The FLATLINING Podcast from Fulcrum Strategies

On the FLATLINING Podcast from Fulcrum Strategies this week, Ron Howrigon and Matthew Handley discuss what sort of healthcare platforms Vice President Kamala Harris could advocate as the new Democratic nominee. They also discuss a recent interview Ron gave with New York Magazine on automatic insurance denials. -- Further reading: Where Kamala Harris Stands on Key Healthcare Issues - Medpage Today In Denial - New York Magazine -- Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

This week on the FLATLINING Podcast from Fulcrum Strategies, Matthew Handley and CEO Ron Howrigon discuss how the Supreme Court overturning Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc. could affect healthcare down the road. There is a possiblity that it could dictate how the Centers for Medicare and Medicaid Services detirmine Medicare reimbursement, whether or not the Food and Drug Administration can approve over the counter medications, and more. Matthew and Ron also discuss how this ruling could affect the No Surprises Act. -- Further reading: What Does the Overturning of Chevron Mean for Healthcare? - Holland and Knight How the Supreme Court has roiled U.S. health-care agencies - The Washington Post We break down the overturning of the Chevron doctrine - NPR -- Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

This week on the FLATLINING Podcast from Fulcrum Strategies, Matthew Handley and CEO Ron Howrigon have a conversation with universal healthcare advocate Wendell Potter. They discuss Wendell's decision to get out of the insurance business and become an advocate for affordable healthcare for all Americans. Wendell Potter was a VP level executive at Cigna before he left in 2008. He now advocates for universal healthcare and is the leader of two reform advocacy nonprofits: the Center for Health and Democracy and Business Leaders for Health Care Transformation. He is also a New York Times best-selling author and his most recent book is For Want of a Dentist: The Rise of the Dental Therapy Movement in Tribal Nations and the US. You can follow his work on his Substack: Health Care Un-covered. --- Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have ubscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn.--- Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

Next week on the FLATLINING Podcast from Fulcrum Strategies, Matthew Handley and Ron Howrigon talk to former Cigna executive Wendell Potter about the feasibility of universal healthcare in the United States. --- Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. Follow Matthew on X and LinkedIn.Follow Ron on LinkedIn. Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

This week on the FLATLINING Podcast from Fulcrum Strategies, Matthew Handley and CEO Ron Howrigon have a conversation with Gus Geraci, MD about the challenges of reforming healthcare. Dr. Gaspere Geraci has more than thirty-five years of clinical, process, and quality improvement experience. He has worked as a physician, recruiting physicians and working with insurance companies. You can find more about him on his website, drgeraci.com, Rate Your Healthcare Employer, and and follow him on X and LinkedIn. -- Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

This week on the FLATLINING Podcast from Fulcrum Strategies, Matthew Handley and CEO Ron Howrigon discuss several healthcare-related news items and how they affect patients and providers. They discuss for-profit HMO’s being banned from participating in Minnesota Medicaid products. They also discuss the economic impact and future of insurance coverage for GLP-1 weight loss drugs such as Wegovy and Zepbound. Also on the program: UnitedHealthcare has announced they will increase their usage of artificial intelligence. Plus: a former AstraZeneca executive is charged with cyber stalking after he sent threatening messages to leadership at CVS Health and Aetna. -- Articles mentioned in this program: For-profit HMOs will, again, be blocked from Minnesota's Medicaid program - Minneapolis Star Tribune Weight loss drug coverage gets more complicated - Becker's Payer Issues Real-World Trends in GLP-1 Treatment Persistence and Prescribing for Weight Management - BlueCross BlueShield UnitedHealth testing 500 AI use cases - Becker's Hospital Review Patient’s Dark Fantasy About Aetna Lands Him in Jail - The Daily Beast -- Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

This week on the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley sit down with Lou Tharp to discuss patient-centered healthcare and patient advocacy. Lou Tharp is the co-founder and executive director of the Global Healthy Living Foundation, a non-profit organization that focuses on improving the quality of life for those living with chronic diseases such as arthritis, psoriasis, IBS, cardiovascular disease, and more. Lou is also the co-founder of Creaky Joints®, an international, digital community of arthritis patients and caregivers. You learn more about the Global Healthy Living Foundation at GHLF.org and Creaky Joints® at CreakyJoints.org. You can also follow Lou on X (@LouisTharp). Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

This week on the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley take a look back at the last 20 years of Fulcrum Strategies. They discuss why Ron left his employment with the payers and began working with physicians and what has changed in the last twenty years. They also take a look at what might change in the future. Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

This week on the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley break down testimony from the Congressional hearings about the Change Healthcare cyber attack. On May 1, UnitedHealth Group CEO Andrew Witty was in the hot seat as senators and representatives grilled him on the impact to patients and providers. Ron and Matthew break it down in a way that is easy to understand and help you know how it impacts you. Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

On today’s episode of the FLATLINING Podcast from Fulcrum Strategies, President and CEO Ron Howrigon and Matthew Handley talk to John Scagnelli, MD, about multiple sclerosis. This disease has no known cause and no known cure, but there have been some incredible advancements in treatment over the past few decades. Dr. Scagnelli specializes in Multiple Sclerosis and Adult Neurology at Raleigh Neurology’s Durham and Raleigh offices. Dr. Scagnelli received his BS in Human Development from Cornell University in 2002. He earned his MD from the University of Miami, Miller School of Medicine in 2006. He then completed his Neurology Residency at the University of Rochester, Strong Memorial Hospital. Following this he was awarded a National Multiple Sclerosis Society Fellowship to study the clinical care and research of patients with multiple sclerosis and related disorders at the University of Virginia. Dr. Scagnelli is a member of the National MS Society and the American Academy of Neurology. --- Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. --- Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. --- Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

Next week on the FLATLINING Podcast from Fulcrum Strategies, President and CEO Ron Howrigon and Matthew Handley are joined by John Scagnelli, MD of Raleigh Neurology. They will be discussing multiple sclerosis, a devastating disease with no known cause and no known cure. But there is hope. Recent research has created new advancements in treatment. You won’t want to miss this episode of the FLATLINING Podcast. Subscribe now wherever you listen to podcasts. ---- Follow Ron Howrigon on LinkedIn. Follow Matthew Handley on X and LinkedIn. ---- Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

On today’s episode of the FLATLINING Podcast from Fulcrum Strategies, President and CEO Ron Howrigon and Matthew Handley discuss some of the most pressing topics affecting physicians and their patients. In this episode, they discuss: • UnitedHealth Group admits they paid the ransom for the Change Healthcare cyber attack • The Justice Department sets up an online portal for people to report anti-competitive healthcare practices • Emergency Medicine physicians in Detroit strike against their private equity backed employer Tune in to hear more about how these topics affect patients and physicians alike. Articles mentioned in this program: UnitedHealth CEO to testify before House subcommittee May 1 - Becker's Payer Issues Feds launch portal for reporting anticompetitive healthcare deals - Becker's Payer Issues Contracted doctors, physician assistants at Ascension St. John go on strike - The Detroit News ---- Follow Ron Howrigon on LinkedIn. Follow Matthew Handley on X and LinkedIn. Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. ---- Fulcrum Strategies is a healthcare consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Our firm has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success. Learn more at FSDOC.com.

This week on the FLATLINING Podcast from Fulcrum Strategies, Matthew and Ron discuss the news that UnitedHealth Group posted a $1.4 billion loss in quarter 1 of 2024 following the Change Healthcare cyber attack. They talk about whether or not providers should care about news such as this. Then, they discuss a new law going into effect in California that ups the minimum wage for healthcare workers to $25 an hour. There could be some very dramatic setbacks to healthcare quality, access, and affordability. Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. Articles mentioned in this program: UnitedHealth posts $1.4B loss in Q1 following Change cyberattack - Becker's Payer Issues California health workers may face rude awakening with $25 minimum wage law - KFF Health News Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. Fulcrum Strategies is a health care consulting firm specializing in payer contract negotiation and strategic planning for physician practices. Learn more about what we can do for your practice at fsdoc.com.

Today on the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley take a look at some of the latest healthcare news. First, they discuss changes to the Medicare Advantage rates published by the Centers for Medicare and Medicaid Services; they explain why insurers are saying out of pocket expenses will go up for seniors. Ron and Matthew also discuss Home Depot’s decision to appeal a settlement with BlueCross BlueShield to the Supreme Court; why wasn’t $2.67 billion enough for Home Depot? Finally, they talk about why a bill to reduce prior authorizations in Kentucky falls flat. Listen to the FLATLINING Podcast from Fulcrum Strategies wherever you listen to podcasts and have every episode delivered to your email by subscribing at www.FLATLINING.net. Articles mentioned in this program: CMS finalizing 2025 Medicare Advantage rates – Becker’s Payer Issues Health insurance shares tumble on CMS news – Bloomberg 🔒 Home Depot asks SCOTUS to rule on BCBS anti-trust lawsuit – Becker’s Payer Issues Kentucky gold card prior authorization bill dies – Becker’s Payer Issues

Today on the FLATLINING Podcast from Fulcrum Strategies, Matthew Handley and Ron Howrigon have a conversation with Matthew Stephens, MD, a board certified radiologists at Radiology of Indiana. Dr. Stevens, Matthew, and Ron discuss the exciting topic of artificial intelligence in healthcare, particularly AI's influence in radiology. They discuss what some of the pitfalls are of using the new technology and what might be coming next. -- Dr. Matthew Stephens is a board-certified Body Imager with a cardiothoracic radiology specialty who joined Radiology of Indiana in 2023. He received his B.S. in Chemistry from Indiana University, Bloomington, IN. He also received his M.S. in Computer Science from Purdue University, Indianapolis, IN, along with another M.S. in Physiology from Indiana University, Indianapolis, IN. His medical degree is from Indiana University School of Medicine. He also finished a fellowship in Medical Informatics from the Regenstrief Institute, Indianapolis, IN. -- Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn.

In this episode of the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley discuss Congress’ late fix to eliminate part of the cut to Medicare physician fee schedule. They also discuss a recent report about a whistleblower case that alleges major accountable care organization Aledade engaged in serious Medicare fraud. -- Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. -- Articles mentioned in this episode: Congress nixes part of the Medicare cut - Matthew Handley at FLATLINING.netAledade accused of Medicare fraud in whistleblower lawsuit - Modern HealthcareAledade’s statement on whistleblower lawsuit — A previous version of this episode had an inaccurate title and an inaccurate description of a former executive at Aledade. Those errors have been corrected. This episode has also been updated to include a statement from Aledade.

Medicare Advantage continues to be one of the most profitable sectors of the health insurance industry, yet a lobby group backed by the nation's largest payers has claimed the federal government isn't paying them enough. Fulcrum Strategies President and CEO Ron Howirgon and Matthew Handley discuss this. Plus, Elevance-owned Anthem BlueCross BlueShield in New Hampshire has royally screwed up their mail-order pharmacy benefits for NH's retired employees. Matthew and Ron also discuss why UnitedHealthcare and UNC Health are possibly going to go non-par on April 1. Subscribe wherever you get your podcasts or at www.FLATLINING.net.Follow Matthew on X: @radioHandley --- Articles mentioned in this program: Payers urge 'stability' from CMS on Medicare Advantage - Becker's Payer IssuesAnthem under fire for 'massively screwed-up' Medicare Advantage contract implementation - Becker's Payer Issues UnitedHealthcare, UNC Health near split date - Becker's Payer Issues

This week on the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley discuss a proposal in Washington to remove the site of service differential. Removing that change would pay doctors the same regardless if a procedure is performed at a hospital or an office. Ron and Matthew also discuss if the Medicare fee schedule is going to change, a PhRMA's lawsuit against the Biden administration over drug price negotiations, and a Florida health plan that now owes the Federal Trade Commission $195 million. Listen wherever you get your podcasts or subscribe at FLATLINING.net. --- Articles mentioned in this program: In Fight Over Medicare Payments, the Hospital Lobby Shows Its Strength - KFF Health NewsJudge tosses PhRMA lawsuit over Medicare power to negotiate drug prices - STATFTC obtains $195M judgment against Florida payer, imposes healthcare ban over 'bogus' product - Becker's Payer Issues

On today's episode of the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley discuss a current US Supreme Court case that is looking at COVID-19 misinformation and free speech. Namely, the justices are evaluating if misinformation is protected speech. Matthew and Ron discuss what this could mean for physicians who think they are giving their medical opinion to patients or to the public on social media. Plus, Ron and Matthew discuss a new list from JUST Capital that lists Cigna and Elevance as two of the nation's most "just" companies. What does that even mean? Listen wherever you get your podcasts or subscribe so it is delivered to your email weekly at www.FLATLINING.net. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible. Articles mentioned in this episode: Supreme Court to weigh whether Covid misinformation is protected speech - STAT News2024 Overall Rankings - JUST Capital2 payers among the 'most just' companies - Becker's Payer Issues

In our continuing series on prior authorization, Ron Howirgon and Matthew Handley discuss a press release from Cigna detailing all the "good" reasons big insurers like it use prior authorizations. They claim it is to save patients money but ultimately, it saves patients' lives. But a new law in New Jersey seems to fly in the face of that saying in its introduction that prior authorizations can be detrimental to patient health in the name of saving money. Matthew and Ron explain. Listen wherever you get your podcasts or subscribe so it is delivered to your email weekly at www.FLATLINING.net. Articles mentioned in this episode: Prior authorizations help keep patients safe, improve health, and make care more affordable - Cigna HealthcareNew Jersey signs prior authorization reform bill into law - Becker's Payer IssuesBill Text: NJ A1255- Legiscan.com