Tyler S.M. Chepolis

❗️Comparison Mindset 🧠 On the Round-Up with Victoria Moll CPC, COC, CPMA, CRC, CPFC, CPCD, CPRC, CEMA, she candidly shared her experiences with comparing her social media posts to others. 💁‍♀️ It’s a relatable struggle—we’ve all been there! 🚫 Toxic Comparison: When we scrutinize our own posts against those of others, we’re not doing ourselves any favors. Whether it’s feeling superior or inferior, this habit creates a negative mindset. 🤔 Mindset Shift: Let’s break free from this cycle! Instead of comparing, let’s celebrate our unique journeys. Remember, everyone’s path is different, and that’s what makes life interesting. 🌟 Change your mindset today! 🔄🧠 To watch the full Round-Up episode with Victoria Moll, find the link in the comments below!👇 Be Renown, Bertram #revenuecycle #healthinformation #medicalcoding #mindset

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Is your PBM truly looking out for you? It's a question that every business owner should ask themselves. Your PBM plays a vital role in managing your pharmacy benefits, but are they really working in your best interest? At DisclosedRx, we believe that accountability is essential. That's why we operate as a fiduciary PBM, contractually bound to prioritize your interests above all else. Stay tuned for our new article tomorrow, where we explain the advantages of working with a fiduciary PBM and how DisclosedRx is committed to working in your best interest. #PBMPartnership #FiduciaryPBM #EmployeeBenefits #DisclosedRx

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While this concentration of spending simplifies coordination, it also presents challenges for both participants and providers. Read more here: https://buff.ly/3VrRtI2 #capturedclients #singleprovider #concentratedspending #entirebudgetallocation #diversification #fraudprevention #NDIS

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Our entire organization thrives on #alignment. As we discussed with William Brent Tafoya (SVP, Customer Care) on the #AstonishingHealthcare podcast, customer care must be in sync with other teams because they are on the front lines and always talking to members, pharmacies, and providers. Whether it's an issue that must be escalated, a process started, follow-up provided, or a problem solved, alignment is a principle we live by, and it's one of the reasons our industry-leading #CustomerCare team is so agile and effective (and at the center of #NeverMoveAgain). 🎧 Listen to the full episode here: https://okt.to/7XmnZN

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Growth doesn’t just happen to business, it happens to leaders. As Alignment Health Health scaled over the last 10 years, I experienced growth as a leader. Over the next week, I’ll distill that experience into three lessons in hopes that they are helpful to others.  𝐋𝐞𝐬𝐬𝐨𝐧 𝐎𝐧𝐞: 𝐔𝐧𝐝𝐞𝐫𝐬𝐭𝐚𝐧𝐝 𝐭𝐡𝐞 𝐝𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐜𝐞 𝐛𝐞𝐭𝐰𝐞𝐞𝐧 𝐟𝐨𝐮𝐧𝐝𝐞𝐫 𝐚𝐧𝐝 𝐂𝐄𝐎. To transition from company founder to CEO requires an awareness that these roles differ significantly. While both roles are “at the helm,” the goals you must meet and the skill sets required to succeed are vastly different. As a founder, you literally start from an idea. You articulate the vision, inspire a founding team and raise money. Your goal is to do anything and everything to launch the concept. As you transition to CEO, your job centers around recruiting, empowering and trusting the very best team of people. Where you once articulated a vision, you’re now inspiring others to own it and run with it. Your goal becomes developing and training a leadership team that functions with perfect chemistry.   Lesson learned? Be prepared to master a different skill set. #leadership #business #entrepreneur #management 

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In 2021, Medicare Advantage beneficiaries spent about $2,541 less in out-of-pocket costs and premiums than beneficiaries with fee-for-service Medicare, a new report discovered. Here is an organization funded by MA Plans, Better Medicare Allowance, promoting their sponsors with this misleading report. This organization claims Medicare beneficiaries have strong access to care and pay less for the care. This is partly bunk and misleading, the beneficiaries have less out-of-pocket costs because when they try to access their "great benefits" the plans deny the care as not medically necessary. The proof is Humana almost always denies SNF coverage for its members based on "Medical Necessity." This quote is spot on: Dr. Rick Gilfillan, an independent consultant who previously called the MA program a “failed experiment” during a panel discussion at the HLTH 2023 conference. “I say failed because for 35 years of its existence, privatized Medicare, now Subsidized Medicare Advantage, has cost more than traditional Medicare,” he said. “In 2023, those numbers are projected to be more than $75 billion to $120 billion in excess payments to MA over what the cost would be in traditional. From a quality standpoint, … what we can say is that [MA plans] put in place obstacles to care, made access to care more difficult.” Time to pull the plug on Medicare Advantage and save taxpayers from the failed Medicare Advantage experiment. #Medicareadvantageplans, #MAplans, #rippoff, #boondoggle, ##bettermedicareallowanceselfinterest https://lnkd.in/eWsNcZYJ

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I hole heartedly agree Benjamin Schwartz, MD, MBA. Anywhere else in an economic system, innovators who can deliver a better product at lower costs are almost always rewarded with greater market share, and frequently set the direction for the future of a product or industry. Not so in healthcare. I think that Terry Adirim, MD, MPH, MBA (below) hit the nail on the head when she references for-profit health insurers in the mix. Although policies have been enacted with the idea of providing better healthcare at lower costs, they have always given the job of administering those policies to a middleman (insurance companies) whose motives are at odds with the objective they claim to be administering. Profit! Innovation is not in the best interest of the payer. They profit through the inefficiency of the system. Until this lack of alignment between quality patient care at low costs and for-profit health care plans is addressed, process innovation and improvement will only be able to nibble at the edges.

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Remote patient monitoring (RPM) is booming! According to Definitive Healthcare, RPM claim volume increased by an incredible 1,294 percent. Notably, chronic conditions like hypertension and diabetes dominated RPM claims between January 2019 and November 2022. And, according to a survey by Sage Growth Partners, 46 percent of healthcare executives plan to boost their RPM budgets in 2024. The rising focus on RPM not only demonstrates a commitment to improving patient outcomes but also represents a trend toward using technology to make healthcare smarter and more efficient. As RPM evolves and becomes more integrated into healthcare systems, it has the potential to make quality care accessible to all, empowering patients to become active participants in their health journey. But to truly make a difference, we need to keep pushing the boundaries of innovation and address healthcare disparities head-on.  #RPM #HealthTech #PatientCare #PatientMonitoring

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