Do people really understand their healthcare bill?

I talk about this all the time on the show, but healthcare is one of the only areas of the economy where the distribution of information is extremely one-sided. What do I mean? I mean that, for the most part, patients receiving care may have a general idea about how much their care will cost, but very few actually have a specific dollar figure upon which to base their decisions. On top of that, unless they are healthcare-trained professionals, they also lack a complete understanding of the treatment options, potential outcomes, and the like. The same holds true for their healthcare bill.

For the most part, people have a general idea of what they need to pay for healthcare services. The problems start to appear when insurance denies claims or treatments require preauthorizations or the like. The resulting bill often comes as a surprise, and can in many cases be rather large. In fact, surprise medical bills have become such a large issue, that the No Surprises Act of 2022 was enacted to try and counter the trend.

This week, I sit down with Frank Lobb, author of The Big Lie in my Healthcare Bill: Why I Don't Owe What My Insurer Fails to Pay". In this book, Frank tackles the topic of insurance denials leading to surprise medical bills.

What we cover in this Episode:

-Who actually pays in healthcare
-How healthcare bills result in true financial burden for patients across the country
-How Insurers structure contracts with providers
-The challenges that come from big healthcare & the push for efficiency
-The Value that Insurers State that they Bring to the Market
-Frank's story of Insurance Denials and Being Unable to Pay out of Pocket for Treatment
-How an Engineer Came to Write a Book About Healthcare Bills

Full episode note: https://rehabupracticesolutions.com/better-outcomes-150

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

How do you set up an RTM Program that's actually profitable in an outpatient clinic?

Well, it's been 3 years since remote therapeutic monitoring, or RTM codes, were introduced by CMS to allow clinicians to monitor patients outside of the clinic. Many clinics rushed to implement RTM Programs in the months following these new codes going live. And many clinics stopped delivering RTM services almost as quickly as they started. But why?

The main reason many of these RTM Programs failed stems from the fact that many were thrown together as "add-ons" to treatment rather than a legitimate program. As a result, clinicians tasked with implementing RTM lacked processes and an understanding of the reasoning behind implementing RTM in the first place. Even now, when I talk with RTM platforms and practice owners, I hear the same thing: Initial sign-ups and patient enrollment were high, then trickled off, and are now almost nonexistent.

So, this week, I sit down with a previous guest, Matt Juke, CPT, to talk about how to set up and implement an RTM program that is not only sustainable, but profitable for the clinic and a value add for patients.

What we cover in this Episode:

-The benefits of RTM Programs in outpatient therapy clinics
-Challenges of implementing & billing for RTM Programs
-The importance of understanding workflows for RTM
-How to select a platform for RTM
-Communicating the value of RTM to all stakeholders

Full episode note: https://rehabupracticesolutions.com/better-outcomes-149

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Can AI Healthcare Phone Services Increase Patient Access & Improve Engagement?

You know what frustrates many patients (including yours truly)? Phone trees. "Press one to select scheduling" (Presses 1) "By pressing 1 you have indicated that you would like to connect to scheduling. Is this correct? Press 1 to confirm or 2 to cancel". It drives many patients to hand up the phone, drop off the schedule, or go find another healthcare provider. But what if there was a way that automated phone messages could increase access, patient engagement, and experience? Enter an AI Healthcare Phone Service.

If implemented well, AI has the ability to greatly increase practice efficiency and allow clinicians to actually spend more time delivering care. The same holds true for the administrative process of care. Healthcare workers, including office managers and patient access personnel who manage scheduling, struggle with the overwhelm of more phone calls and requests than they can manage. And, despite the fact that many healthcare providers offer an online patient portal, only around 30% of patients actually use those portals. Patients still want to talk on the phone with their providers. So, this week, I speak with Ada Andruszkiewicz from Talking.ai about how implementing AI into processor care can actually increase patient access and improve human connection in healthcare.

What we cover in this Episode:

-The winding road from tech development to the healthcare SaaS market
-Burnout in Healthcare
-Understanding Value in Healthcare Technology
-Challenges in running independent healthcare practices
-How implementing technology can actually increase human connection in -healthcare
-Thoughtful implementation of Artificial Intelligence in healthcare
-Deploying an AI Healthcare Phone Service in a practice

Full episode note: https://rehabupracticesolutions.com/better-outcomes-148

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Is Value-Based Care Too Much for Independent Healthcare Practices?

I've talked about the consolidation in the healthcare market before. I recently sat down with the folks at StrataPT to talk about PE firms buying up healthcare practices and how small, independent healthcare practices are beginning to feel the pressure. But one thing I haven't discussed on the show is what exactly has caused the consolidation in healthcare (big players buying up little players). Over the years, many independent healthcare practices have been purchased by either private equity firms or health systems/hospitals. But why?

Part of the drive for this consolidation stems from economies of scale. Big healthcare systems and hospitals leverage their size to combat rising overhead costs, declining reimbursement, and even compliance and the ability to participate in alternative payment models. That last one is an interesting take that I hadn't considered before. But, over the holidays I read an article entitled Value-Based Payment and Vanishing Small Independent Practices. In this article, the authors argue that one driving factor for the consolidation in the healthcare market stems from the fact that value-based payment models require a lot of administrative work & data management that independent healthcare practices struggle to manage. So, this week, I take a dive into this idea and discuss some ways that independent healthcare practices can maintain viability in the world of big healthcare.

What we cover in this Episode:

-Understanding how Big Healthcare benefits from value-based payment models
-How economies of scale help improve data exchange and combat decreasing reimbursement in healthcare
-Understanding Value in Healthcare
-Challenges in running independent healthcare practices
-Independent Healthcare practice as a business
-Some strategies that independent healthcare practices can employ to remain competitive
-How to create an effective healthcare positioning strategy to thrive in the current healthcare landscape

Full episode note: https://rehabupracticesolutions.com/better-outcomes-147

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

What is Healthcare Positioning?

When I talk to clients about Healthcare Positioning, the first question to address is “What is positioning?” And that’s a fair question. I usually tell people that positioning involves communicating the value you/your company creates for your customers/clients in a way that differentiates you from competitors and builds perceived credibility & authority to your ideal target market. This week on the podcast, I take a deep dive into the idea of healthcare positioning strategy. I discuss how to develop an effective positioning, some challenges and pitfalls that many of my clients have fallen victim to, and some thoughts around the nuances of positioning in healthcare vs. other industries.

What we cover in this Episode:

-Define healthcare positioning strategy
-Marketing strategies that work in healthcare
-Communicating Value in Healthcare
-The goals of healthcare positioning
-Identifying your target market in healthcare
-Using healthcare positioning to make strategic business decisions
-How to create an effective healthcare positioning strategy

Full episode note: https://rehabupracticesolutions.com/better-outcomes-146

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

A year in review: Healthcare in 2024

It seems like only yesterday that I was planning for 2024. Scheduling out projects for the year, booking speaking engagements, and lining up interviews for the podcast were in full swing. Then, in the blink of an eye, we arrive at the end of 2024. And what a year it has been. From cyberattacks to breaking healthcare innovations, 2024 has had its share of big news stories. So, this week, I take the time to do a "2024 Year in Review: Healthcare".

What we cover in this Episode:

-The Change Healthcare Cyberattack and it's downstream effects
-The Expansion of & Breakthroughs in Artificial Intelligence in Healthcare
-Hospital and Healthcare Closures and Financial Troubles
-Remote Patient Monitoring and Telehealth & Virtual Healthcare
-Anti-Trust issues and litigation in Healthcare Tech
-Health Equity comes to the forefront of healthcare policy discussions
-Integration & Interoperability in Healthcare Tech
-Leadership in healthcare amidst tragedy and turmoil
-Healthcare policy shifts and the future political landscape for healthcare in the US

Full show notes: https://rehabupracticesolutions.com/better-outcomes-145

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

How do we begin implementing technology-enabled healthcare services?

We cover this topic a lot on the show, but technology-enabled healthcare continues to receive a lot of attention. Much of the conversation and media around technology and healthcare innovation revolves around the innovation itself. We hear about the benefits, features, and capabilities of these new solutions and innovations. But, one often overlooked topic in healthcare innovation includes practical implementation. How do you actually take these new innovations and tools and use them to meaningfully improve healthcare? How do we make sure that a new software, device, or platform ends up actually making healthcare better, rather than just a neat marketing ploy?

So, this week, I dive into the research around technology-enabled healthcare. Parts of this podcast come from a few different presentations I've recently given on this topic covering digital health, implementing virtual healthcare services, and using data in healthcare decision-making.

What we cover in this Episode:

-Define digital health & virtual service delivery
-Applying digital health tools in clinical practice
-Research around digital health and its effectiveness
-Remote Patient Monitoring and Telehealth
-Will artificial intelligence replace clinicians?
-How technology enabled healthcare solutions will alter reimbursement and revenue models
-Achieving Better Outcomes by implementing technology in healthcare

Full show notes: https://rehabupracticesolutions.com/better-outcomes-144

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

A Few Thoughts on Healthcare Positioning Strategy

I'm talking to a lawyer the other day about business, scaling, growth, and specialization. As we're talking, he says something in passing that totally exemplifies both the concept and the power of a strong positioning strategy. He says, "You know, it's like if I was a furniture maker and someone asked if I could give them a price to build a deck. Sure, I have all the tools necessary to do that job, but if I say yes, they're not going to be happy, and I'm not going to be happy. So I just say "no" to those types of inquiries, even if there's good money involved."

I know I've said this before on interviews: but the worst deals I've ever put together —the worst clients, worst results, most stressful projects— have all come from saying "yes" to jobs that I should have rejected. I quickly learned with my consulting work to only accept projects and clients that fit in my positioning. And, in broad areas, healthcare has adopted this idea of specialization. Orthopedic MDs don't accept cardiology referrals etc.However, within each specialty area, there are countless specializations or sub-specialties. For example, take Physical Therapy as an example...Often times, I hear one of two problems from practice owners, each of which can be fixed with a good dose of positioning:

1. Too many referrals
2. Not enough referrals

Interestingly, no one ever says "I think we're good. We have enough referrals." It's either "we have way too many" or "we need any referrals we can get". But how does positioning help solve either of these problems? It solves these problems like this:

Too many referrals? Look through the variability in those referrals. If you have a selected specialization (positioning strategy), and you have more referrals than you have capacity to handle, you simply take all of those excess referrals that don't fit in your stated specialization and refer them out to other providers.The patients will be happy, because they're not on a wait list. The referring provider will be happy because their patients will get seen sooner, AND they'll think of you with more respect in your area of specialization...

Too few referrals? Reach out to ONLY the referral sources that match your stated positioning (specialization). Often, when the schedule gets light, clinic owners and managers reach out to anyone who could possibly refer them a warm body to treat...

This does harms the practice in 2 ways:

1. Patients don't get the best results (which means less positive reviews and likely less referrals from that referring provider)
2. They just sound desperate (no one like groveling...)

In addition, you only have so many resources to commit towards marketing & business development. Having a clear and specific positioning keeps you from spreading those resources too thinly to make a real, meaningful difference in referral generation.

What we cover in this Episode:

-Positioning Strategy in Healthcare
-Putting positioning to work in Lead Generation
-Building a team and culture at a healthcare business using positioning
-Reducing the stress involved in business development strategy
-Achieving Better Outcomes by dialing in your healthcare positioning strategy

Full show notes: https://rehabupracticesolutions.com/better-outcomes-143

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!