Outcomes Rocket

The transformative potential of AI in healthcare is no secret, but there are certain limitations and risks associated with its generalization.In this episode of the AHIP 2024 series, Yoni Shtein, CEO of Laguna Health, discusses how his company uses conversational AI to enhance care management for health plans. He explains how Laguna leverages ambient listening and a large language model to analyze conversations between care managers and members, improving efficiency, outcomes, and effectiveness in chronic, high-risk, or acute care management. The technology aligns with the needs of regional and national payers and facilitates better member service and patient outcomes. Yoni emphasizes integrating new technology in Interactive Care Planning (ICP), utilizing virtual, multimodal interactions like telephonic chat text, and highlights companies such as Abridge, Ambience, Nabla, and Suki for capturing language across mediums to gain valuable insight He also covers the pros and cons of conversational AI in healthcare, addressing cybersecurity risks and AI hallucinations while emphasizing the importance of recognizing opportunities and concerns. Tune in and learn how conversational AI is starting to leave its mark on healthcare!Resources:  Watch the entire interview here. Follow and connect with Yoni Shtein on LinkedIn. Learn more about Laguna Health on their LinkedIn and website. Listen to Yoni’s previous interview on our podcast here.

AI offers customizable, Lego-like solutions for health systems, providing genuinely modular and flexible coding tailored to your specific needs, whether it's clinical billing or value-based care.In this episode, Hamid Tabatabaie, co-founder and CEO of CodaMetrix, discusses medical coding and the revolutionary ways AI is making coding automation a possibility and a reality. He explores how CodaMetrix, with its roots in Mass General Brigham, is transforming the revenue cycle by enhancing coding accuracy and harnessing the full potential of clinical data. Hamid also introduces the concept of value-based coding, a holistic approach that promises to streamline coding processes across various departments within health systems. He also provides insights on CodaMetrix's exciting collaborations and developments, including their partnership with Epic and their plans for scaling. Whether you're a healthcare professional, tech enthusiast, or someone curious about the future of medical coding, this episode is packed with insights you will want to take advantage of. Let's dive in!Resources:  Watch the entire interview here. Connect and follow Hamid Tabatabaie on LinkedIn. Learn more about CodaMetrix on their LinkedIn and website. Reach out to CodaMetrix via email here. Listen to Hamid Tabatabaie’s previous interview on our podcast here.

Andrew L'Huillier, a leader in the diagnostics industry, joins us to discuss his work on groundbreaking diagnostic products. Learn about the challenges and opportunities in regulatory compliance, drug discovery, and the implementation of cGMP guidelines. Discover how precision medicine is revolutionizing healthcare and improving patient care.Tune in!Resources:Connect with and follow Andrew L'Huillier on LinkedIn.

Addressing social isolation and loneliness is crucial for improving overall health outcomes.In this episode of the AHIP 2024 series, Tom Carlough, Chief Technology Officer at Wider Circle, discusses the significance of building trust and community in healthcare, particularly focusing on health equity and social isolation. He explains how Wider Circle uses in-person community groups to foster social connections and trust, which helps in collecting essential health information and encouraging health practices like home visits. Tom shares insights from a recent study showing significant improvements in health outcomes through their approach, emphasizing the importance of addressing loneliness and social isolation as fundamental health needs. He also highlights the new CMS regulations mandating health equity, urging healthcare plans to prioritize trust-building and personalized community support, and underscores that social proof and peer pressure within community groups can encourage individuals to prioritize their health.Tune in and learn how community and trust can transform healthcare and promote health equity!Resources:  Watch the entire interview here.  Follow and connect with Tom Carlough on LinkedIn. Learn more about Wider Circle on their LinkedIn and website.

Trust and collaboration between payers and providers are crucial for better healthcare outcomes.In this episode of the AHIP 2024 series, Chuck Feerick, VP of Sales for Clarify Health Solutions, discusses the evolving dynamics between payers and providers, with a focus on AI's role and the integration challenges it faces. Chuck explains fee-for-service 2.0, which lets providers act as if they're in a value-based contract, and emphasizes the importance of trust and collaboration in payer-provider relationships, highlighting Clarify's tools for assessing provider performance and improving care quality. He underscores the need for standardized healthcare contracts and data's role in creating opportunities, noting that Clarify aims to reduce friction and improve healthcare flow by combining health plans and provider data. Chuck also talks about how AI in healthcare faces challenges like hallucination and emphasizes the need for accurate data input while also stressing that innovation in healthcare is driven by everyone involved, from providers to payers.Tune in and learn how value-based care is evolving, focusing more on outcomes than processes!Resources:  Watch the entire interview here. Connect and follow Chuck Feerick on LinkedIn. Learn more about Clarify Health Solutions on their LinkedIn and website.

Early and continuous engagement in quality programs can significantly boost health outcomes and ratings.In this episode of the AHIP 2024 series, Ryan Boulier, VP of Business Development at Sprinter Health, shares insights into how his company is enhancing healthcare engagement through in-home services. He explains how Sprinter Health focuses on reaching underserved populations by providing preventive care at home using a skilled workforce known as "sprinters." By employing community-based sprinters who perform various diagnostic services such as A1C tests, blood pressure checks, and diabetic eye exams, Sprinter Health fosters trust and improves patient follow-up. Ryan emphasizes the importance of early and continuous engagement in quality programs to boost health outcomes and ratings while also highlighting the success of their consumer-based outreach methods in engaging patients who often skip visits. Tune in and learn how innovative home-based healthcare solutions can transform patient engagement and outcomes!Resources:  Watch the entire interview here.  Follow and connect with Ryan Boulier on LinkedIn. Learn more about Sprinter Health on their LinkedIn and website. Listen to Sprinter Health’s previous episode on our podcast here. 

AI has the potential to significantly improve prior authorization, payment structures, and patient navigation. In this episode, Brian Urban, Director of Innovations and Emerging Markets at FinThrive, talks about why understanding and utilizing non-clinical data is crucial for addressing social health needs effectively. He explains how FinThrive, a leading revenue cycle management company, is addressing issues like payment integrity, care coordination, and social health needs. Brian emphasizes the importance of AI in reducing remittances and friction and improving provider-payer relations. He also discusses the importance of social determinants of health data and why he believes intrapreneurship within organizations can drive significant advancements in the healthcare sector, underscoring the importance of data literacy for creating a sustainable healthcare system. Tune in and learn how AI and innovation are set to revolutionize the healthcare industry, making it more efficient and equitable!Resources:  Watch the entire interview here.  Connect and follow Brian Urban on LinkedIn. Learn more about FinThrive on their LinkedIn and website. Listen to FinThrive’s podcast, Healthcare Rethink, here.

Navigating healthcare economics, particularly Medicare Advantage, presents challenges but offers learning opportunities.In this episode, Ed Liebowitz, EVP and Chief Strategy Officer at Solera Health, discusses his path from being diagnosed with juvenile diabetes at 26 to getting inspired for a bright career in health tech. Solera Health started by supporting digital diabetes prevention and expanded to cover various health areas, including mental health, weight management, and hypertension.  Ed explains how the company utilizes a pay-for-performance model, ensuring cost-effective, clinically relevant outcomes. Throughout this interview, he shares insights on the complexities of healthcare economics, especially in Medicare Advantage, and the potential of AI in improving healthcare delivery. Ed also emphasizes the importance of innovation, patient care, and leveraging technology to empower individuals and encourages listeners to stay updated on digital health advancements. Tune in and learn about the transformative power of digital health solutions and the future of healthcare innovation!Resources:  Watch the entire interview here.  Connect and follow Ed Liebowitz on LinkedIn. Learn more about Solera Health on their LinkedIn and website. Learn more about Solera Health’s partners:  Sworkit  Kaia Health Sword  Vori Health 9amHealth

True power lies in naivety, creativity, curiosity, and courage, transforming visionary ideas into tangible outcomes.In this episode, Christian Coachman shares insights from his journey from academia to entrepreneurship, emphasizing the essential qualities of naivety, creativity, curiosity, and courage that have fueled his success. He explores the development of Digital Smile Design, the importance of collaboration to enhance patient outcomes, and his philosophy of sharing ideas to foster innovation while addressing challenges in the dental industry, such as clinicians' business acumen and maintaining quality care amidst scalability pressures. Whether you're a dental professional or curious about tech in healthcare, this episode offers insights as Christian Coachman shapes the future of dentistry, one smile at a time.Resources: Connect with and follow Dr. Christian Coachman on LinkedIn and Instagram. Follow Digital Smile Design on LinkedIn and Instagram and explore their website! Watch the entire episode on YouTube and get more details at Think Oral Health.

AI and predictive analytics offer exciting possibilities for improving patient care and operational processes.In this episode, Jonathan Adam Fialkow emphasizes the importance of empathy and support in medical care, personalized and value-based care strategies, and the effective use of technology in cardiology and population health. He highlights the necessity of addressing provider burnout, the benefits of team-based and concierge care, and the rapid development of big data technologies while also covering how digital tools improve patient engagement and streamline care management, leading to better outcomes and physician satisfaction. Tune in and learn how combining empathy, technology, and innovative strategies can transform patient care and healthcare systems!Resources: Connect and follow Jonathan Adam Fialkow on LinkedIn. Follow Baptist Health South Florida on LinkedIn. Discover Baptist Health South Florida’s Website! Listen to the Baptist HealthTalk podcast here! About Memora Health:Memora Health, the leading intelligent care enablement platform, helps clinicians focus on top-of-license practice while proactively engaging patients along complex care journeys. Memora partners with leading health systems, health plans, and digital health companies to transform the care delivery process for care teams and patients. The company’s platform digitizes and automates high-touch clinical workflows, supercharging care teams by intelligently triaging patient-reported concerns and data to appropriate care team members and providing patients with proactive, two-way communication and support.