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Healthcare Simplified: Clarity | Transparency | Solutions

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14: Self-Funded Employers: Quit Losing Money to Hospitals w/ John Glascott

10/17/2017
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Everybody in the healthcare continuum should care about AMPS. Because reference-based payment is the future, that’s why. Today’s episode of Healthcare Simplified features John Glascott, Chief Revenue Officer of Advanced Medical Pricing Solutions (AMPS), which offers medical bill review. “We have something we call clinical only medical reviews that review overcharges mistakes—what we call fat finger—a charge that was $710 entered as $71,000,” Glascott said. Find a breakdown of this...

Duration: 00:32:47


13: 3 Ways You Can Prevent Hospital Error w/ Leah Binder

10/10/2017
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Let’s get the bad news over with first. The number of people who die from hospital mistakes could be as high as 400,000 per year. On today’s episode of Healthcare Simplified, Tyler Woolsey interviews Leah Binder, President and CEO of the Leapfrog Group. She specializes in helping employers use their leverage to get safer and higher quality care for their employees. “When they looked at their own covered lives, they were stunned to realize that they were potentially losing an employee...

Duration: 00:27:58


12: The Pros and Cons of Reference-Based Pricing w/ Karl Ahlrichs

9/26/2017
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Wouldn’t it be great to walk into a doctor’s office and have them tell you exactly how much a procedure is going to cost? Mechanics do it. Contractors do it. Even veterinarians do it. But, for the most part, doctors don’t. Or, it might be more accurate to say, they can’t. Our healthcare system just doesn’t work that way. In this episode, Karl Ahlrichs, with Gregory and Appel Insurance , breaks down what reference-based pricing is, and how it can help limit post-doctor visit sticker...

Duration: 00:26:45


11: How Much is Your Lifestyle Costing You? w/ Jim Campbell

9/19/2017
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It shouldn’t surprise anyone that daily decisions and lifestyle choices affect health. The next step, of course, is that these decisions in turn affect healthcare costs. The main issue in combating prevalent problems like obesity and prescription costs has been figuring out how to quantify how an individual’s choices cost. The rise of wearable technology and wellness apps are beginning to solve this problem. In this episode, Jim Campbell, President and CEO of BWell, gives some insight...

Duration: 00:21:14


10: What to Do about the $29 Billion in Specialty Care Waste w/ Geb Buchness

9/12/2017
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On today’s episode of Healthcare Simplified, Geb Buchness, Senior Vice President of Business Development at Armada Health, is here to say that overlooking referrals specialists is a huge mistake. “One of the biggest pain points in healthcare is the breakdown between primary care and specialty care—when a member gets a diagnosis and needs a specialist,” Buchness said. Everybody wins when you use advice to achieve quality outcomes and to find good specialty care.

Duration: 00:17:49


9: Psst! You Are Spending Too Much on Drugs w/ Kathy Campagna

8/15/2017
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So, you bought some milk online for $15 a gallon, only to go to the store and see that you could have spent $4. Believe it or not, this happens in healthcare all the time. (But with drugs, not milk.) That’s why we’re here talking to Kathy Campagna, Vice President Business Development and Director of Specialty Drug Strategy at Magellan Rx, which has a site of service program to help you save money without a lot of member disruption. She has worked for the last 10 years in the medical...

Duration: 00:29:52


8: Utilizing Good Data to investigate fraud, waste, and abuse w/ Scott Ward

8/1/2017
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No matter what your profession, it’s painfully evident that healthcare costs are out of control. From skyrocketing premiums, to erroneous payouts, the healthcare world is confusing, and without the right help, can be ripe with fraud, waste, and abuse. Luckily, this is where Scott Ward and the team at Health Integrity LLC come in. With a team of 75 investigators nationwide, Health Integrity provides data-driven analysis for the healthcare industry, with a particular eye on fraud, waste,&...

Duration: 00:20:01


7: How Cost Transparency Is Giving Power Back to Healthcare Consumers w/ Dr Bill Hennessey

7/18/2017
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Pratter, Inc. is bringing real-cost transparency of healthcare to millions of insured Americans, giving them power to spend (or not spend) as healthcare consumers. Today’s guest is Dr. Bill Hennessey from Pratter. Dr. Hennessey is passionate for people to realize their place as consumers, rather than see themselves as patients. Listen as he talks with us about how cost transparency is helping employers and employees understand the true cost of healthcare.

Duration: 00:21:20


6: How Small Insurers Can Use Big Data to Get Massive Results w/ Dustin Plantholt

7/11/2017
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How is a health insurance company like a battleship? This is surprisingly easier to answer than how a raven is like a writing desk. Large national health insurers have all the impressive size and capability of an iconic battleship, but they also have the issues of movement that come with that size. On the other hand, smaller insurers can adjust more quickly to changes in the market. They’re more likely to implement new methods of doing business like focusing on the local life or using...

Duration: 00:24:37


5: How Data Integration Is Reducing Healthcare Waste w/ Mick Simon

7/4/2017
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HCMS Group is a health information service company, who exists to help self-insured employers, health and disability insurance plans, and health service providers. Their cloud-based data solutions are changing the population health management game to the benefit of both individuals and organizations. Today’s guest is Mick Simon from HCMS Group. Here, Mick speaks with us in detail on the how and why behind the HCMS Group mission to reduce healthcare waste, while improving individual health...

Duration: 00:23:56


4: Revolutionizing Population Health Management and Employer Concierge Care w/ Dr. Florin Selaru

6/23/2017
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Despite being a physician, Dr. Florin Selaru knows the frustrations of a patient. He’s experienced the two to three week wait to get his children to a doctor. He knows what it’s like to see them have only 10 minutes allocated to them once they’re there, and to receive a high-priced bill that doesn’t always clearly match the quality of the appointment. As a physician, he also has recognized the limitations of the system. So his mission was to figure out a system that works better for...

Duration: 00:29:43


3: Why Your Employee Assistance Program Is As Valuable As Insurance w/ Dawn Motovidlak

6/20/2017
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Business Health Solutions (BHS) is redefining occupational health with their innovative employee assistance programs (EAP). They recognize that wellness is both mental and physical and their services remind employers that everyone needs a little help from time to time. Our guest today is Dawn Motovidlak, president and CEO at BHS. She shares with us the industry struggles of current EAP and her mission to affect change within organizations through preventative mental health care for...

Duration: 00:20:48


2: How Active Management Solves Common Healthcare Problems w/ Dr. Mark Lamos

6/20/2017
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The Greater Baltimore Medical Center (GBMC) is very progressive with its primary care model. This is especially true in some of their efforts to provide greater access to care. Today’s guest is Mark Lamos from GBMC. Listen in as Mark explains how he has demonstrated wellness in his own life, as well as how GBMC has set up systems to address many of the problems that healthcare centers commonly face.

Duration: 00:23:41


1: Why You Should Listen to Healthcare Simplified

6/20/2017
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Imagine going to a restaurant, ordering whatever you want, then getting a mystery-cost bill at the end: that's what the healthcare industry is like today. We're looking to change that. We want to enlighten our audience to transparency, which is now a cliche term in healthcare and many other industries. Still, we really do want to open your eyes up to the real healthcare industry today, which may not be as bleak as you think.

Duration: 00:09:04