk about the latest hiring and HR trends the pandemic inspired. They contemplate hybrid and remote workforces, workforce health, DEI initiatives, and the benefits of interim leadership. 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 with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Follow us on Facebook: Episode Synopsis Did you know 95% of HR leaders expect that at least some of their employees will work remotely after the pandemic? The shift to hybrid work will be a massive driver of transformation, and leaders must prepare to support it. Workforce health is a growing concern, especially in the healthcare field. Employees are leaving companies at an alarming rate for new opportunities that address their needs in the wake of the pandemic. How do you bridge the gap and attract suitable candidates? Click to listen to the episode. Extras
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