Nick Melrose

Walmart Exits Healthcare Market: RPM Steps Up to Fill the Gap... Walmart's departure from the healthcare market, including its virtual health care services, will leave a void in care services for underserved communities. While hospitals and primary care providers (PCPs) remain the backbone of our healthcare ecosystem, their resilience is rooted in the trust relationships they've built with patients. This trust is a cornerstone of effective care, and RPM can help hospitals and PCPs extend their reach. RPM uses digital technologies to monitor patients' vital signs, health data, and other relevant information remotely, enabling healthcare providers to deliver timely interventions and preventive care. By leveraging RPM, we can: - Increase access to care for underserved communities - Detect health issues early, preventing complications - Deliver personalized care plans - Reduce healthcare costs - Empower patients to take a more active role in their healthcare As we move forward, RPM can help address the disparities in healthcare access and ensure that everyone has access to quality care, regardless of their zip code or background. Let's harness the power of RPM to create a more equitable and accessible healthcare ecosystem! #RemotePatientMonitoring #Telehealth #DigitalHealth #HealthcareAccess https://lnkd.in/eD7CcaEm

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#PatientSatisfaction #HealthcareQuality #Healthcare #USHealthcare In 2023, the average Net Promoter Score (NPS) for US hospitals stood at just +58, indicating room for improvement in patient satisfaction. Our upcoming blog post in the series "US Healthcare: A Blueprint for Quagmire Needing Disruption" shifts focus to "Tracking the Satisfaction of End Users, the Patients." Authored by Dr. Errol R. Norwitz, MD, PhD, MBA, and Venkata Narasimham Peri, it explores crucial patient satisfaction priorities such as accessibility, affordability, compassion, and high-quality care.

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Great article from Katie Adams from MedCity News interviewing Lee Schwamm, MD. These are three great nuggets. I've built for clients the digital front door wrapper he's referencing. Depending on the maturity and budget availability of an organization, I would argue it's possible to do this even without the software development kit. Unfortunately, those can be cost prohibitive and inaccessible for many health system teams with limited expertise and bandwidth. I do wonder about how an LLM could work to overcome both a wide range of ways a patient might describe their condition and looming challenge information asymmetry between clinically trained knowledge and patient knowledge? Would it be trained to be so risk averse to still always default to an overrun primary care system? Would it really enable to bypass to a specialist when there might be access issues or referrals needed for that specialty? I really like the insight from Lee about the "mid-level, consistent, reliable experience." He talked about this at the Reuters Events Healthcare in San Diego a few weeks back and I still like it! Overall - great article Katie and Lee! https://lnkd.in/gyMRaMKh

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The recent downsizing of VBC operations by giants like Walmart, Walgreens, and CVS marks a pivotal moment in the healthcare sector. This shift from a previous era of aggressive expansion to a more measured approach in scaling value-based care (VBC) reflects a maturing market that prioritizes sustainable growth over size. However, the contraction of these clinics doesn't signal a decrease in the viability of VBC models. In fact, top-performing Accountable Care Organizations (ACOs) continue to prove the profitability of focusing on primary care. These ACOs excel by strategically targeting practices that manage sick yet stable patients—those who are most manageable within a VBC framework and are crucial for consistent shared savings. The success formula is clear: select practices with the right patient demographics and ensure alignment with local specialists and hospitals ready to embrace collaborative, value-driven care. Maximizing risk scores and focusing on preventing care cost escalations in these targeted patient populations are essential tactics. As we move forward, let's consider these shifts as strategic realignments rather than setbacks. For those of us dedicated to transforming healthcare, it's a reminder to remain adaptable, data-driven, and patient-centered in our approaches.

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Quarterly Q&As are out! These are mini refreshers or clarifiers for everyone in the home health industry! Question 1 is GOLD for businesses like ours. Question 1: A third-party external auditor consistently states that our OASIS functional status items are “underscored” and recommends changing the responses to the OASIS items. Is the assessing clinician required to accept the auditor’s recommendations? Answer 1: While a home health agency may use third party external auditors to review OASIS coding and make recommendations, the assessing clinician is responsible for determining OASIS coding based on their assessment. We often get clinicians who don’t understand the reasoning or rationale. The longer or more detailed it is— consider it unread. That is NOT compliance. Truth be told, most of the clinicians are reviewing these changes in the field or at home after a 10 hour home health shift. Their brains are at capacity for receiving more info. I should know, I was one of those clinicians. Family time is now met with 6 inch long “yellow sticky notes”. That’s why most of these clinicians have my personal email and phone number. I thrive on educating and so I always encourage them to “call me with questions”. You’ll usually find me at 9pm explaining why M2020 is likely marked as 3 if M1860 is stating patient requires assistance or supervision of another person at ALL times during ambulation. What’s your consultant team doing to bridge the gap between making clinicians aware of changes made and EDUCATING on changes being made? Contact me for more info on how C&C Strategic Consulting can assist your agency!

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Walmart closing 51 Health Centers over “Lack of Profitability!” Walmart Health Virtual Care (telemedicine) offerings will also end. Article by Daniella Alessandra Genovese Fox Business Network April 30, 2024 MY TAKE: · What does ‘lack of Profitability” really MEAN? o Is it meant that this service line is losing money – financially upside down? o Or does it mean that the line is not producing the “EXCESS PROFITS” that were envisioned - and that corporate leaders and shareholders demand?   ·    Healthcare delivery is NOT a simple business model, though increasingly we see corporate entities entering this arena, often envisioning large profits or - in the case of private equity - valuable ASSETS whose value can be accelerated over short periods - or at least sold off as value-added components.   ·    It has been said that the LURE of ‘excess profit’ invariably leads to GREED, and that in healthcare - greed invariable leads to worsening conditions within healthcare workplaces and worsening outcomes for patients! American Medical Association American Hospital Association American College of Emergency Physicians U.S. Senate Committee on Health, Education, Labor, & Pensions Tennessee Medical Association Jesse Pines Chadd Kraus Lara Vanyo Rita Manfredi TENNESSEE COLLEGE OF EMERGENCY PHYSICIANS Timothy Wilson Ryan Stanton Gabe Kelen, Deidre McPhillips Mollie Pillman Alison Haddock, MD, FACEP Susan Morse mor Chelsea Torres Amy Feldman Jesse Ehrenfeld MD MPH Mel Cortez Larry Bucshon, M.D. Peter Stavros Fox article link - https://lnkd.in/gynsbScT

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We’re all too familiar with one of digital health’s most “popular” sore spots: point solution fatigue. I’ve even written about this for the Forbes Business Council (https://buff.ly/43ADMKt) With the rising demand for GLP-1s, buyers are looking for yet another solution to help mitigate rising costs. But have they considered taking a closer look at current vendors they may have to treat chronic or cardiometabolic conditions? For example, Omada Health has been working with members taking GLP-1s since 2019 at the launch of its diabetes program - and now has a GLP-1 Care Track available across its full cardiometabolic suite, which includes diabetes prevention, diabetes, and hypertension. Buyers should provide a program that takes more than just weight loss into account. They should consider MSK support, and sustainable outcomes (i.e. long-term support should members discontinue the drugs). We’re not here for a quick money grab, but to support members for long-term weight health. Learn more about Omada’s approach to GLP-1s: https://lnkd.in/gm77rfWk

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New Video Series: Conquer T2D Management in Older Adults! Having trouble helping your older patients manage Type 2 Diabetes (T2D)? Patient Care Online's new #ConsultantLive series tackles the unique challenges of geriatric diabetes care with Dr.'s Medha Munshi & D. James Bailey. Here's what you'll learn: - How to tailor treatment plans for patients 65+ - T2D trends, challenges, and physiological changes in older adults - Setting individualized glucose targets to avoid hypoglycemia Each episode provides actionable tips to empower you to give your T2D patients the best care possible! Watch the first episode now! https://lnkd.in/gM73hw47 #GeriatricDiabetes #T2DManagement #MJHPM #

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This is a difficult time for digital health startups. After flooding the field with capital, investors overall soured on the sector, with investment levels falling by 63% between 2021 and 2023. For the estimated 70 health tech unicorns left (those companies valued at $1 billion or more), this new reality means that an initial public offering is likely not in their immediate future. For smaller companies, it means that it will be difficult, if not impossible, to raise the next round of venture capital they’d been counting on. The upshot: The health tech herd is about to be culled. Some companies will be acquired by larger ones, probably at a value far less than they’d hoped for. Others will simply close. There’s more to survival, of course, than just keeping money in the bank. It’s clear now that some types of digital health businesses are better than others. #vc #digitalhealth #investors https://lnkd.in/e_DEQKRs

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It’s hard to believe its over 2 years since we went live with the worlds first fully cloud native ecosystem in Amazon Web Services (AWS), more than 3 years since we started the implementation and more than 5 years since beginning our journey too getting health systems out of the data center. How far we’ve come. And it’s STILL getting CHEAPER and BETTER by the day!!! Have a listen to the discussion!

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Excited that Becker's Healthcare will air its “CEO + CFO Virtual Forum tomorrow and our panel’s discussion titled, “Hospital Financial Strategy Reboot: How to Proceed as Healthcare Exits the Hospital.” As I noted, UC Davis Health is optimizing the most effective and wise ways to balance care for inpatient, outpatient and at-home contexts, while always putting our patients at the center of everything we do.   https://lnkd.in/ebbkH4Ws

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We’re excited to announce the launch of our new report “Bridging the Health Plan/Provider Gap: Data-Driven Collaboration for a Value-Based Future.” The report, based on a survey of 70 health plan and provider leaders, uncovers insights about the fractured plan-provider relationship—and where the two players can collaborate more effectively to unlock unparalleled value. Learn more and download the report: https://hubs.la/Q02zDYgR0 #valuebasedcare #azaraDRVS

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I'm thrilled that today, we announced a significant milestone for Clover Health: the launch of Counterpart Health. Our innovative Clover Assistant (CA) platform is now available to all Medicare Advantage payors and providers under the new brand name Counterpart Assistant. Why am I so excited about this? This move is a strategic leap forward in our mission to improve healthcare for everyone. With Counterpart Assistant, we're not just expanding our reach—we're leveraging cutting-edge AI and machine learning capabilities that have already proven to make a real difference in patient care. The healthcare landscape is evolving rapidly, and the need for advanced, data-driven tools has never been greater. Medicare Advantage plans, in particular, are under pressure to improve patient outcomes while managing costs. That’s where Counterpart Assistant comes in. By bringing our technology to more providers, we're empowering clinicians with the tools they need to deliver high-quality, personalized care. What makes Counterpart Assistant special? First, we’re broadening our impact by allowing providers outside of Clover Health's Medicare Advantage plan to benefit from our technology. Our hybrid SaaS and shared-savings model aligns financial incentives with health outcomes, ensuring flexibility and scalability. CA’s AI-driven insights enhance clinical decision-making, and are associated with earlier diagnosis and better management of chronic diseases. Plus, we've built a robust support system to ensure seamless integration and ongoing assistance for all users. Clinicians using CA have seen significant improvements in Medical Cost Ratios and patient outcomes. The timing couldn't be better. The healthcare industry is ripe for transformation, and our technology is poised to lead the way. By expanding the use of Counterpart Assistant, we’re not just keeping up with the changes—we’re driving them. Join us on this exciting journey. Visit our website for more details. Thank you for your continued support as we strive to bring high-quality healthcare to everyone on Medicare. #HealthcareInnovation #AI #MedicareAdvantage #ValueBasedCare #CloverHealth

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Here’s your recap of last week’s health IT news 🗞️ Notable partnerships 🤝 • Kaiser Permanente is partnering with Innovaccer to incorporate their population health and AI platform        • MUSC Health adopted Andor Health’s ThinkAndor in its ED to reduce wait times and “leaving without being seen” rates.      • Upperline Health is partnering with Navina to improve clinical workflows and improve the accuracy of patient histories.      • Intermountain Health deployed Nuance Communications DAX Copilot, an AI ambient scribe solution.      • PA Clinical Network is partnering with Guidehealth  to improve outcomes and care quality while improving physician efficiency. Product updates 👩🏼‍💻 • Klara released a new patient intake product for athenahealth users.    • Baton Health released Universal Primary Source, giving users access to hundreds of primary source databases for credentialing.    • InsightRX released InsightRX Apollo, an analytics platform that provides insights on clinical performance.    • Trovo Health launched with a $15 million seed round, offering specialty-specific AI combined with clinical experts to help practices add to their capabilities.    • Quest Diagnostics acquired PathAI’s diagnostic laboratory business (PathAI Diagnostics) to improve Quest’s oncology services.    • GenHealth.ai launched its Automated Prior Authorization platform.    • Veradigm® is partnering with MedEvolve, Inc. to make its suite of products available to Veradigm users.    • CLEW announced availability of a newly FDA-approved patient surveillance platform. Posts we enjoyed 👏 • Eric Topol, MD shared a compelling piece reviewing the state of research on AI in medicine. In short, we’re seeing our first early evidence that AI can reduce mortality as a research endpoint, but large language models are not yet the panacea we’ve been promised. (https://lnkd.in/e6hK-4mr)    • Nikhil Krishnan of Out-Of-Pocket shared a deep dive on Stedi, which converts X12 EDI into JSON-based APIs for healthcare tech developers. (https://lnkd.in/eqS9V5zW) --- Want to stay in the loop? Sign up for the Elion Briefing to get all of the latest healthcare tech news delivered to your inbox 📬 👉 https://bit.ly/49z6AUW

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🎙 Tune in to our Advancing Precision Oncology Podcast! 🎙 This 3-part series will explore how biomarkers and advanced testing capabilities are expanding patient access to precision oncology and improving health outcomes for cancer patients. Delve into the rapidly evolving landscape of biomarker testing, the benefits of integrating multi-data sources and the challenges and opportunities that lie ahead. 🔬💊 Listen to Part 1 with Dr. Gwyn Bebb and Wyatt Gotbetter: https://lnkd.in/eAuvzhFj #Podcast #Oncology #Biomarkers #NovelInsights

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🍕 Glue pizza, anyone? We've been monitoring the changes Google has been making to its Search Engine Results Page (SERP) over the last few months and have been taking notes on the changes its been making to its search results - especially as they've introduced Search Generative Experience (SGE) results. Now that they've converted the SGE results to AI Overviews, the world is going to get weird... 🙄 Google's roll-out of AI Overviews hasn't been without some issues (one AI Overview told users to add glue to pizza to make it taste better). But, despite some missteps, Google continues to incrementally launch AI Overviews in the US and healthcare organizations need to know what to expect now and how to prepare for the future. Have no doubt, your organic strategy will definitely need to change. I'm really excited to be hosting a webinar with two authorities in this space -- Aaron Watkins from Johns Hopkins Medicine and Jason Hamrick from Phase2 -- where we'll be talking about everything we know and answering top questions we've been getting about how to think differently about how to connect with patients and consumers digitaly now and in the future. If you haven't RSVP'd yet, we'd love to have you join on Thursday, June 6 at 11am ET. You can find more information here: https://lnkd.in/ewj8mcR5

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As we continue to navigate the evolving landscape of healthcare, the significance of value-based care (VBC) in improving patient outcomes and reducing costs has never been clearer. The recent playbook on #VBC best practices released by AMA, NAACOS, and AHIP provides a roadmap for success in this area. At PointClickCare, our focus aligns perfectly with these initiatives and our commitment to innovation and collaboration to drive forward the future of healthcare has never been more important. #ValueBasedCare #Innovation #HealthcareFuture

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Privia Health had a solid start to 2024 with continued growth and execution. One notable trend is Privia's pullback on capitation. Privia wants to be thoughtful about taking full risk - in markets and scenarios where it makes sense (and it's profitable of course). Flexibility is built into Privia's operating model, and you can see the levers being pulled in Q1 and in 2024 given significant MA headwinds. You can see the pullback in value-based care revenue in Q1 2024 in a chart below. By the way - what do you guys think of the new one-pager format?? If you like these, you'll love my newsletter. Subscribe here! https://lnkd.in/gniNmHvz

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