Kristen Duell

Key Metrics a Virtual Hospital Manager Should Monitor In the rapidly evolving landscape of healthcare, virtual hospitals are at the forefront of leveraging technology to provide accessible and high-quality care. For a virtual hospital manager, monitoring key metrics is crucial to ensure smooth operations and optimize resource allocation. Appointment and Patient Flow Management Completed Appointments: Track successfully completed appointments. Cancelled Appointments: Monitor cancellation rates. Pending Appointments: Keep an eye on appointments awaiting confirmation. Geographic Distribution Patient Distribution Map: Visualize patient numbers from different regions. Service Coverage Areas: Identify high-demand regions. Service Performance Average Service Time: Measure service completion times. Patient Satisfaction Scores: Analyze feedback to improve services. Resource Utilization Staff Workload: Track patient numbers seen by healthcare professionals. Equipment Status: Monitor availability and functionality of medical devices. Emergency Management Emergency Calls: Track number and nature of emergency calls. Response Times: Measure emergency response times. System Health and Security Server Performance: Monitor IT system health. Data Security: Track security incidents. Financial Performance Revenue and Expenditures: Monitor income and operational costs. Insurance Claims: Track processed claims and billing accuracy. AI and IoT Integration Diagnostic Accuracy: Measure AI-based diagnostic tools' accuracy. Remote Monitoring: Ensure IoT devices are properly connected. By prioritizing these metrics, virtual hospital managers can create a responsive, patient-centered healthcare environment that meets the needs of a diverse and dispersed patient population.SEHA AL RAHBA HOSPITALSanalBeePudena Health Consulting Co.Mustafa Köroğlu

5

1 Comment

Have you thought about hiring a positive messaging nurse retention consultant? Why not? If you aren’t sure why you would need that? Read this. Or listen to it. I’m telling you, Dean Malpass is one of the best business mentors and consultants I’ve met. It’s exactly what American healthcare needs. Your welcome. #healthcare #leadership #expert

5

2 Comments

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

35

12 Comments

📝 The Importance of Advance Directives: Planning for Your Healthcare Future Have you thought about what kind of medical care you want if you can't speak for yourself? Advance directives are crucial for ensuring your healthcare wishes are known and respected. Here’s why they matter: 1️⃣ Empowerment: Take control of your healthcare decisions by outlining your preferences in advance. 2️⃣ Family Peace of Mind: Spare your loved ones the stress of making tough decisions during difficult times. Clear guidelines help avoid family disagreements. 3️⃣ Legal Protection: Advance directives ensure that your wishes are honored by healthcare providers, reducing the chances of unwanted treatments. 4️⃣ Flexibility: You can update your directives anytime as your preferences or circumstances change. 5️⃣Avoiding Prolonged Suffering: Advance directives can help prevent unnecessary or unwanted medical interventions that might extend suffering or diminish quality of life. 6️⃣ Clarity for Healthcare Providers: Having clear instructions in place helps healthcare providers make timely and informed decisions aligned with your values and preferences. 🌟 Start the conversation with your family and healthcare provider today! Do you have one in place? If so, like this post!  ✨Check out my newest book for more information, “The Roadmap to Hospital Care,” available now on Amazon to purchase! Link below:  https://lnkd.in/ggZGPfAi #AdvanceDirectives #HealthcarePlanning #PatientEmpowerment #HealthcareFuture #LivingWill ##AdvanceDirectives #HealthcarePlanning #LivingWill #HealthcareProxy #DurablePowerOfAttorney #PatientEmpowerment #HealthcareDecisions #PeaceOfMind #MedicalPlanning #InformedConsent #HealthLiteracy #EndOfLifeCare #PatientRights #WishesMatter #LifePlanning #HealthCareAwareness #FuturePlanning #KnowYourOptions #PlanAhead #FamilyHealth #WellnessJourney #HealthcareFuture #EmpowerYourself #LegalDocuments #HealthCareChoices #SelfAdvocacy #PatientAdvocacy #TakeControl #YourVoice #HealthcareSupport

2

Exciting times at 4C Digital Health! Wilmington, Delaware - 4C Digital Health (4C), the preeminent organization delivering independent financial oversight and control solutions for self-funded employee health plans, recently announced the strategic expansion of its services into the Commonwealth of Kentucky. In late 2023, 4C successfully competed for an initial award issued by Kentucky’s Department of Employee Insurance, and Kentucky has since extended the initial contract to allow 4C to continue its important work on behalf of the Commonwealth, its employees, and its taxpayers. The Kentucky Employee Health Plan (KEHP) serves more than 288,000 members, which amounts to 1 in 16 Kentuckians. In addition, KEHP spends over $1.8 billion dollars in total healthcare benefits on behalf of its members per year and covers over 8.2 million claims per year. KEHP objectives include “improving employee health and well-being” and “providing state-of-the-art benefits while maintaining reasonable premiums.” Recognizing its important fiduciary responsibilities to its employees and its state health plan, the Commonwealth of Kentucky enacted Senate Bill 42 (2023) introduced by Senator Stephen Meredith for the purpose of ensuring that critical health plan dollars are being spent properly on behalf of state employees. The legislation requires that 4C analyze 100% of medical claims submitted for payment to KEHP; identify erroneous overpayments; and identify inappropriate or erroneous fees imposed by KEHP’s third-party administrator. Ron Templeton CEO of 4C Digital Health stated: “4C Digital Health is grateful to the Commonwealth of Kentucky for recognizing the fiduciary responsibility that state and local governments have to their employee health plans and for the opportunity to provide our services in support of this mission. We appreciate Kentucky’s goal of using 4C’s expertise and innovative solutions to improve healthcare outcomes and reduce healthcare costs for the Commonwealth, its employees, and its taxpayers.” About 4C Digital Health: 4C Digital Health (https://lnkd.in/eB-fJg4X) is a healthcare data analytics company that was founded for the purpose of developing a disruptive technology targeted at bringing transparency and honesty to the healthcare marketplace.

15

3 Comments

**CMS 2025 Final Rule & Key Implications** -Payment Rates: A 2.93% reduction for 2025 (conversion factor: $32.25). Your focus on efficient care delivery and accurate coding is essential to offset reductions. -KX Modifier: Therapy thresholds increased to $2,410 for PT/SLP and $3,000 for OT, making documentation critical to avoiding denials. -Telehealth Adjustments: Congress may determine whether current flexibilities continue. New allowances include audio-only telehealth and expanded billing for caregiver training services (CTS). -Therapy Assistant Supervision: General supervision replaces direct supervision in outpatient settings, offering greater flexibility and improving access to care. -Therapy Plan Certification: Physician orders can now act as signatures, reducing delays in therapy initiation and administrative burdens. Check out the HealthPRO Heritage comprehensive overview of the latest changes and their potential impact on your organization by reading our detailed summary of the Final Rule updates. #CMSFinalRuleUpdates

6

As 2024 concludes, healthcare leaders have gained critical insights amidst rapid advancements and challenges. Here's a glimpse of the year's key lessons: 🔍 Data as a Strategic Ally: Harnessing real-time analytics transforms operations and patient care. 💻 Telehealth’s New Era: Virtual care isn't just an option—it's expected. 🩺 Workforce Resilience: Supporting staff well-being is pivotal for quality care. 💡 Personalized Patient-Centered Care: Building trust through tailored approaches ensures loyalty and satisfaction. 📜 Adapting to Regulations: Proactive compliance safeguards growth and quality. 🚀 Tech Integration: Innovations like AI show promise but demand careful execution. 💰 Value-Based Care's Rise: Aligning rewards with patient outcomes reshapes operations. As we step into 2025, the focus remains on resilience, innovation, and care. These takeaways set the stage for a robust and adaptable future. What 2024 lessons resonate most with your healthcare journey? Let’s connect and discuss! #HealthcareLeadership #InnovationInCare #2024Lessons #FutureOfHealthcare

1

1 Comment

Thank you to our wonderful participants this afternoon in the HCT Consulting Group Healthcare Transformation Executive Roundtable. Brian D. Washburn, DHA, MHA, FACHE, FACMPE, CHFP, PMP Chris Saxman Elizabeth Crawford Restat Elya Prystowsky, MS, PhD Mark Korth. I was encouraged by several insights from this amazing group: 👉 #Transformation - we know it when we see it! 👉 #Valuebasedcare - we know it when we don't! 👉 #Valuebasedcare means different things to #patients and #providers but we should not lose sight that like or not, we have to play by the language and definitions being proposed by the Centers for Medicare & Medicaid Services 👉 #Transformation towards #VBC should be keeping healthcare simple, local and well-coordinated - what 99% of people are trying to do today. Organizing to stop the despicable 1% is adding 30% of costs to everyone - especially #ruralhealth 👉 #EMR Transformation has put some hospitals out of business and in some communities, when the hospital closes, the whole community shuts down 👉 #Transformation this group sees on the horizon includes demand for change only intensifying, doing more with fewer providers, addressing #documentation challenges, #AI should focus on removing the hassle of the little things 👉 MAJOR RISK AHEAD - Will #transformation defined by CMS + #BigTech lead to a loss of simplifying the provider-patient experience? Will documentation to meet #VBC demands only escalate due to the 'potential' of what technology offers? And therefore, will health disparities only expand due to the inability of #ruralhealth to keep up? Ultimately - will we eventually have to unwind many of the current technology investments to one day return to a simpler provider-to-patient connection? Thanks again to our amazing participants. DM me if you'd like to be on our roster to participate in the next one!

12

🔥Really big news out of Centers for Medicare & Medicaid Services right now with their plan for payments from the government to MA plans expected to increase on average by 4.33%, or over $21 billion, from 2025 to 2026, as proposed. 📰 The news is much needed as Medicare Advantage has faced two years of flat reimbursement growth from CMS that has Humana down 43% in the last year along with CVS Health down 44% that leaned into MA last year. 💵 Humana is up big (4.5%) in after hours trading along with UnitedHealth Group up 2.5% as they UNH is the largest Medicare Advantage provider with over 7.8 million lives (3 million pdp) while Humana is second with 6.2 million lives (2.3 million pdp/8.5 million total). CVS Health is up 2% in after hours trading as well which is a nice shift for them. ⬇️ Medicare Advantage was one of the hottest lines of business in healthcare but over the past 6 quarters seniors have experienced high utilization post COVID, reimbursement was starting to slow as there was a 5.0% increase in 2023, 3.32% in 2024, and 3.7% for 2025. This 4.33% increase is a big unexpected tailwind for Medicare Advantage providers. UnitedHealth Group, Humana, CVS Health, Elevance Health, Kaiser Permanente and Centene Corporation are the largest providers of Medicare Advantage in the US so this will be good news headed into the weekend! Nice little shot in the arm for HCSC which is expected to close on the 600,000 member Medicare Advantage business from The Cigna Group in Q1! Interested to hear comments this week J.P. Morgan Healthcare Conference in San Francisco #healthcare https://lnkd.in/g2qZTaxM

37

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

9

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

2

🚑 Transitional Care Management: Smooth Transitions, Better Care From hospital to home, we’re here to ensure smooth transitions for your patients. 🏥➡️🏡 Reduce readmissions and improve satisfaction with Medify Health! 🌟 Learn more: medifyhealth.com. #TransitionalCare #PatientSupport #HealthcareSuccess

4

4 Comments

Let's keep hospice focused first and foremost on the PATIENT. After all, we only get one chance to do it right... "There are six primary trends that are influencing consolidation and professional practices: regulatory complexity. technology and integration, private equity ownership. demographics, economies of scale and consumer expectations,” Henderson said. “So many of these things that we see that are influencing health care consolidation need to be pointing toward the patient." #patientsfirst #hospicecare #youonlygetoneshot https://lnkd.in/gbbgV-YF

17

1 Comment

🚦 𝐓𝐡𝐞 𝐒𝐭𝐫𝐚𝐭𝐞𝐠𝐢𝐜 𝐏𝐨𝐰𝐞𝐫 𝐨𝐟 𝐒𝐚𝐲𝐢𝐧𝐠 𝐍𝐎: 𝐀 𝐇𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 𝐋𝐞𝐚𝐝𝐞𝐫𝐬𝐡𝐢𝐩 𝐏𝐞𝐫𝐬𝐩𝐞𝐜𝐭𝐢𝐯𝐞 Brian Halligan's insights on strategic decision-making at HubSpot offer profound lessons for healthcare organizations. In an era where healthcare opportunities are expanding exponentially, the 𝒑𝒐𝒘𝒆𝒓 𝒐𝒇 𝒔𝒕𝒓𝒂𝒕𝒆𝒈𝒊𝒄 𝒇𝒐𝒄𝒖𝒔 has never been more critical. 🎯 The healthcare sector faces constant innovation, regulatory changes, and expansion opportunities. Yet, the most successful organizations aren't those that chase every opportunity - they're the ones that choose their battles wisely. 𝐊𝐞𝐲 𝐒𝐭𝐫𝐚𝐭𝐞𝐠𝐢𝐜 𝐏𝐫𝐢𝐧𝐜𝐢𝐩𝐥𝐞𝐬: 𝘍𝘰𝘤𝘶𝘴 𝘥𝘳𝘪𝘷𝘦𝘴 𝘦𝘹𝘤𝘦𝘭𝘭𝘦𝘯𝘤𝘦 𝘪𝘯 𝘩𝘦𝘢𝘭𝘵𝘩𝘤𝘢𝘳𝘦 𝘥𝘦𝘭𝘪𝘷𝘦𝘳𝘺 🔬 Resources concentrated on core competencies yield better outcomes Strategic "NO" protects organizational mission and patient care quality 💡 𝐓𝐡𝐞 𝐌𝐒𝐏𝐎𝐓 𝐅𝐫𝐚𝐦𝐞𝐰𝐨𝐫𝐤 𝐢𝐧 𝐇𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞: Mission: Clear healthcare impact goals Serve: Defined patient segments Plays: Strategic initiatives to execute Omit: Non-core opportunities to decline Track: Outcome metrics 𝐏𝐫𝐨𝐯𝐨𝐜𝐚𝐭𝐢𝐯𝐞 𝐐𝐮𝐞𝐬𝐭𝐢𝐨𝐧: How many healthcare organizations compromise their excellence by trying to be everything to everyone? 🤔 #HealthcareStrategy #HealthcareLeadership #StrategicPlanning #HealthcareManagement #HealthcareInnovation What tough strategic decisions have transformed your healthcare organisation? 🙌

8

Why I’m the Leader Your Organization Needs In today’s evolving healthcare landscape, success demands more than just meeting goals—it requires transforming challenges into opportunities and driving measurable impact. With years of executive leadership experience in healthcare, I’ve led organizations to higher performance, stronger teams, and greater patient satisfaction. From elevating Medicare Star ratings and generating revenue growth to scaling quality programs across markets, I turn strategy into results. I believe in empowering teams, leveraging data, and creating sustainable solutions that improve both business outcomes and patient care. My entrepreneurial mindset and passion for innovation allow me to see the bigger picture while delivering real-time results. I’m ready to bring this vision and energy to an organization committed to growth, excellence, and meaningful change. Let’s connect and talk about how I can help lead your team to success! #Leadership #HealthcareInnovation #QualityImprovement #OperationalExcellence #DataDrivenResults #TransformationalLeadership

12

For all the talk about value-based care, progress still is very slow. Advisory Board data shows the small amount of progress made from 2017 to 2022, which varies drastically by line of business. Medicare Advantage is the primary segment driving VBC, mainly due to aligned incentives where plans and providers could get paid more through upcoding (or "appropriate coding") of patients to drive more revenue & margin through the entire system. That drove penetration of VBC in MA, and CMS has paid attention, releasing significant headwinds (v28, RADV, Stars) aimed at reducing these perceived overpayments. In other segments, VBC has been very slow to grow. Commercial VBC arrangements were essentially stagnant. Anecdotally, this is starting to change. Plan sponsors (employers) -- especially large, sophisticated ones -- are demanding more from their carriers. They want to see network arrangements that impact quality & cost. Will that be enough to drive VBC activity in the commercial space? We'll see. Employers -- the customers -- will be the ones who will drive VBC forward here. TPAs alone don't have the incentive to make changes. I remain hopeful, but skeptical. #valuebasedcare #healthtech #digitalhealth

34

Dear Purchaser of Consulting Services, There is something you need to be aware of that will change how you find the specialized help you need from time to time. At ProNexus Advisory, we've built a virtual network of Independent Healthcare Consultants. We saw a gap between the larger, pricier, more traditional firms, whose model hasn't changed in decades, and the over 20K independents and small boutique firms that few know and who by definition, are somewhat limited in their scope and scalability.  The team we've curated numbers over 270 now and there isn't much within the healthcare continuum that we can't address. We have expert advisors from all walks of life, including C-Suite, MD's, Dept. Heads, RN's and more covering the acute, non-acute, ambulatory and Health Tech sectors. We have solutions and expertise in Pharmacy, Radiology, Regulatory, Compliance, Quality, Safety, Finance, Operations, HR, Medical Staff, Start-up, Facilities Expansion, Virtual Health, Elderly Care, PT, Payor, Medicare and all things AI and Technology to name a few. The compelling value of our network is we don't bring just one person or advisor, we can bring a team of folks depending on the complexity of the situation or project. On the Health Tech side, our TaaS (Talent as a Service) model allows us to help you leverage great expertise without burdening your P&L upfront. In the end, you can continue to do what you've always done, which is overpay for questionable expertise and recommendations you provided during discovery, or you can dip into the gig economy and try our virtual network. 100% of the time, our team will have the solutions, expertise and strategic partnerships you need at a fraction of the cost with more flexibility and options to scale to your needs. Let's chat and learn more about each other. ProNexus Advisory: Where Innovation and Expertise Meet. https://lnkd.in/gESGmerr #healthcareconsulting #healthcareleaders #consulting #virtualnetworks #independenthealthcareconsultants ProNexus Advisory Ronnie H. Kinsey, MBA Rebecca Love RN, MSN, FIEL Maria Granzotti Don Rowe CJ Lee Fred Just Lloyd Duplechan Donald Bernard Ron Stewart Kevin B. Dull, JD, MBA, MSML Danielle Lord, PhD Dr. Michael Grow, DrPH, MBA, MT, CIC David Mike Amir Emamifar, PharmD, MBA Suzanne DiGerlando Richards Dr. Suzanne "Suzi" Waddill-Goad Christopher Kodama, MD, MBA Christopher J Colombo MD, FACP, FCCM, CEC Douglas Arent Cyndi Manuel Dr. Julie Rennecker, PhD Julia Cooney, MBA, BSN Arash Dabestani John Kriak, PharmD Shelley Simkins Patches (Pace) Seely Demetrius Kirk, DNPc, MBA,MSN, RN, LNHA, LSSGB, PAC-NE, QCP Adrian Gonzales PharmD, APh, BCPS Kevin Ball Ann Zuehlke Michael Pereira Scott Zielski Scott Cook John Mentgen FACHE Mark Kestner MD Bert Miller Jordan Dominic Paul Jurgensen

35