In this episode of the Surviving Healthcare podcast, we will continue this month’s discussion of technology and its place in healthcare with a conversation about how technology can help us better coordinate health care. Too often, a lack of coordination between the patient and family and various physicians and specialists can result in a very confusing situation.

You’ll hear from Asif Khan who is the founder and CEO of CareMerge. His goal through CareMerge is to “forge meaningful connections between providers, payers, families and seniors seeking to improve communication in today’s complex healthcare environment.” Asif is a leader in the technological revolution that is happening in healthcare.

As you listen to our conversation, you will hear about Mr. Khan’s background and why he seeks to improve the communication and coordination aspects of healthcare delivery. You’ll be surprised at how much his experience probably lines up with what many of us deal with and I think you’ll agree with his basic premise. Which is the importance of getting the right information at the right time to the right people.

We then talk about care coordination and how technology is helping to solve the problem, especially with seniors. In many cases, there are a great many actors responsible for a patient’s care and each has to know what the others are doing. We discuss what Caremerge does and how it’s changing things to improve health care by freeing healthcare professionals up to do their job more efficiently and more completely.

The conversation then turns to the dynamics of the current medical records system and how the technology fits into it. You will hear a discussion of the issue of adoption of this type of technology and the role of the Affordable Care Act in that adoption. His description of the value of technology in helping physicians and others do their job is excellent. Asif describes the benefit to everyone involved at nearly every level of the healthcare system. We also discuss the importance of patient information and data in improving the quality of life for everyone.

You’ll then hear his thoughts on the future of healthcare. One of the uses of technology is collecting a lot of useful data that could potentially lead to improved care, but it could also prevent health problems and lead to people leading healthier and more productive lives. We also discuss how technology will make patients more active and involved with their own health care, including those with chronic conditions.

As always, this conversation is extremely informative and should give you significant insight as to the importance of technology in moving the healthcare system forward. I think you’ll really enjoy this discussion.

Resources:

Caremerge

Asif Khan on Twitter

Asif Khan on LinkedIn

In this episode of Surviving Healthcare, you will hear one way technology and health are partnering to achieve better outcomes. My guest for this episode is Ted Spooner. Ted is the co-founder and CEO of Respondwell, one of the best and most-honored physical rehabilitation software companies in the country. RespondWell is a leader in the area of fitness gaming and telerehabilitation. Ted is one of the best possible experts to talk with regarding the use of technology in the healthcare field.

As you listen, you will hear a general discussion of Respondwell and how it evolved from a fitness gaming company, making games for the Xbox, to a company that used the knowledge gained from that endeavor to a company that uses modern technology to achieve better outcomes in healthcare. Included in this discussion is the difference between preventive and prescriptive rehabilitation and why both are important.

You will also hear a fascinating discussion of the various needs people have for different types of therapy and how technology can make it easier to engage in therapeutic activity that can prevent certain problems from occurring in the first place. That leads to the discussion of the biggest difference between healthcare and other markets.

You will hear why the future of healthcare seems to be in the hands of patients more so than physicians and insurance companies, and how that may look in the future. This, the liveliest part of the discussion, demonstrates the learning process that Mr. Spooner and his team have gone through and how they make technology work for both the patient and the physical therapist. We discuss the importance of communication in the rehabilitation process and how the Respondwell facilitates that.

We then talk about the various payment strategies available to both the patient and the physical therapist, and which ones are most likely to work best. The discussion then evolves into a more general discussion of them gaming aspects of physical therapy and how that may change in the future. It follows a typical game model, which can include:

• The need to achieve a goal, based on an engagement model;
• The need to establish a relationship between the “coach” and the player through “personification” technology;
• The need to create an ultimate expectation for the therapy and;
• A reward based on what the user finds important.

Ted explains all of this in great detail and I believe you will find it fascinating. We discuss the importance of the interactive abilities of the technology to patients and physical therapists. And that leads to one of the biggest challenges as technology infiltrates healthcare, which is the importance of the data collected

The future of healthcare is already here, in many ways, and this episode of the podcast gives us a glimpse of that future and how that may look.

Resources

Ted Spooner

Respondwell

Open enrollment for health insurance begins November 1. Which means individuals under 65 that want to change their plan or need to get a plan, now is the time to enroll.

With that in mind, for this episode of the Surviving Healthcare podcast, you will hear what factors to look for to get the most out of open enrollment and get the plan that works best for you. Joining me in this discussion is Sally Poblete, who is the founder and CEO of Wellthie, a company with a software platform that is designed to help people understand their options, so that they can choose the right plan. Before that, she had extensive experience at Anthem, which is one of the largest insurers in the country and she has been awarded for her efforts to help transform the health insurance field. I think you’ll agree that she’s a great guest to help us through the health insurance minefield.

Our discussion begins with an assessment of the value of education when it comes to choosing a health insurance plan. If you don’t think you are comfortable choosing a health plan, you are not alone. Sally explains why she went into this field and why she started her company, and the reason will make you think. We also talk about the relative health insurance literacy of the nation as a whole, which may astound you, as it did me, and make you realize that, not only are you not alone, but there is a huge need for better health insurance education out there. That is what Wellthie is trying to change.

You’ll hear about the effects of technology on the future of health insurance agencies and brokers, and the overall human component of the health insurance industry. We discuss the importance of insurance companies making their products friendlier and the need for better consumer education.

You will hear specific details that all health insurance consumers should look for and be aware of, as a rule. Here are some basic things all consumers should know going in:

• Open enrollment begins November 1 for individuals under 65
• There are four levels of plans available
• Consider the balance between the cost and the coverage you need, without weighing one as more important than the other.
• Check each health plan’s network and continue to check every year
• Assess the insurance company’s approach to customer service, especially when it comes to answering questions
• Remember, you can get a higher deductible plan and find a direct primary care physician using tax favored funds

We get into more detail on each of the above (except finding a direct primary care physician). We also discuss “skinny networks” and why it matters that you know the importance and why it’s important to make your insurance company speak to you in plain language, in a way that you understand and to ask a lot of questions. We also discuss in great detail why insurance companies may have a hard time speaking to consumers, historically speaking, and why we think that should change in the future. A lot of things may be changing in the future, and some transformations may be huge, especially with regard to transparency in costs and practices.

This episode should provide you with a lot of great information as you prepare for open enrollment beginning November 1.

Resources:

Wellthie

Sally Poblete

@wellthie on Twitter

Facebook

In this episode of Surviving Healthcare, you will hear tips and tricks to surviving Medicare’s annual open enrollment period. This happens every year from October 15th to December 7th. This is a very important time of year for Medicare recipients, and this particular show aims to provide you with important information during this time as well as hints that you are on the right Medicare path.

You will hear from Danielle Kunkle, who is a founding partner at Boomer Benefits, a Medicare insurance agency that is licensed in more than 40 states and which consistently ranks among the premier national Medicare agencies in the country. She specializes in educating Medicare beneficiaries about their available insurance options, so they can go into the market with eyes open and confidently choose the insurance plan that best fits them and their medical needs. She has written numerous articles on the subject of Medicare benefits and is a frequent speaker on these issues.

Our discussion begins by talking about what Medicare open enrollment is, what it means and how it works. Specifically, we talk about the different parts of Medicare and how open enrollment works with each.   Danielle explains how Medigap insurance fits into the picture. She explains the Annual Notice of Change letter, what that means to you and how you should handle it.

Next, you’ll hear how changes to your Medicare plan have to be made and why and she gives some great advice for easily making side-by-side comparisons of costs and plan details. During this part of the discussion, she reveals some new legislation being considered in Congress that could be a game-changer.

You will also find out what happens when you sign up for a plan during open enrollment and the importance of research before you choose or change a plan and making sure you’re comfortable. There are many choices you should know about and consider.

Danielle provides questions everyone should consider when choosing between a Medicare Advantage plan and a Medigap plan, such as:

• How do you get your peace of mind?
• Where do you live during the year?
• Are you on a fixed income and will the cost of a plan be too much?
• Does your current plan raise rates every year?

There are several things you should know about Medicare’s annual open enrollment and Medicare Advantage plans. Such as:

• Have you reviewed your Notice of Change packet this year?
• Are you willing to review search out the best plan for you if your plan changes?
• Are your doctors are in the network?
• Do you want co-pays and deductibles or a higher premium?

In closing, you’ll hear Ms. Kunkle discuss the importance and the relative advantages of Medicare Advantage and Medigap plans overall. This show is a very informative discussion that anyone facing Medicare’s annual open enrollment will find informative.

Resources

Boomer Benefits

Danielle Kunkle

Articles at Benefits Pro

1-855-732-9055

This episode of Surviving Healthcare is a continuation of direct primary care with practical applications. You will hear how business, both large and small, can implement direct primary care to both improve the healthcare of their employees and decrease what they are paying for medical costs. Joining me on the show again is Dr. Stephen Schimpff. Dr. Schimpff is an internist with training and board certifications in internal medicine, medical oncology and infectious diseases. Dr. Schimpff was a clinician, educator and researcher before taking on multiple leadership roles within the University of Maryland Medical System, which is recognized as one of the largest and most prestigious medical systems in the country and even the world.

You will hear Dr. Schimpff begin by summarizing direct primary care and immediately dive into how direct primary care is of great benefit to patients by building a stronger, more personal relationship. Additionally, physicians have more time to spend with their patients in this model of care. Dr. Schimpff gives several specific examples to illustrate the potential savings, by using models championed by specific companies.

Dr. Schimpff then discusses the new dynamic between the patients, employers and insurance companies. He explains how he envisions the future, which I found very interesting and I believe you will, too.

You’ll hear specific scenarios in which companies can convert their current health benefit systems into a direct primary care model, while getting a better handle on care and costs. Specifically, we discuss how this approach gives patients more control over their care and reduces the waste in the system. You will hear how self funded groups as well as fully insured groups can implement this in their business.

Dr. Schimpff explains how direct primary care helps “the sickest of the sick” by discussing a company that is doing just that around his area. If the quality of outcomes is better and the cost savings are realized while serving these Medicaid patients, which you’ll hear about, then this model can be applied in your company.

The bottom line is, doctors and patients are not getting the time to develop a relationship which is critical to better healthcare. Direct primary care allows a return to relationship medicine and drops the total cost of healthcare and it is a model you can employ as an individual or a company today.
Resources:

Dr. Stephen Schimpff

Medical Megatrends

Fixing the Primary Care Crisis

The Future of Healthcare Delivery

In this episode of Surviving Healthcare, you’ll hear about a topic of huge importance and excitement, one that can have an enormous impact on our healthcare system. I’m talking about direct primary care. My guest for this show is Dr. Stephen Schimpff.

Dr. Schimpff is a physician with tons of experience and insights into our healthcare system. He is internationally renowned as a cancer specialist and has held numerous leadership positions with the University of Maryland Medical System, one of the largest medical systems in the country and the world. He has authored a number of books about our healthcare system including the one we’ll be discussing today, Fixing The Primary Care Crisis.

Our discussion begins with the problem: physicians have too little time to spend with patients. Patients don’t feel like they’re getting proper care from their physician with the limited amount of time and physicians are extremely frustrated. Dr. Schimpff explains what direct primary care is, what it entails and why it gives both physicians and patients the time they need.

You’ll hear about the benefits of direct primary care. We talk about the importance of allowing the physician to spend more time on patient problems and lifestyles and not just pawn off patients to specialists or send them home with a prescription. We discuss the negatives that opponents bring up. You’ll see how paying your primary care physician directly is actually more cost-effective.

The next part of our discussion focuses on the dynamic among patients, doctors and insurance companies. The indirect relationship between you and your physician is a symptom of a big problem. Dr. Schimpff discusses how paying the doctor directly, called direct primary care, actually makes health care better and improves the doctor-patient relationship.

We then talk about the financial aspects of such an approach, wherein you take a less expensive, high-deductible insurance plan and buy a primary care membership and/or pay for each visit through a medical savings account, which could save you money on taxes, as well. We also talk about how many direct primary care physicians save their patients money on drugs.

The ideas in this podcast may seem counterintuitive, but when you hear this discussion, you may change your mind. Paying for your own primary care could means more time with your physician and higher quality care. It may even save you some money.   The important thing to remember is it is something you can do immediately to improve the time and access to your physician. Listen and let us know what you think.

Resources:

Dr. Stephen Schimpff

Medical Megatrends

Fixing the Primary Care Crisis

The Future of Healthcare Delivery

In this show you will hear a useful discussion for parents regarding the issue of adolescents and mental health, which I hope will help parents get this stage of their child’s life in a healthy, happy way. My guest for this discussion is Dr. Adelita Segovia, a board-certified psychiatrist at the Clayton Behavioral Center in St. Louis. Dr. Segovia focuses her practice on issues having to do with adolescent mental health and is an assistant professor of clinical psychiatry at Washington University.

Our conversation starts with the biggest risks parents often have to deal with regarding a teenager’s mental health. Dr. Segovia talks about several studies that have been done in recent years that analyze the biggest risks, including depression and a number of other troubling statistics that make consideration of a child’s mental health a very important factor in their lives.

You will hear the most important signs of depression and other mental problems and how they differ from standard adolescent emotional problems and adult emotional problems. She explains why parents should be attuned to a teenager’s behavior, so that they can recognize the behavioral changes that serve as signs of a potential problem.

You’ll then hear about the potential triggers of such concerning behavior and Dr. Segovia explains some of the greatest stressors, such as bullying, academics, social problems and how they can affect a teenager. One of the biggest risks is substance abuse, and Dr. Segovia explains why that is the case. You’ll hear her discuss the biological tendencies of the adolescent brain and how these risks can affect their mental health.

The next portion of the show turns to treatment. This includes the use of therapy and medication, including some of the most common therapy modalities, like cognitive behavioral therapy and interpersonal psychotherapy, which she explains in great detail. She also explains why it’s important to help families understand and change some environmental factors that contribute to the mental health problems experienced by adolescents.

We also discuss the importance of modeling behavior for adolescents and to deal with environmental factors that may be contributing to mental health problems or to prevent them from happening in the first place. These include setting clear rules and boundaries in their day-to-day life, and the importance of positive reinforcement. This leads to a very freewheeling discussion of how parents, even those from broken families, can help teenagers make good choices and how that can contribute to good mental health. She explains why it’s important to place the child’s well-bring first, no matter what.

Communication with teenagers is often very difficult, and Dr. Segovia will give you some great strategies for bridging that communication gap. Understanding teenagers involves a lot of listening and less reacting. There is a reason why teenagers act the way they do and you have to engage with them to a greater degree, and Dr. Segovia explains how to do that.

The show concludes with a discussion of how parents can know they need to get professional help for their teen and how to go about doing that. There are specific steps to take and you should take them in order.

Resources:

Dr. Adelita Segovia

Clayton Behavioral

This episode of Surviving Healthcare features an interesting conversation about one physician’s journey to open his own direct-pay practice after being in an insurance based practice. My guest for this episode is Dr. Erik Korzen, a chiropractic physician at Dynamic Physical Health, who also teaches Human Anatomy and Human Physiology at Wheaton College and the National University of Health Sciences. Dr. Korzen prides himself on taking an evidence-based approach to health care.

Our discussion begins with an explanation of how Dr. Korzen decided to become a physician in the first place, including his thought processes at the time he decided to become a physician when he was an undergrad studying physical therapy. You’ll hear him explain what that caused him to switch and go to chiropractic school. He then talks about the progression of his career, from working as a doctor in a chiropractic practice to starting his own direct-pay practice.

You’ll hear his experience working in an insurance based practice with the focus on quantity rather than quality. Dr. Korzen discusses what drove him to open his own practice and use a direct-pay model. He also talks to me about how he was able to set up a successful practice despite the fact that he had no previous business experience, which is fascinating. He was able to create a model in which the business side takes a back seat to patient care, and how he got there is a great story.

The discussion then turns to how he deals with patients and prepares them for the experience of dealing with a doctor on a cash basis, and his policies on dealing with patients on the business end. You’ll hear about the barriers that he had to overcome when setting up his own practice.

Dr. Korzen then talks about his unconventional and interesting choices regarding marketing. He explains his choice of practice location and why it has been a strategic dream, for him and his patients. We then turn to the implications of being a “cash-only” practice, and how he communicates that to the patients who rely primarily on insurance to pay for their medical care.

Overall, this discussion is a great one for anyone who is considering opening up their own practice, with a lot of great and useful information, and I hope you enjoy it and find it useful.

Resources:

Dynamic Physical Health

Dr. Erik Korzen

[email protected]

Back to Basics Blog

In this episode of the Surviving Healthcare podcast, you will hear a very active and wide-ranging discussion of chiropractic care, including its origins, its status when it comes to medical care and its future. Our guest for this episode is Dr. Erik Korzen, a chiropractic physician at Dynamic Physical Health.
Our conversation begins with the principles of chiropractic care and what that means, including the philosophy behind it, as well as its evolution. He explains the two schools of thought and why some chiropractors are considered “straights” and others are considered “mixers.” We also discuss the dynamic between science and philosophy with regard to chiropractic care and what chiropractic care entails.

You will hear Dr. Korzen straighten out some of the misconceptions people have about chiropractic care, why some of the worst misconceptions persist and how they can sometimes lead to patients not getting the care they actually need. That leads us into the science of chiropractic care and what that means to a practice like Dr. Korzen’s, and how his “mixer” approach to chiropractic care is more effective than simple “spinal alignment.”

We then discuss what patients should look for in a chiropractor and how state laws and licensing restrictions vary. The variation results in chiropractors who practice in a wide variety of ways, some of which I found surprising, and I’m sure you will, too. We then talk about the training that chiropractic physicians undergo and what is required at various schools, as well as how that’s changed over the years, with more medical training and more requirements for internships and clinic work.

The next area we get into is very interesting, as we discuss the attitudes of patients toward chiropractic care, including people who swear against it and those who won’t go to any other type of physician, as well as everyone in between. This is where we talk about the main tensions between traditional medicine and chiropractic care, which parallel those between science and philosophy.

We end our discussion with some advice for people who might want to look into becoming a chiropractic physician, including a discussion of the best chiropractic schools in the country that he would recommend. We also discussed standards, and how those are changing and whether things are becoming more equal nationwide and how things work with regard to insurance, as well as Medicare and the Affordable Care Act, and how reforms are changing the way chiropractors are paid.

Resources:
Dynamic Physical Health
Dr. Erik Korzen
[email protected]
Back to Basics Blog

In this episode of the Surviving Healthcare podcast, you will hear an enlightening discussion about the prevalence of Celiac Disease, and how gluten actually affects the body and overall health. With this show’s guest, Jama Lambert, you will discover and learn about a new test, the Array 3, that is far more effective in differentiating between Celiac Disease and non-Celiac gluten sensitivity. Ms. Lambert is the Director of Education at Cyrex Laboratories, which is where this new test was developed.

We begin our discussion with an educational discussion regarding Celiac Disease and its related cousins, non-Celiac gluten sensitivity and wheat sensitivity. You will hear about the differences between them and how they manifest themselves in the human body. We talk about how to recognize each one and what each one means to the health of the human body, including the negative health consequences of each.

Our conversation then turns to the difficulties in diagnosis. Not everyone presents with the same symptoms, in fact two individuals may have Celiac disease but the their symptoms are appear completely opposite. Ms. Lambert talks about the most common complaints and symptoms, some of which may surprise you, and there is a very detailed explanation of the process of getting a full and proper diagnosis, including the biological processes involved with these conditions.

We then talk about the problems with misdiagnosis, as well as the inefficiency and inadequacy of much of the testing in this area. This leads us to a detailed explanation of a new, more accurate test, called the Cyrex Array 3 that has a much wider range than the standard Celiac panel. That, in turn, leads to a discussion of the value of expanded testing capability and how it will help a lot of patients who are currently not being helped.

Our discussion then moves to insurance companies and the ins and outs of getting tests covered, even if they deny the claim for testing the first time. Ms. Lambert also discusses the possibility of patients ordering the tests directly. We talk about how certain tests like the Array 3 can change a person’s life by getting them the right information about their gluten sensitivity, we discuss the barriers to getting more comprehensive tests like the Array 3 into the market. This leads us into a lively discussion of the politics and bureaucracy of the entire medical system and how that will probably change in the near future.

We end our conversation with a discussion of the effects of gluten itself, and why people with a sensitivity should stay away from it for life, and what will happen if they don’t. We also discuss the importance of patients being persistent in finding a root cause for their medical conditions and not just accepting the first convenient diagnosis.

Resources:

Cyrex Laboratories

Joincyrex.com

What is Celiac Disease?

Cyrex Array 3