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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