VillageMD Working Smarter

In this episode we explore the new CMS framework for health equity. Health equity as a regulatory mandate is a new concept. We’ve long had some related requirements including a) ADA physical environment rules, b) ant-discrimination and c) language assistance. But until now, we have not seen a regulatory focus on health equity. Join us for this episode with Cris Lopez, VillageMD Vice President of Diversity, Equity & Inclusion, and Gary Jacobs, Executive Director of VillageMD Center for Public...

The tide may be turning on medical malpractice trends and I think we should explain what this means. Primary care physicians have historically not had high rates of malpractice claims, but we see this trend changing. Not to worry, however, because Kelley Smits, the Director of Risk Management at VillageMD, discusses how to prevent these problems with VillageMD’s National Medical Director Dr. Torontow. In Part 1 we will discuss the data that’s coming out on these trends, where to find it, and...

We’re back with Kelley Smits and Dr. Torontow with part 2 of Medical Malpractice Trends! If you haven’t heard part one, we highly encourage you to check out that episode first. In this episode we will be looking at some case studies on malpractice trends, lessons we can take away from these studies, and best practices on how to avoid becoming a part of a medical malpractice lawsuit in your practice. VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that...

In recent years, we have heard more attention being focused on the social factors that complicate health and medical care. One of these factors is access to transportation, which has long been an issue in Medicare coverage. In this episode, We are joined by Andrea Osborne, VMD Senior VP of Delegated Services to discuss the complicated rules for non-emergency ambulance transportation. Andrea shares with us some recent changes that may have an impact on patients and some guidance for the...

The cost of prescription drugs can take a significant toll on patients and impact their drug adherence and overall health. Primary care providers, historically, have been unable to do much to help patients manage this problem, but recent regulatory changes are adding price transparency which may help. Experts Michael Adelberg and VillageMD’s very own Adam Chesler discuss the details of new transparency initiatives for both Medicare Advantage and commercial drugs and predict the potential...

“That’s not my job”. This was a common refrain in healthcare when there was a clear separation between staff who treated patients and others who were responsible for billing. But as healthcare evolves further into value based care, the gap between billing rules and clinical care requirements is converging. In this first episode of 2022, we invite Megan Harkins to talk about the slow creeping convergence of billing and clinical rules and the impact this has on the various skills needed by the...

We have surveyed topics you wanted to hear more about, and overwhelmingly our listeners said "telemedicine." In the first half of this week's episode, we are joined by Megan Harkins, one of our VillageMD experts to discuss telemedicine requirements and how they have changed as a result of COVID-19. During the second half, we sat down with those working on the front lines of telemedicine, Dr. Karen Wetherell, one of our VillageMD physicians and Stacy Gabrysz, a VillageMD Regional Practice...

Surprise! In this episode, we are sharing the key features of the new federal Surprise Billing Rules. In general, a “surprise bill” happens when a patient isn’t given a choice of provider and receives an out-of-network charge. Some recent research have illuminated the scope of this problem, and were the catalyst for this new bill. The concepts are simple, but the rules are complex. The first phase became effective as of September 13, 2021. Tune in for the details! VillageMD's Working...

There are a number of rules that apply to offering free items or services to patients or waiving their copay. These rules were generally created to avoid over utilizationin a fee for service world. As we movetoward population health and value based payment, some of the rules have evolved to support the movement from volume to value in healthcare. Tune in to this week's episode as we dive into what you can do, what you should avoid, and the reason behind these regulations. We are joined by...

If you work in healthcare, you probably hear about a number of laws, rules, and cases that apply to the work we do. We all feel like we should know what this means, but this can get confusing (even for lawyers!) Tune in this week for a quick primer about the sources of healthcare law, the reasons some things are proposed before final, and what to do when state and federal laws conflict! VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that are never...

Back by popular demand! We know that the Direct Contracting program continues to change and adapt, including a new abbreviation: GDPC. We brought back our VillageMD expert on the Direct Contracting program, Lucy Sola, to walk us through these changes. This is helpful information for any provider or healthcare group who is thinking about participating in this new CMS program. Thank you to all of our loyal listeners, or as we call them, Smarties! If you enjoy the podcast, we want your help in...

Medicare Advantage Enforcement is a focus area for the OIG this year. The OIG has already released four audits so far this year, and we have learned that the OIG audit can amount to a no good, very bad day for these Payors. In general, these audits provide insight into areas of OIG focus including: a) acute care codes b) codes that are diagnosed but not treated including or c) codes that are otherwise not supported by the record. We did the hard work to sort through these audits. Tune in for...

Simply stated, attribution is the process to assign patients to providers in a population health environment. But the process is far more complicated and varies widely in different settings. Luckily we have two experts at VillageMD that can help explain what this means and how attribution works. Our guests this week include Steve Valdiserri, VillageMD's VP of Value Attribution and Mason Budelier, VillageMD's Associate General Counsel. This episode is a must listen for the primary care...

Data, data, data! The data revolution has (finally) come to healthcare! Filing cabinets and paper charts are signs of a bygone era. We’re thrilled to welcome Modern Healthcare's Michael Brady to share his insights on the effectiveness and impact of Big Data initiatives, including price transparency. Thank you to all of our loyal listeners, or as we call them, Smarties! Send us a picture of you listening to sharon@villagemd.com, and you will be entered for a chance to win Working Smarter...

Join us this week as we dive into the Landscape of Healthcare Enforcement in 2021 with two very special guests. I am thrilled to welcome Linda Wawzenski, Deputy Chief of the Civil Division of the U.S. Attorney's Office, and Lisa Noller, former Assistant U.S. Attorney in Chicago and current Chair of the Government Enforcement Defense Investigations at Foley & Lardner, LLP. Linda primarily supervises civil fraud work especially healthcare fraud. I asked Linda and Lisa about what to expect...

If you're confused about the various CMS Quality Programs and their corresponding ratings, you are not alone! On this episode, we decided to ask an expert: Joanna Losier, Director of Quality at VillageMD. Joanna shares the 2021 quality payment criteria for physicians and ACOs, and explains how these work with the Medicare Advantage Plan quality programs. This is an essential guide to any physician practicing in primary care! Thank you to all of our loyal listeners, or as we call them,...

We are honored to be joined this week by Dr. Ezekiel Emanuel for a discussion around the evolving healthcare policy landscape. On this episode, he shares his experience to help craft the Affordable Care Act (ACA), how it has changed over time, and what to expect in the next few years. Join us as Dr. Emanuel predicts healthcare priorities under the Biden administration, gets candid on his regrets during the Obama administration, and relays his conversations with Trump about stalling the ACA...

Heads up! A new rule effective January 2021 takes hospital price transparency to the next level! If enforced, it will open up a new source on hospital charges, and will shed light on some of the most closely held pricing information in healthcare. In this episode, we give a summary of what you can expect to see over the next 1-3 years. We also used our best detective skills to see how some hospitals are adapting to these rules. Thank you to all of our loyal listeners, or as we call them,...

On this episode of Around the Village, we are highlighting an intern from our VillageMD internship program. Zach Hattig is currently an pre-med undergraduate student at Northwestern University. During his time with VillageMD, he concentrated on a research project with our clinical team. He was identified as an exceptional intern through the program, we are talking with him about his experience, and what he learned throughout his time with us. If you are interested in future VillageMD...

If you think Usain Bolt is fast, you should see how fast the federal government (especially CMS) have been pushing out regulatory changes! Our team has been keeping up with this “Regulatory Sprint", and we condensed the most significant changes into a manageable summary. In this episode, we provide you a recap of these changes, and discuss what we are expecting to see from the new Biden administration. If you liked this summary, stay tuned for our deep dive episodes that we will be releasing...