Khosrow Shotorbani

The Association of Healthcare Value Analysis Professionals (AHVAP) celebrates Elizabeth Eisenberg, MSN, RN, CVAHP from Scripps Health for commitment to excellence in the specialty of healthcare value analysis! Liz has signified this commitment by signing the official Association of Healthcare Value Analysis Professionals (AHVAP) healthcare value analysis pledge. To learn more about the Association of Healthcare Value Analysis Professionals (AHVAP) Commitment pledge: https://lnkd.in/gqEWPBue. #AHVAP #valuebasedcare #excellenceincare #valueanalysis

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If you want to up your value analysis game by uncovering hidden utilization savings, don’t stop with just tracking, trending, and observing changes in your supply spend. Start benchmarking your 350+ categories of purchase to elevate and maximize your savings results.

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#Nurses and #doctors are noticing firsthand that anemia is growing faster globally than we ever thought. They truly represent a new culture of first responders in this critical area of healthcare. We hope that medical colleges, #hospitals, and nursing associations will support awareness of the vital roles these healthcare professionals play in serving the public's needs. These healthcare providers, along with many companies, also represent the foundation of potential cures for anemia worldwide. Consider this: The smallest amount of air blown into a balloon will automatically increase its size and visibility. The relationship between healthcare providers and anemia needs to be seen on a much larger, broader scale—just like that balloon. This also enhances the dignity and respect they’ve always deserved. We can't afford to let this balloon deflate, as doing so would set us back significantly. Our work focuses on building bridges that bring healthcare providers closer to understanding the patient. We’ve created a meaningful insignia for doctors and nurses that fosters trust and understanding from the very first examination. This is a new concept for #anemia, and we anticipate new partnerships and ideas that will expedite awareness even further. Until then, we deeply appreciate all collective efforts—together, we will defeat public enemy number one: Anemia. UChicago Medicine Englewood Hospital Cleveland Clinic Mayo Clinic Geisinger Johns Hopkins Medicine Loma Linda University Health Hackensack Meridian Health Penn Medicine, University of Pennsylvania Health System Mount Sinai Health System NewYork-Presbyterian Hospital MedStar Washington Hospital Center American Society of Hematology American Nurses Association American Academy of Anesthesiologist Assistants UCLA Health Yale New Haven Health Jefferson Health NYC Health + Hospitals

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The Psoriatic March: PsA before PsO https://buff.ly/3CQxT2s

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What does calling my cable company have to do with Medicaid? I had to call a certain notorious cable/internet provider recently. The one with customer service so bad that it was skewered in a classic South Park episode. I blocked out an hour and braced for my inevitable PCOM aneurysm rupture. Shockingly, it was a breeze. The rep was friendly, and my issue vanished in minutes—a far cry from their usual 'dial-one-to-scream-into-the-void' reputation. So, what changed? Competition happened. A decade ago, our choices for cable and internet were as limited as the soda options in a health spa. Now, thanks to a buffet of streaming services—even including live local TV—the old cable giants had to step up their game or step aside. Turns out, competition is more effective than caffeine at improving service quality. Why can't Medicaid beneficiaries get the same treatment? Currently, most Medicaid coverage is through Managed Care Organizations (MCOs), where the state pays a fixed monthly rate per patient. This model should spur cost-efficiency, but it often just limits the scope of care. Low payments to doctors, restricted access to necessary services—who does that help? Could strict government regulations guarantee better service? Maybe, but FA Hayek (and a basic reading of history) prove that bureaucracy alone can't engineer excellence. And choice for Medicaid patients? Virtually non-existent. Many areas offer just one MCO. If you're dissatisfied, too bad—there's no alternative. It's like being stuck with dial-up in the era of fiber optics. Long wait times for basic procedures, no freedom to seek better coverage... It's eerily reminiscent of the old cable monopoly days. In the private sector, at least there's a semblance of choice: HMOs, PPOs, HSAs... But for Medicaid recipients? Sorry, the state chooses for you. Hope you like it. Our Medicaid system desperately needs a dose of competition. Isn't it time we offer Medicaid patients the luxury of choice that drives quality up and costs down? https://t.co/C7XE6CpIIP Joe Grogan Lisa Grabert Joanne Spetz Cheerag Upadhyaya, MD, MBA, MSc, FAANS, FACS Brian R. Gantwerker, MD, FAANS, FACS Sanjay Dhall Larry Bucshon, M.D.

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When our FDA commissioner speaks, we listen 😊 Last year, it was terrific to read his thoughts on real world data for regulatory decision making (https://tr.vet/40mjvZw). The clear thinking helped us ensure that Truveta is providing our partners the data and analytics they require to exceed FDA expectations. Last week, he opined on “Artificial Intelligence in Health Care” – but this time, I found the lack of specifics less helpful. “The FDA has authorized almost 1000 AI-enabled medical devices and has received hundreds of regulatory submissions for drugs that used AI in their discovery and development.” I expect AI is being used in some way in the discovery and development of every drug and medical device right now. The paper concludes: “The FDA will continue to play a central role in ensuring safe, effective, and trustworthy AI tools to improve the lives of patients and clinicians alike. However, all involved entities will need to attend to AI with the rigor this transformative technology merits.” It’s encouraging to see the FDA emphasize the importance of rigorous oversight. Yet, clearer expectations would provide innovators a more defined path forward. Last year, I offered some thoughts on potential guidelines in this space: https://tr.vet/48tLLeQ. Curious to hear from others on this important topic – let me know your POV in the comments 👇 https://tr.vet/3Uydt4i

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Wow! This checklist is a fantastic resource for tackling the HHR crisis head-on! It's incredible to see actionable steps that can make a real impact across the healthcare system. Let's keep the momentum going—please take a moment to explore and share with your networks. Together, we can drive meaningful change! 🙌🔗 Jump over to the Canadian College of Health Leaders to join the National Conversation - Part 3, taking place in October !!! #Healthleadership

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Great Post Bob ... I have said a few times... "The role of Supply Chain in healthcare is evolving significantly, shifting from a transactional role to a strategic function with a direct impact on financial performance. Supply Chain now has a presence at the C-level, underscoring its importance in driving margins and supporting sustainable financial models. By adopting a holistic approach to expense management and overseeing all non-labor spending, Supply Chain leaders can create substantial value.And its not all created equal. Exmaple: reducing costs by just 5% can yield the same profit impact as increasing revenue by 100%, highlighting the efficiency of cost management over revenue initiatives in improving profitability. This transformation aligns closely with strategic imperatives around delivering higher value with fewer resources, supporting revenue generation, and enhancing competitive advantage. Moving towards clinically integrated, population health-focused, and value-based contracting models is critical for the future."

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Each year, Modern Healthcare's Top 100 includes numerous CEOs from massive hospital systems, PBMs, digital health/technology companies and carriers whose actions have played a significant role in creating the most expensive healthcare system in the world, one that delivers shockingly poor outcomes. It’s no surprise, given that many of these institutions are prioritizing profits over patient care, and in some cases, they’ve been found guilty of practices that harm both taxpayers and vulnerable populations. Let's take a look at some of the past honorees—leaders from companies like Tenet Healthcare, which paid over $500 million in fines for defrauding Medicaid and exploiting pregnant women through illegal kickback schemes, or Pfizer, whose $2.3 billion settlement for fraudulent marketing was the largest healthcare fraud case in history. UnitedHealth Group leadership always makes the list and has faced multiple False Claims Act lawsuits for inflating Medicare Advantage payments, and Oak Street Health, under Annie Lamont, recently agreed to pay $60 million to resolve allegations of kickbacks in Medicare Advantage recruitment. Centene Corporation, led by Sarah M. London, has paid billions to settle claims of overcharging state Medicaid programs. UPMC, RWJBarnabas Health, AdventHealth, Ascension and other hospitals' leaders are always on the list. And we cannot leave out Steward Health Care's Ralph de la Torre. He has made the list multiple times, including as recently as 2021. In all fairness, the list is "most influential," not necessarily "most influential in a good way..." Look, It’s not about the list itself, but imagine the powerful statement we could make if those who want real change inundated Modern Healthcare with a new kind of nominee. It would serve as an indictment of the current system—a call for leaders like Marilyn Bartlett, Cynthia Fisher, Dave Chase, Health Rosetta-discovering archaeologist, Kevin Lyons, Dave Chase, Health Rosetta-discovering archaeologist, Hugh O'Toole, Ryan Kline, Mark Cuban, Scott Conard, MD, Stacey Richter, Ann Lewandowski.... those who are genuinely working to reshape healthcare for the better. Let’s show that we demand integrity, transparency, and results—not just shareholder returns and growth. Make your voice heard- it’s time to send a message to the industry that we want a different kind of influence—one that is about integrity, transparency, and results for the American people. #healthcare #leadership #changemakers #modernhealthcare #nominate #transparency

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Epic Systems’ recent move to back the TEFCA medical records exchange is interesting. On the surface, it’s all about creating a seamless flow of patient data across hospitals, QHINs, and all relevant stakeholders. But let’s be real—data is the oil of the new economy, and interoperability is the pipeline that delivers this precious resource to all the right stakeholders. By aligning with TEFCA, Epic might just be positioning itself as the refinery. All in all, this is a welcoming move by Epic Systems—especially if it really is as straightforward as they make it sound. But given the lack of details, one has to wonder if there are any hidden catches. After all, when it comes to something as valuable as healthcare data, it’s wise to look out for the fine print. Let’s hope this is genuinely about improving patient care. https://lnkd.in/gDdDCcmj

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Excellent read Medical Economics. We appreciate you sharing our report findings on the #Valuebased health care Market Read @ https://rb.gy/j3q3ld .View market insight @ https://t.ly/ZyYAD 

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👀check this out!👀 The all-new Vizient, Inc Essential Medications report is here, and it’s more powerful than ever! Imagine this: how can we truly measure resilience? How can we proactively safeguard continuity of care? This reimagined report dives deep, integrating demand planning and market resiliency insights. It’s a must-see transformation—don’t miss out!

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If you're worried about building trust in AI maybe quit (obsessively) talking about it so much in your marketing/messaging/positioning. Seriously, the only people who truly care about your tech stack are VCs....customers/users sure don't. Tell me how your solution helps me and quit wasting my time telling me how you built it and what's under the hood. #ai #generativeai #healthcareai #medicalai #software #applications #saas #cloud #marketing #messaging #positioning #strategy #gotomarket https://lnkd.in/gWuf8Yc9

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Engage with leaders from #healthsystems, #heathplans, #lifesciences #pharma #advocacy and #government who are innovating strategic initiatives to advance #valuebasecare at the #thincValue: Value Based Care Summit, October 28-29, in Washington, DC. Produced by The Healthcare Innovation Company (thINc) Speakers include: Lee Handke, PharmD, MBA, Chief Executive Officer, Nebraska Health Network Conrad Vial, MD, Senior Vice President and President, Sutter Health Network Richard Gurley, Founder and Chief Executive Officer, Ryse Health Eric Gallagher, Chief Executive Officer, Ochsner Health Network, Ochsner Health Elaine Ziegler, President, Palliative Division, Gentiva Sandy Balwan, M.D. MD, Senior Vice President and Executive Director, Clinical Integration Network IPA, Northwell Health, Mollie Gelburd, JD, Senior Director, Delivery System & Payment Transformation, America's Health Insurance Plans (AHIP) Carol Vargo, Vice President, Physician Practice Sustainability, The American Medical Association (AMA) Aisha T Pittman, MHP, Senior Vice President of Government Affairs, National Association of ACOs (NAACOS) Ann C. Greiner, MCP, President and Chief Executive Officer, Primary Care Collaborative  Jeff Micklos, Executive Director, Healthcare Transformation Task Force Michael Udwin, MD, FACOG, Medical Director, Provider Collaboration and Network Transformation, CareFirst BlueCross BlueShield Alexander Ding, MD, MBA, Associate Vice President, Physician Strategy & Medical Affairs, Humana Catherine Anderson, Senior Vice President, Health Equity Strategy, UnitedHealth Group Stephen Ondra, Vice President, Center for Transforming Health, MITRE; Director, CMS Alliance to Modernize Healthcare (Health FFRDC) Conor Sheehey Sheehey, Senior Health Policy Advisor, Senate Finance Committee, United States Senate  George Lourentzatos, Chief of Strategy and Operations, Union Health Center Lisa Wetherbee, Chief Executive Officer, Trinsic, A Clinically Integrated Network Mark Carley, Vice President-Managed Care & Ambulatory Services, Multistate Division, AdventHealth Zachary Rabovsky, Director, Practice Transformation and Population Health Strategy, CareFirst BlueCross BlueShield Ryan Tyner, MD, FACS, Chief Medical Officer, Ryse Health Lisa Stockdale, Director of Value Based Care, Silver Cross Health Jen Norton, Senior Vice President, Head of U.S. Patient and Market Access, Takeda Joseph (Joe) Smith, MD, PhD, MD, PhD, Chief Scientific Officer, Becton Dickinson Jennifer Bright, President, International Consortium for Health Outcomes Measurement (ICHOM) Jason Spangler, MD, MPH, FACPM, Chief Executive Officer, Center for Innovation & Value Research Natalie Davis, Chief Executive Officer and Co-Founder, United States of Care #healthcare #healthoutcomes #personalizedcare #wholepersoncare #percisioncare #preventativecare https://lnkd.in/eCAp8BpR

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Digital health leaders should be *hoping* for an investment boom this year instead of *bracing* for one... One statistic jumped out at me: 46% are *still* working to achieve meaningful product-market fit. Doesn't seem to bode well for fundraising? Don't get me wrong - I'm hopeful that digital/virtual care options as part of the continuum of care can help people improve their health and finally start to bend the cost curve in healthcare. But a crowded market, with operating cash stretched and less purchasing activity suggest consolidation this year. Any investors care to weigh in? https://lnkd.in/gtG8uz6d

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Walmart joins so many others in quickly entering and leaving or scaling back in healthcare after ambitious plans to scale. This morning, Walmart said it will close all 51 of its health-care clinics, as well as shut down their telehealth virtual care services. This is right after an announcement in March that they wanted to double the size of their clinical operations by opening up over 20 more locations this year and more next year. The reasons they cited? “Like others, the challenging reimbursement environment and escalating operating costs create a lack of profitability that make the care business unsustainable for us at this time.” As a physician, it’s been fascinating to watch over the past few years as so many non-medical companies try to get their bite of the huge percentage of the GDP that is healthcare. They pour money into trying to deliver healthcare at scale, ignoring the many concerns that hospital systems and physician private practices have been citing for years: declining reimbursements, shortages of clinicians, and expensive labor costs. Healthcare is broken, and those that are in it understand why. Patients need - and deserve - quality health care. This requires safe staffing practices, skilled clinicians who can feel good about what they do, and insurance companies that pay their bills. We can’t have a system where insurance companies can get away with record profits while finding more and more reasons not to pay for care and eroding away at the heart of healthcare. You cannot scale your way out of America’s healthcare problem. You actually need to fix the incentives, regulate insurance companies, pay clinicians appropriately, prioritize clinician well being and retention, and focus on the patient. The days of paying lip service to physicians leaving medicine and physician burnout are numbered. Supply and demand forces will necessitate real solutions that move the needle. Companies will come and go in the healthcare space when they realize how hard it is on the ground in healthcare these days. The question for patients and legislators is, who will be left to pick up the pieces if there’s no support for physicians, other healthcare workers, and hospital systems?  The percentage of clinicians leaving healthcare annually because they no longer recognize the heart of why they joined the profession is astounding, with over 1/4 of clinicians looking to leave within the next few years. Relying on the altruism of clinicians and the erosion of quality healthcare to support profits for corporations is just not a sustainable business model in healthcare - not to mention terrifying for public health. #HealthcareOnLinkedIn #PhysicianBurnout #PhysicianShortage #Walmart

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Since we’re talking healthcare reform, let’s consider: 𝘁𝗿𝗮𝗻𝘀𝗽𝗮𝗿𝗲𝗻𝗰𝘆 and 𝘀𝗼𝗹𝘂𝘁𝗶𝗼𝗻𝘀. Mark Cuban’s transparency ideas: publishing prices, simplifying incentives, and exposing inefficiencies—shows how markets can do much of the heavy lifting. But healthcare doesn't behave like other markets. People aren’t always “rational actors,” and patients aren’t “equally informed consumers.” I'd like to see us leverage AI to help out. By pairing transparency with AI-driven tools, we can address the gaps in rational behavior, improve decision-making, and align incentives across the board. Here’s how AI could support transparency and innovation for each key stakeholder in U.S. healthcare: 🏛️Governments AI can monitor costs, quality, and outcomes in real time, making inefficiencies and disparities visible. Predictive analytics could forecast the impacts of new policies, making Medicare and Medicaid more efficient. AI could also detect and address rampant Medicare fraud, and government could fund AI tool development for doctors, nurses, and patients (below). 💼Insurers as Third-Party Administrators Insurers acting as TPAs could automate claims processing (without default denials), streamline workflows, and reduce errors. Transparent data-sharing with employers and providers would improve coordination while eliminating financial incentives to block care. 🏢Employers (althought I'd prefer we separate healthcare from employment entirely) Employers could use AI to analyze employee health trends, target wellness programs, and reduce absenteeism and workers' comp claims. 💊Pharma Pharma's already adopting AI for drug discovery — bravo! But we desperately need transparency, like Mark Cuban Cost Plus Drug Company, PBC is doing. Why are Americans paying so much for our medicines? 🏥Hospitals/Health Systems AI could optimize patient flow and reduce bottlenecks in emergency rooms and ORs. Transparent reporting on costs and outcomes would help patients and payers compare hospitals and push for better value. 👩‍⚕️👨‍⚕️Doctors & Nurses AI could drastically reduce charting, coding, and documentation burdens, allowing providers to focus more on patients. It could also help process the massive amounts of data doctors and nurses need to interpret every day, improving decisions and outcomes. Could be a godsend. 🙋‍♂️Patients AI could empower patients with tools like a “foundational health” chatbot for basic health concerns, offering self-care advice and directing them to a doctor or ER when needed. Trust me: "My child has a fever" and "Does this cut need stitches" chatbot could help every stakeholder in this list. 💡 The Opportunity Ahead Transparency exposes inefficiencies, and AI helps fix them? Together, they could simplify processes, align incentives, and improve outcomes across the system. If we combine these forces (along with a bunch of other changes, to be clear), we can build a healthcare system that works for everyone.

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