Prateek Jain (CDCS,CAIIB)’s Post

Here's a litmus test to determine value creation in healthcare: If the lives of patients, physicians, providers, and staff are not improved by what you're doing, it's not Value-based Care. A dear friend sent me an article from the 10/8/2023 edition of the Economist - "Who Profits Most From America's Baffling Healthcare System?". (I wasn't able to post a link in here.) It described the consolidations across healthcare and how Big Health and Big Money were gaining more and more control of the industry, often times under the guise of Value-based Care. Using the same machine and only changing the label on it doesn't make it different. If docs are still cogs and patients are still widgets, the outcomes will remain poor. The bastardization of value-based care will continue to ruin healthcare delivery in the US just as effectively as our conventional fee-for-service model has. Enjoy your Thursday!

Is this how you make healthcare better, more equitable, and more affordable? Becker's Healthcare emailed me to register for $2000-$6000 to attend this meeting and hear speakers like the former Super Bowl MVP and 43rd President. Now I know that they are good speakers. And I also know that they get $100,000 to $200,000 per speech. And there are several more. So this is one big expensive meeting. But is this part of the $4 trillion annual US healthcare spend? You can be sure it is expensed by the healthcare systems. Just wondering when this madness will all end; or are we in an endless loop of burgeoning expenses and marginally valuable activities? Just asking.

The Hassle of Prior Authorization: A Call to Streamline Healthcare As healthcare professionals, we've all been there: stuck in the cycle of prior authorization requirements by commercial healthcare payors. The paperwork, the phone calls, the delays... it's a hassle that takes us away from what we do best: caring for our patients. THE PROBLEM - Prior authorization requirements are intended to ensure that patients receive necessary and appropriate care. But in practice, they often lead to: - Delays in treatment - Increased administrative burden - Frustration for patients and providers alike THE IMPACT - The consequences of prior authorization hassles are real: - Patients may experience delayed or foregone care, leading to poorer health outcomes - Providers face increased administrative costs and decreased time for patient care - The healthcare system as a whole suffers from inefficiency and waste SHARE YOUR EXPERIENCE Have you dealt with prior authorization headaches? How have you navigated the process? Share your stories, tips, and suggestions in the comments below. Let's shed light on the challenges and explore ways to make healthcare work better for everyone. #ADVENTKNOWS #PriorAuthorization #HealthcareChallenges #HealthcareProfessionals #PatientCare

In the complex landscape of healthcare, the intersection between patient care and administrative processes often presents significant challenges. My recent discussion with The New York Times shed light on a critical aspect of this intersection: the prior authorization process. This mechanism, intended to regulate healthcare costs and ensure appropriate treatment, frequently acts as a bottleneck, delaying necessary medical interventions and placing additional stress on patients and healthcare providers alike. The reality is that while prior authorization aims to serve as a checkpoint for cost control and care appropriateness, it can inadvertently prioritize paperwork over patient well-being. These delays can lead to exacerbated health conditions, increased hospitalization rates, and a higher overall cost to the healthcare system—outcomes that are the antithesis of the process's original goals. As a physician, I witness the direct impact of these delays on my patients. The time spent navigating these administrative hurdles is time taken away from patient care. It's imperative that we advocate for a reevaluation of the prior authorization process, focusing on strategies that streamline administrative procedures without compromising the quality of care. We must champion reforms that prioritize the health and well-being of patients. This includes advocating for transparency in the criteria used for authorizations, expediting approvals for routine and non-controversial treatments, and ensuring that healthcare professionals are at the forefront of decision-making processes regarding patient care. The path forward should be a collaborative effort among healthcare providers, insurers, and policymakers to devise a system that upholds the principles of timely, effective, and patient-centered care. Let's come together to advocate for a healthcare system that values patients over paperwork, ensuring that every individual has access to the care they need when they need it. #HealthcareReform #PatientCare #PriorAuthorization #MedicalEthics #HealthPolicy #FixTheSystem #FixThePriorAuth --- Thank you The New York Times for covering this important topic. https://lnkd.in/e4BvatM7 ETA: here is the YouTube link in case you are unable to access through NYT https://lnkd.in/e8ZKhnd9

According to a recent Gallup survey, only a small percentage of Americans know the actual cost of healthcare services. Surprisingly, many people are unaware of the expenses associated with medical treatments, procedures, and prescriptions. Understanding healthcare costs is crucial for making informed decisions about our health and finances. It empowers us to compare prices, explore alternative options, and advocate for transparency within the healthcare system. By educating ourselves and others about healthcare expenses, we can work towards creating a more affordable and equitable healthcare system for all. #Inoventive

Paul Mango, former HHS Deputy Chief of Staff for Policy, delves into the healthcare industry highlights of the first quarter of 2024. He shares his observations and advises Healthcare insurers on significant shifts in the Healthcare value chain, challenges, and promising opportunities. Click to read this insightful piece. #CXMatters #HealthcareStrategy #HealthcareTransformation #HealthcareTrends #WhitePaper

Who Needs To File With OHCA Under California’s New Healthcare Transaction Regulations? Who do the California Office of Healthcare Affordability's cost and market impact review regulations apply to? That depends on three questions, according to a recent webinar. http://ow.ly/fOVi105gwOT

Revenue Growth Spotlight 💡 Unlocking Revenue Potential in Healthcare 💰 Learn how HealthVue's tailored strategies have consistently increased revenues for medical centers by 26-55%. Our commitment to financial health ensures a thriving future for healthcare providers. Review: https://g.co/kgs/o4bLKFN #HealthcareFinance #RevenueGrowth #FinancialSuccess

𝗪𝗲𝗱𝗻𝗲𝘀𝗱𝗮𝘆 𝗪𝗶𝘀𝗱𝗼𝗺 - 𝗔𝗱𝘃𝗮𝗻𝗰𝗲 𝗖𝗮𝗿𝗲 𝗣𝗹𝗮𝗻𝗻𝗶𝗻𝗴 (𝗔𝗖𝗣) 𝗘𝗱𝗶𝘁𝗶𝗼𝗻 🌟 Myth: "If I fill out an advance directive, I immediately lose control over my healthcare decisions." FACT: An advance directive is only in effect when you are no longer able to make your own decisions. Navigating healthcare decisions can be daunting. Amidst the complexity, myths often swirl, creating unnecessary confusion and anxiety. One revolves around the misconception that completing an advance directive relinquishes immediate control over one's healthcare choices. Let's debunk this myth and shed light on the facts. 🛑 Myth Debunked: Filling out an advance directive does not strip you of control over your healthcare decisions. Instead, it serves as a tool to ensure your wishes are respected and upheld when you are unable to express them yourself. 🤔 Clarifying Misconceptions: Contrary to popular belief, completing an advance directive empowers you to maintain control over your healthcare decisions. By clearly expressing your preferences in advance, you retain autonomy and ensure that your values guide your care, even when you cannot actively participate in the decision-making process. 💪 Empowerment Through Planning: Far from relinquishing control, ACP empowers individuals to proactively shape their healthcare journey. It enables you to assert your autonomy and make informed decisions that reflect your unique beliefs and priorities. Filling out an advance directive is not about surrendering control; it's about asserting your autonomy and ensuring that your voice is heard, even in challenging circumstances. Embrace the power of advanced care planning to navigate your healthcare journey with clarity, dignity, and peace of mind. Let's dispel the myths, embrace informed decision-making, and advocate for our right to control our healthcare choices every step of the way. 💬💖 https://lnkd.in/geE7Gp4h #AdvanceCarePlanning #MythBusting

Strategies for Revenue Cycle Success in the Healthcare Industry