Joe Russell, Vice President of Network Management and Contracting at Strategic Healthcare shares his invaluable perspective on how community-based providers can thrive despite the dominance of managed care plans and the ever-present issues of fraud, waste, and abuse.

Our conversation uncovers the influence of pivotal regulatory shifts, such as the Affordable Care Act and CMS initiatives, on managed care. We navigate the delicate balance between cost containment and quality care, addressing critical challenges like authorization limits and the impact of timely payments on providers.

As we look to the horizon, our dialogue transitions into the evolving dynamics of provider-payer relationships, where data-driven quality metrics take center stage. The burgeoning landscape of managed Medicare Advantage plans demands a new level of collaboration between payers and providers, with an emphasis on trust and innovative cost-containment solutions.

We explore the significance of aligning with metrics like star ratings and rehospitalization rates to enhance opportunities and reimbursement. Value-based care in post-acute settings is poised for growth, and providers must lead the charge by understanding their costs and crafting compelling value propositions for managed care plans.

Join us as we chart the course for the future of healthcare, where collaboration and strategic partnerships will redefine success.

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Unlock the strategies that can transform your approach to healthcare communication! Join Jennifer Kennedy, CHAP's lead for compliance and quality, and Pat Driscoll, a professor in healthcare administration and chair of CHAP's board, as they reveal how to effectively communicate value and quality in today's fiercely competitive healthcare landscape. This episode is packed with actionable insights on overcoming the challenges faced by post-acute care providers, ensuring continuity of care, and fostering proactive collaboration between hospital systems and community-based providers.

Discover how to elevate your post-acute care value by engaging with key decision-makers early and designing robust programs for managing chronic diseases and high-acuity patients. Pat Driscoll offers expert advice on becoming indispensable partners in the continuum of care, emphasizing the importance of delivering on promises and embracing value-based care models. The episode concludes with a compelling discussion on fostering dynamic partnerships and integrating learnings back into your organization for continuous quality improvement. Don't miss this opportunity to elevate your healthcare practice and improve patient outcomes through effective communication and collaboration.

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How have federal regulatory changes reshaped the role of hospice medical directors from mere formalities to key players in patient care and organizational leadership? Join Jennifer Kennedy and our esteemed guest, Dr. Daniel Maison, as we unpack the historical "three S's" and explore the significant transformations driven by CMS regulations. You'll gain valuable insights into the evolving responsibilities of hospice medical directors, highlighting their integral contributions to both operational and clinical aspects within hospice organizations.

Tune in to discover practical strategies for engaging medical directors in leadership roles and optimizing interdisciplinary group (IDG) meetings. Dr. Maison shares his expert advice on creating a collaborative environment that values physicians' contributions, prevents burnout, and fosters continuous education. Learn how to leverage physicians' expertise for educational opportunities and involve them in decision-making processes to enhance patient care and drive organizational growth. This episode promises a comprehensive look at the enhanced recognition and vital role of hospice medical directors in today's healthcare landscape.

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Join us as we dissect the top 10 hospice deficiencies for 2023 with Keri Culhane, CHAP's Clinical Nurse Educator. Expect to learn about the intricacies of individualized care plans, the critical nature of accurate medication profiles, and the emerging challenges of standard precautions and timely bereavement assessments. We don’t just highlight problems; we also provide actionable strategies to enhance compliance and elevate patient care quality every single day. We also discuss the pivotal role of initial bereavement assessments and an interdisciplinary approach, even when patients opt out of certain disciplines among other essential items. Tune in to find out.

Click below for:

1. Upcoming Accreditation Intensives
2. PDF of the Top 10 Hospice Deficiencies for 2023
3. CHAPcast: Home Health Top 10

Be sure to listen for details on our upcoming micro-learning sessions dedicated to individualized care plan development, designed to help you meet and exceed CHAP standards.

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Join us for an insightful episode as we dissect the top 10 home health deficiencies for 2023 with CHAP's esteemed Clinical Nurse Educator, Keri Culhane. With decades of expertise in post-acute healthcare, Keri sheds light on persistent issues and emerging trends in care planning, emphasizing the critical elements of the plan of care and the necessity for individualized care plans. Understand why "cookie cutter" approaches often driven by electronic medical records (EMRs) are falling short and discover new deficiencies around maintaining complete records and conducting timely initial assessments. Keri also offers practical strategies like using SMART goals and customizing EMR processes to enhance compliance and improve care quality. Our conversation also covers critical infection control practices, with an emphasis on hand hygiene and bag technique during field visits among other essential information. Listen to find out.

Click below for:

1. Upcoming Accreditation Intensives
2. PDF of the Top 10 Home Health Deficiencies for 2023
3. CHAPcast: Hospice Top 10

Be sure to listen for details on our upcoming micro-learning sessions dedicated to individualized care plan development, designed to help you meet and exceed CHAP standards.

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Ever wondered why patients miss their medication schedules despite clear instructions? Our enlightening conversation with Dr. Kate Jones reveals the critical shift from simply labeling patients as "non-compliant" to understanding the complexities behind "patient adherence." Discover how patient-centered care and shared decision-making can transform healthcare outcomes and why addressing social determinants of health (SDOH) is paramount for effective and realistic care plans.

Through a real-world case involving medication refills, we underscore the importance of thorough patient questioning. You'll hear how a nurse's persistence uncovered the true reasons behind missed refills and how practical solutions like pharmacy delivery services or mail-order options can prevent hospital readmissions. This segment highlights the value of taking extra time to identify and solve underlying issues, ultimately improving patient care.

Communication is the cornerstone of healthcare, and in our final segment, we discuss strategies to enhance patient interactions. Learn how using phrases like "tell me more" can foster a non-punitive, supportive environment and explore organizational techniques to encourage a culture of empathy and understanding. We also touch on the upcoming health equity standards from CHAP, emphasizing the need for continuous advancement in quality care. Join us for a thought-provoking episode that advocates for a more holistic and empathetic approach to healthcare.

Guide for Reducing Disparities in Readmissions
How Using the Term "Non-Compliant" Keeps Providers From Partnering With Patients

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As a nurse, witnessing the pervasive disparities in healthcare access was a profound wake-up call. Our conversation with Marisette Hassan takes us on a journey through the challenges and aspirations of achieving health equity, a mission that has never been more critical than in the shadow of the COVID-19 pandemic. When systems fail to serve everyone equally, the consequences are dire, and our discussion underlines the urgency of this issue. With Marisette's insights on the CMS health equity framework, we unpack the layers of this complex issue, from the importance of data collection to the necessity of culturally tailored services.

• CMS Framework
• TEP Report

With the pandemic spotlighting the stark inequities impacting Black and Brown communities, the episode with Marisette Hassan navigates the intricate paths of the CMS framework designed to bridge these alarming gaps. As we dissect the five priorities of this framework, it becomes clear that understanding and addressing the social determinants of health goes beyond mere demographics. It's a call to action for inclusive imagery, language accessibility, and a healthcare system that welcomes diversity in all forms, including provision for those with disabilities and hearing challenges. This comprehensive strategy reflects a commitment to not just heal but to include, resonating deeply with us as healthcare professionals seeking to serve all communities effectively.

Our final reflections circle back to the role of leadership in championing health equity. Sharing the excitement of developing CHAP's health equity standards, we highlight the incremental steps taken towards this monumental goal. Acknowledging Marisette's invaluable contributions, we invite our listeners to become part of a movement towards a healthcare landscape that's not only quality-driven but also equitable. Join us as we explore the nuances of health equity and take away insights that will empower you to partake in the transformation of healthcare into a system that truly caters to everyone.

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Take a first look at the Fiscal Year 2025 Hospice Wage Index Rule with the unparalleled insights of industry authorities Katie Wehri (NAHC) and Patrick Harrison (NHPCO). Our conversation slices through the complexity to deliver a focused commentary on what this proposed rule signifies for hospice care providers, highlighting the rule's unexpected early release and the notable absence of anticipated program integrity proposals. We delve into the ramifications of the missing measures and the adaptability required in the wake of this development. The advent of the HOPE assessment tool is scrutinized as it transitions from a patient-centric assessment to a pivotal data collection asset, with an eye on the nuances of its rollout.

The hospice community stands at the precipice of change with the Medicare Advantage hospice component sunset within the VBID model by CMS. We dissect the repercussions of this pivot from earlier value-based system inclinations and emphasize the balance between cautious optimism and the realities of the evolving healthcare system. The episode also honors the dedication of hospice workers amid workforce tribulations and increased CMS scrutiny, championing a dual focus on patient care and compliance. We invite our listeners to deepen their engagement with this critical dialogue by leveraging resources such as NHPCO and NAHC, and by partaking in informative webinars that illuminate the path ahead. Your involvement and feedback are the heartbeat of our community, and we're thankful for every clinician's commitment to excellence in hospice care.

Upcoming Events:

1. NHPCO's Focusing on Opportunities and Challenges on the Front Lines - click here to register

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