Risk Adjustment

Technology Revisited

As we round out season two of The Business of Primary Care, hosts Dr. Hart and Katila Farley, RN, take a bird's-eye view of some of the technological advancements discussed throughout the season that improve patient care. This episode explores tools like ambient dictation, AI chatbots, and remote patient monitoring, focusing on how these tools support high-quality, value-based care while also lessening the burden on physicians and other healthcare providers. They also discuss the “appropriate application of relationship and technology” and how to strike a balance between hands-on care and technology. In this episode, we’re joined by: Bobbi Weber, Vice President Product Marketing and Customer Success, QliqSOFT You can connect with them here [https://www.linkedin.com/in/bobbiweber/]. Vijay Verma, Vice President of Product Strategy at Televox You can connect with them here. [https://www.linkedin.com/in/vijayverma75/]  Eve Cunningham, MD, GVP, Chief of Virtual Care and Digital Health at Providence You can connect with them here [https://www.linkedin.com/in/evecunninghammd/]. Episode topics: 3:17 - Tech Tools: Ambient Dictation 11:13 - Tech Tools: Facial Vital Signs Technology 14:14 - Tech Tools: Conversational Chatbots in Healthcare 16:51 - Closing Care Gaps 21:46 - Bi-Directional Communication 33:52 - Remote Therapeutic Monitoring (RTM) 35:33 - AI Tools for Care Management 39:55 - MedPearl:  Digital Assistant for Clinicians 46:28 - Bingley: AI-Guided Triage Tool 48:02 - Nimble: Fall Prevention and Bladder Control 50:34 - Virtual Care and Remote Patient Monitoring Resources mentioned in this episode: Abridge - https://www.abridge.com/ [https://www.abridge.com/] Augmedix - https://augmedix.com/ [https://augmedix.com/] Nuance - https://nuance.com/ [https://nuance.com/] Upvio - https://upvio.com/ [https://upvio.com/] FaceHeart - https://hcs.faceheart.com/ [https://hcs.faceheart.com/] Advanced Health Intelligence - https://www.ahi.tech/ [https://www.ahi.tech/] QliqSOFT - https://www.qliqsoft.com/ [https://www.qliqsoft.com/] TeleVox - https://televox.com/ [https://televox.com/] Logicall - https://www.logicallhealth.com/ [https://www.logicallhealth.com/] MedPearl - https://medpearl.com/ [https://medpearl.com/]         Bingli - https://www.bingli.us/en-us/ [https://www.bingli.us/en-us/] Nymbl - https://nymblscience.com/ [https://nymblscience.com/] Learn more: ⁠Ask A Question⁠ [https://www.thebusinessofprimarycare.com/ask-us]  ⁠VBC Commonly Used Terms⁠ [https://www.thebusinessofprimarycare.com/articles/vbc-introduction-commonly-used-terms] ⁠VBC Drivers [https://www.thebusinessofprimarycare.com/articles/vbc-drivers-pt-1]

Risk Adjustment

“ … When you set up processes like this, it makes you not have to worry about the coding—you worry about just practicing good medicine.” In this episode, hosts Dr. Hart and Katila Farley, RN, CMOM, are diving into HCC (Hierarchical Condition Category) and RAF (Risk Adjustment Factor) coding—crucial value-based healthcare components. Joined by expert guests, they discuss the intricacies and importance of coding practices in documenting a patient's disease burden and how this documentation doesn’t just factor into reimbursement but plays a vital role in improving patient outcomes. They also explore how accurate coding can free up physician bandwidth for more direct patient care. Dr. Hart and Katila also touch on the recent changes in HCC coding and the crucial role of comprehensive education for physicians. In this episode, we’re joined by: Sara Faust, BSN, RN, CPC, CRC, Senior Clinical Analystat Blue Cross Blue Shield of Alabama You can connect with her here. [https://www.linkedin.com/in/sara-foust-bsn-rn-cpc-crc-41baa577/] Justin Williford, BSN, RN, PMP, CPC, CRC, CCM, Senior Clinical Consultant at Blue Cross and Blue Shield of Alabama You can connect with him here [https://www.linkedin.com/in/justin-williford-rn/]. Samuel “Le” Church, MD, MPH, CPC, CRC, FAAFP  Connect with him here. [https://www.linkedin.com/in/samuel-le-church-md-mph-cpc-crc-faafp-05758013/] Joseph Hafner, Upperline Health Connect with him here [https://www.linkedin.com/in/joseph-hafner-880547184/]. Episode topics: 02:11 - Intro to HCC Coding 05:08 - Accurate Documentation 10:11 - Challenges and Common Errors in HCC Coding 14:49 - Workflow Tips and Practical Advice 33:52 - Importance of Comprehensive Documentation 34:56 - Introduction to SNOMED and ICD Codes 36:07 - Leveraging Technology and Teamwork 39:10 - Team-Based Documentation Benefits 43:20 - Challenges and Opportunities with AI in Healthcare 48:04 - Version Changes in HCC Coding 53:33 Educating Physicians on HCC Coding Learn more: ⁠Ask A Question⁠ [https://www.thebusinessofprimarycare.com/ask-us]  ⁠VBC Commonly Used Terms⁠ [https://www.thebusinessofprimarycare.com/articles/vbc-introduction-commonly-used-terms] ⁠VBC Drivers [https://www.thebusinessofprimarycare.com/articles/vbc-drivers-pt-1]

SDOH Pt. 2

In part two of this series, Dr. Hart and Katila Farley, RN-CMOM, explore the significance of Social Drivers of Health (SDOH) and their impact on patient outcomes, highlighting the challenges of identifying and addressing social risks in healthcare.  We’re joined by industry experts to discuss implementing precision care that incorporates SDOH assessments into practice. We cover various aspects of SDOH, including health equity, data collection challenges, and technological solutions for improving patient care by addressing social needs such as health literacy, nutrition, and housing. Today’s discussion ultimately underscores the necessity of addressing social determinants to improve patient well-being. Have a question about VBC? Ask us a question for Dr. Hart & Katila Farley RN to answer on BoPC here. [https://businessofprimarycare.com/ask-us] In this episode, we’re joined by: Craig Worland, Chief Operating Officer at Southeast Primary Care Partners.  You can connect with him here. [https://www.linkedin.com/in/craig-worland/] Robert Millette, Senior Vice President, Prospect Medical Systems You can connect with him here. [https://www.linkedin.com/in/rmillette/] Olufunke Sokan (PharmD MPharm BCACP), Advanced Practice Pharmacist, University of Maryland  You can connect with her here. [https://www.linkedin.com/in/olufunke-sokan-pharmd-mpharm-bcacp-83202431/] Brian Buckley, Director, Health Equity Initiatives NCQA You can connect with him here. [https://www.linkedin.com/in/bobuckley/] Episode topics: 01:03 - The Importance of SDOH 05:27 - Real-World Examples of Addressing SDOH 19:32 - Integrating Behavioral Health into Primary Care 21:11 - Addressing Social Risk 28:34 - Closing Thoughts on SDOH and Upcoming Topics Learn more: ⁠Ask A Question⁠ [https://www.thebusinessofprimarycare.com/ask-us]  ⁠VBC Commonly Used Terms⁠ [https://www.thebusinessofprimarycare.com/articles/vbc-introduction-commonly-used-terms] ⁠VBC Drivers [https://www.thebusinessofprimarycare.com/articles/vbc-drivers-pt-1]

SDOH Pt. 1

Social determinants of health (SDOH) are “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” In part one of our series breaking down the impact of SDOH on patient outcomes, we’re reinforcing the importance of identifying, assessing, and addressing social risks that affect patient well-being.  In part one of this series diving into the importance and implementation of SDOH, hosts Dr. Hart and Katila Farley, RN, and their guests cover various challenges in tracking SDOH within patient populations. They also share expert insights on implementing strategies to tackle these social risks. Discussions with guests explore the roles of health equity and the potential of technology in capturing and addressing SDOH effectively to aid in whole-person, value-based care. In this episode, we’re joined by: Natasha VanWright, Senior Vice President of Clinical Operations, Belong Health You can connect with her here. [https://www.linkedin.com/in/natasha-vanwright/] Brian Buckley, Director, Health Equity Initiatives NCQA You can connect with him here. [https://www.linkedin.com/in/bobuckley/] Dr. Neechi Mosha, Senior Vice President of Growth, Clarify Health Solutions You can connect with him here. [https://www.linkedin.com/in/neechi/] Bobbi Weber, Vice President Product Marketing and Customer Success, QliqueSoft You can connect with her here. [https://www.linkedin.com/in/bobbiweber/] Jordan Holland, Vice President, Value-Based Contracting, Compassus You can connect with him here. [https://www.linkedin.com/in/jordan-holland-/] Episode topics: 00:45 - Social Determinants on Health 04:12 - Addressing Social Risks, Equity, and Whole Person Care 10:29 - The Role of Health Literacy and Community Resources 18:37 - Leveraging Technology to Address Social Determinants 35:45 - The Power of Home Health in Understanding Social Needs Learn more: ⁠Ask A Question⁠ [https://www.thebusinessofprimarycare.com/ask-us]  ⁠VBC Commonly Used Terms⁠ [https://www.thebusinessofprimarycare.com/articles/vbc-introduction-commonly-used-terms] ⁠VBC Drivers [https://www.thebusinessofprimarycare.com/articles/vbc-drivers-pt-1]

Infrastructure and Experience

Physician burnout and patient satisfaction go hand in hand, but many providers and staff hesitate to implement new technology and workflows. In today’s discussion, our hosts, Dr. Hart and Katila Farley, RN, sit down with experts across the healthcare field to discuss solutions for building high-quality care infrastructure that results in exceptional patient experience —all while mitigating provider burnout. Our guests and industry leaders share their insights on building long-term relationships, utilizing telehealth services, the value of community engagement, and leveraging technology for more efficient patient care. Have a question about VBC? Ask us a question for Dr. Hart & Katila Farley RN to answer on BoPC here. [https://businessofprimarycare.com/ask-us] In this episode, we’re joined by: Rick Merill, Co-Founder and President, Arrowhealth You can connect with him here. [https://www.linkedin.com/in/rick-mirell-7823b428?miniProfileUrn=urn%3Ali%3Afs_miniPro[%E2%80%A6]Ad_flagship3_search_srp_all%3B%2BB6Dxb4mQvuruXtYI39g3Q%3D%3D] Jamie Ulmer, CEO, Healthcare Network Learn more about him here. [https://healthcareswfl.org/about/leadership/] Lisa Soroka, founding member of The Marblehead Group, LLC You can connect with her here. [https://www.linkedin.com/in/lisa-soroka-92931916/] Jordan Holland, Vice President, Value-Based Contracting, Compassus You can connect with him here. [https://www.linkedin.com/in/jordan-holland-/] Wren Keber, Managing Director, Huron Consulting Group You can connect with him here. [https://www.linkedin.com/in/wkeber/] Sean Mehra, Healthtap You can connect with him here. [https://www.linkedin.com/in/seanmehra/] Michelle McCormick, Millennium Physicians Group You can connect with her here. [https://www.linkedin.com/in/michelle-jacobs-mccormick-746a858/] Episode Topics: 01:01 - Patient Experience and Infrastructure 04:00 - The Importance of Patient Experience in Value-Based Care 04:47 - Physician-Patient Relationships 6:14 - Exploring the Impact of Infrastructure on Healthcare Delivery 18:57 - Enhancing Patient Care with Technology and Infrastructure  22:51 - Building Relationships and Trust in Healthcare 28:12 - Beyond the Clinic Walls 39:16 - Engagement and Adherence 56:04 - Improving Healthcare Delivery Learn more: ⁠Ask A Question⁠ [https://www.thebusinessofprimarycare.com/ask-us]  ⁠VBC Commonly Used Terms⁠ [https://www.thebusinessofprimarycare.com/articles/vbc-introduction-commonly-used-terms] ⁠VBC Drivers [https://www.thebusinessofprimarycare.com/articles/vbc-drivers-pt-1]