Heather Hart Bechtold, MBA

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 used purposefully and responsibly, artificial intelligence improves equity in every part of a hospital, including the emergency department. Previous research found Black patients have a 20% greater chance of being mis-triaged in the emergency department, potentially delaying urgently needed care. Now, the Kaiser Permanente Division of Research is developing a clinical decision support tool that runs on machine learning to improve emergency department patient assessments. #AI #EmergencyMedicine #HealthEquity https://ow.ly/Rlz450Ub6NP

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An important report from California Health Care Foundation that sheds light on pressing health disparities within #Asian communities. 🔎 Key insights include overall access barriers and how that contributes to reduced access to quality care. Varying health needs and preferences require tailored approaches to care and support for this diverse community. 💡 So why does this matter? Addressing these disparities is crucial for achieving overall #healthequity and improving outcomes for ALL populations, but also highlights the importance of developing #healthcare solutions that are culturally sensitive AND accessible. 🙌 I encourage you to read the report: A Closer Look: Health Disparities Among California's Asian Communities (chcf.org) #HealthEquity #AsianCommunityHealth #CulturalCompetency #HealthcareAccess #PublicHealth #HealthDisparities #Advocacy #InclusiveHealthcare

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𝗝𝘂𝘀𝘁 𝗿𝗲𝘁𝘂𝗿𝗻𝗲𝗱 𝗳𝗿𝗼𝗺 𝗖𝗛𝗜𝗠𝗘 𝗙𝗮𝗹𝗹 𝗙𝗼𝗿𝘂𝗺, 𝗮𝗻𝗱 𝗵𝗲𝗿𝗲’𝘀 𝘁𝗵𝗲 𝘁𝗮𝗸𝗲𝗮𝘄𝗮𝘆: I had the honor of joining “𝗚𝗲𝗻𝗲𝗿𝗮𝘁𝗶𝘃𝗲 𝗔𝗜 𝗜𝗺𝗽𝗮𝗰𝘁: 𝗥𝗲𝗮𝗹 𝗗𝗮𝘁𝗮 & 𝗨𝗻𝗳𝗶𝗹𝘁𝗲𝗿𝗲𝗱 𝗣𝗲𝗿𝘀𝗽𝗲𝗰𝘁𝗶𝘃𝗲𝘀” alongside Veena Jones, Medical Director at Sutter Health, moderated by Shivdev Rao, MD, CEO & Founder of Abridge. 𝗛𝗲𝗿𝗲 𝗮𝗿𝗲 𝗺𝘆 𝘁𝗼𝗽 #𝗖𝗛𝗜𝗠𝗘24 𝘁𝗮𝗸𝗲𝗮𝘄𝗮𝘆𝘀: 👥 CHIME Fall Forum: Small-Scale, Big Impact Instead of a massive expo, this is a focused gathering of IT leaders, all here to go deep on what matters: solutions and results. • 𝗖𝗼𝗻𝗻𝗲𝗰𝘁𝗶𝗼𝗻 𝗶𝘀 𝗞𝗲𝘆: In healthcare IT, connection is the backbone. Leaders emphasized that true progress comes from breaking silos and building meaningful relationships. • 𝗧𝗿𝗮𝗻𝘀𝗳𝗼𝗿𝗺𝗮𝘁𝗶𝗼𝗻 = 𝗖𝗼𝗹𝗹𝗮𝗯𝗼𝗿𝗮𝘁𝗶𝗼𝗻: Digital transformation isn’t just an “IT project.” It’s a team sport—business and clinical sides must work together to drive real change. • 𝗔𝗜: 𝗧𝗵𝗲 '𝗪𝗵𝘆' 𝗠𝗮𝘁𝘁𝗲𝗿𝘀: Beyond the AI hype, CHIME leaders stressed purpose. A clear ‘why’ can boost ROI, reduce burnout, and improve patient access. • 𝗔𝗜 𝗮𝘀 𝗮 𝗖𝗼-𝗣𝗶𝗹𝗼𝘁, Not a Replacement: Consensus here? AI is a tool to support, not replace, healthcare professionals, helping clinicians focus on what they do best. • 𝗢𝗽𝘁𝗶𝗺𝗶𝘀𝗺 & 𝗜𝗻𝗻𝗼𝘃𝗮𝘁𝗶𝗼𝗻: There’s hope and excitement about AI’s role in patient engagement and challenging issues like opioid management. • 𝗖𝗮𝘂𝘁𝗶𝗼𝘂𝘀 𝗔𝗜: Leaders are testing before scaling AI. The focus is on purposeful, pilot-based implementations.• Patient Engagement Front and Center: Patient engagement is now a priority, with “digital doors” designed to work across generations—from texts to calls. • 𝗘𝗺𝗽𝗼𝘄𝗲𝗿𝗶𝗻𝗴 𝗥𝘂𝗿𝗮𝗹 𝗛𝗲𝗮𝗹𝘁𝗵: Rural providers prioritized solutions like responsible AI and cybersecurity. • 𝗦𝗺𝗮𝗿𝘁 𝗛𝗼𝘀𝗽𝗶𝘁𝗮𝗹𝘀 𝗼𝗻 𝘁𝗵𝗲 𝗛𝗼𝗿𝗶𝘇𝗼𝗻: Integrating tech and interoperability with a strong focus on culture and organizational change. • 𝗡𝗮𝘃𝗶𝗴𝗮𝘁𝗶𝗻𝗴 𝗗𝗶𝗴𝗶𝘁𝗮𝗹 𝗛𝗲𝗮𝗹𝘁𝗵’𝘀 𝗙𝘂𝘁𝘂𝗿𝗲: Physician execs highlighted understanding user needs to enhance efficiency. Dr. Michelle Rozen insights on focusing on the “people” side of healthcare were powerful, urging leaders to commit to uplifting teams and driving meaningful change. The CHIME24 Fall Forum reminded us of healthcare IT’s shared mission: to drive impact through collaboration, innovation, and a people-first approach. It was especially great to see so many CIOs in person, and a highlight was connecting with ! Ajay Kapare Akhtar Chaudhri Raju Togi, MBA, CFCHE Sonney Sapra MBA CHCIO Harun Rashid Shakeeb Akhter, CHCIO, CDH-E Saad Chaudhry Khurram Mir Aamir S. Michael J. Reagin, CHCIO, MBA Inderpal Kohli Dr Zafar C. ♻️ Reshare to help others in healthcare tech. #CHIME24 #HealthcareIT #GenerativeAI #DigitalTransformation

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Here are some shocking facts regarding the senior-care referral business within California:   Anyone can go into business as a senior-care referrer, no qualifications required. Senior-care referrers have absolutely no obligation to disclose their financial relationships with the assisted living communities to which they refer their clients. Senior-care referrers are not required to perform any due diligence on the communities they recommend. They don’t even have to confirm that these communities are licensed!   I take due diligence very seriously   As a Certified Senior Advisor (CSA®), I follow a very detailed process to ensure the communities at which I place my clients meet my high quality standards. Here is my process:   Step 1: Check Licensure   I always start at the California Department of Social Services’ licensing website, to review all recent visits that their inspectors have made to a community. If there have been minor infractions, I speak with the facility’s owner regarding how these were resolved. If there have been severe infractions, I immediately take that facility out of consideration.   Step 2: Visit Site   Whether it’s a six-bed residential care home or a large assisted-living facility, prior to contracting with them I visit the community and interview them based on a five-page Care Capabilities Checklist. I’m not just looking around to check for cleanliness and atmosphere. I need to know what level of care they are trained, willing and staffed to provide.   While there, I tour the entire community, take photos and ask to speak with residents (and their family if they happen to be visiting at the time).   Step 3: Continuous Reassessment   Once I am considering a community for placement of a particular client, I revisit the Department of Social Services’ website to obtain updated information. After all, things can change, and with that there can be problems at a facility that I previously would have considered a viable option.   Step 4: Communicate with Community   Prior to touring a family, I communicate with the senior community owner or manager regarding the specific care needs of my client. Are they capable right now of managing these care needs?   Step 5: Bring Family on Community Tour   You can bet that while I am there, I pay close attention to what I see.   Step 6: Follow Up   Once I place a resident in a community I return within the first week, and periodically thereafter, to speak with them and their family about their experiences. This feedback then gets added to my database for referencing going forward.   Not all advisors in my field take the same approach   As this recent expose in the Washington Post explains, it can be pretty scary out there!   Yes, the reason I am able to provide my services at no cost to my clients is that, as I fully disclose, I receive a commission from those communities in good standing at which I place my clients.

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September is National Suicide Prevention Month. Thank you Katrina Domingo, PsyD for nominating subject matter expert, Terra Morais, Psy.D., provide insightful tips for suicide prevention. Dr. Morais has worked for Kaiser Permanente for 9 years, and has been manager of its Psychiatric Consultation Service for 2 years. She has specialized training in the treatment of psychiatric emergencies in children and teenagers. We all have times when we feel sad or overwhelmed. For some people, these feelings can become so strong that they have thoughts of ending their life. Suicide is a leading cause of death in the United States and has been on the rise across all groups for years, but we can take steps to help prevent it.   SELF If you are having serious thoughts that you or your loved ones would be better off if you were dead, the most important action you can take is getting immediate help. You can call or text 988 to talk to someone who knows how to keep you safe. If you notice yourself having these thoughts occasionally, or find yourself feeling hopeless, here are some steps to help prevent those thoughts from getting worse: 1. Tell someone you trust how you are feeling. This can be scary, but it the people who care about us want to help us feel better and can be devastated by the thought that they could have helped if only they had known how their loved one was feeling. 2. Prioritize your sleep and reducing stress in any way you can. Lack of sleep contributes to problems with mood, thinking, and emotional regulation. 3. Make a plan to do something enjoyable with a loved one and ask them to help you stick to it. Research has shown that social connections and responsibilities are highly protective factors in preventing suicide deaths. OTHERS Here are some warning signs that someone may be having thoughts of suicide: https://lnkd.in/dyz2BZsd If you notice worrying changes in someone you know, here are a few ways to help: 1. Ask them if they have been feeling like hurting or killing themselves. Sometimes people worry that asking will “put the idea in someone’s head,” but in fact people struggling with thoughts of suicide are usually relieved that they can talk about it. 2. When someone tells you about their thoughts of suicide, listen without judgment or argument and ask if they want assistance reaching out for help. You can call or text 988 with them or make sure they have the number.   RESOURCES The National Suicide Prevention Lifeline (24/7 toll-free suicide prevention service): Dial 988, https://988lifeline.org/   Suicide Prevention Hotline in Spanish: 1-888-628-9454, https://988lifeline.org/   LGBT Youth Suicide Hotline: 1-866-488-7386, or text START to 678-678, https://lnkd.in/d656hGQy   The Crisis Text Line: Text "HOME" to 741741 for free, 24/7 crisis support #suicideprevention #suicidepreventionawarenessmonth #TPMG #DSA #health #wellness #leadership #tips #support

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Fabulous webinar and conversation yesterday about AI in Healthcare cross-country from Mid-Atlantic Permanente Medical Group | Kaiser Permanente with my colleague from SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP Dr. John Rott, thank you Chris Corriveau and the entire team who helped organize. Sharing these apropos tips from our most recent Forbes Technology Council article on "19 Ways To Manage Different Stakeholders 😍" https://lnkd.in/eWymqdkg Top 19! 1. Strive For Collaboration 2. Prioritize Investments Based On Results 3. Communicate Openly 4. Embrace A Long-Term Portfolio Strategy 5. Prioritize With A Strategic Framework 6. Assess Dependencies 7. Develop A Transparent, Systematic Framework 8. Determine Needs And Wants 9. Use Outcome-Oriented Metrics 10. Consider The Value 11. Help Stakeholders Find Common Ground 12. Establish And Follow A Principle-Driven Approach 13. Let Data Drive Your Decision-Making 14. Implement Teams To Focus On Stakeholder Engagement 15. Prioritize Streamlining Workflows And Processes 16. Understand Your Customers’ Needs 17. Hold Stakeholder Meetings Regularly 18. Put A Governance Mechanism In Place 19. Encourage Empathy

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🚨 Breaking News in Healthcare! 🚨 MultiPlan and major insurers, including UnitedHealth, Aetna, Kaiser Permanente, and Cigna, are facing a proposed class action lawsuit. The suit, filed by Live Well Chiropractic PLLC, alleges that these companies have colluded through MultiPlan's pricing tools to systematically underpay out-of-network providers. According to the complaint, MultiPlan's repricing algorithms suppress reimbursement rates, forming a cartel with insurers to fix prices and deprive healthcare providers of fair payments. This alleged scheme is said to have resulted in over $19 billion in annual underpayments, contributing to financial hardships for many providers. The antitrust lawsuit highlights growing concerns about software intermediaries influencing pricing decisions in the healthcare industry. The complaint includes claims for violations of sections 1 and 2 of the Sherman Act. MultiPlan denies these allegations, asserting their commitment to lowering out-of-network costs and reducing patient out-of-pocket expenses. Stay tuned for more updates on this developing story. #Healthcare #Antitrust #RevenueCycleManagement #MedicalBilling #MultiPlan #Insurance #HealthcareProviders Read the full article here: https://lnkd.in/e3-mKr7z

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Where does he get this money?

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One of the reasons we stay in CA and pay one of highest rates of state taxes is this: If you live in Los Angeles, you are one hour away from the beach, the snow, the desert, or the mountain trails. You can be in Santa Monica beach and sit next to the most bougie people, or see the drum circle in Venice, or see the homeless all together enjoying the beach. We coexist and appreciate the gifts we have all around us. But not everything is fairy tales. We also have earthquakes; we live in fault lines, and we often have wildfires. Wildfires are no joking matter. So much damage occurs every fire season. Yesterday was no different when I stepped outside for my run, and I smelled the familiar scent of burning mountain brush. It made me think that life is truly like a wildfire. Things can happen unexpectedly, and there are times a fire is needed to change the direction in our life. Fire, like changes in life, make you feel you can’t breathe and the visibility of the path ahead is not clear. Yet it is important not to panic, and when not in imminent danger, realize trust and calm are the best way to get through to the other side. Help is always on the way, and the firefighters or those in your life will come to help. After the fire has been extinguished, there is always calm and stillness. This is the time to dream of a new future, to rebuild and enlist the help of others. This is true for wildfires or of your life. We must keep faith when the smoke overpowers us, when the path is not clear, when we feel the burn of the fire, when all we see is stillness and ashes, we trust we will be reborn. A new version will come through the pain. That is life. Pain and pleasure. It is not one or the other, or only one. We have both. The sooner we embrace it and the fact that help can also look amazing (literally 😉), the sooner we can go through the up and downs of life with more ease and acceptance. So today, no matter where you are in life. Whether you are burning, you are not seeing the path ahead, you are in stillness or you are ready to rebuild, remember this: You are never alone. Pain may be something we want to avoid, but if we want to grow to a better version, we will have to go through the fire. It is in fire that we are reborn. And if you are a physician and the path seems unclear, you feel lost, or overwhelmed come speak confidentially to a peer 7 days a week via Zoom. Because you matter. Because it is time if you are reading this and because you are never alone. Check out Physician Coach Support in the comments and get to clarity today.

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Enhanced Care Management (ECM) is a whole-person healthcare approach that improves care coordination and outcomes for California’s most vulnerable populations. This statewide benefit addresses the complex needs of high-risk members, from those experiencing homelessness to individuals with #MentalHealth and substance use disorders. Read the full CareThreads blog to learn how ECM provides dedicated care managers and leverages tools for efficient service delivery, ensuring timely interventions and better health outcomes for Californians: https://okt.to/n6Gx5N

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I'm excited to share what one of my clients (UCI Health) is doing to enhance patient experience by boosting communication between doctors and nurses. NRC Health's new article covers their journey and key takeaways. Plus, catch the full webcast on-demand for more details. Read and watch at the link below! #HumanUnderstading #PatientExperience

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The wildfires ravaging Los Angeles County have severely strained the region's healthcare infrastructure. Hospitals, clinics, and nursing homes face evacuations, staffing shortages, and disrupted operations. At least one clinic burned down, while over 700 nursing home residents were evacuated amid swirling embers. Healthcare providers, many displaced themselves, continue working tirelessly to care for patients despite personal losses. Dr. Ravi Salgia, an oncologist, exemplified this dedication, responding to a hospital emergency command center at 2:30 a.m. despite his own home being threatened. St. John’s Physician Partners’ clinic in Pacific Palisades burned down, while major hospitals like Providence St. John’s Health Center and USC Verdugo Hills Hospital prepared for potential evacuations. Power outages and road closures further hindered operations, forcing facility closures and canceled surgeries. Emergency services are overwhelmed by high call volumes, treating burns, smoke inhalation, and related injuries. With disrupted routine care and ongoing challenges, healthcare workers emphasize community resilience and commitment. Our home healthcare clients in California stand ready to serve communities impacted by these devastating wildfires, continuing to be a vital bridge for homebound patients during this critical time. Our hearts go out to the families affected, and we remain committed to supporting their care and recovery. Cliniqon is committed to delivering Guaranteed Quality, Ensured Compliance, and Unparalleled Outcomes in Home Health and Hospice agencies. #HomeHealthServices #HospiceCare #FrontEndServices #BackOfficeSolutions #HealthcareManagement #RevenueCycleManagement #HealthcareCompliance #PatientSupport #CareCoordination #MedicalBilling #ClaimsManagement #PatientEngagement #HealthcareOutsourcing #MedicalCoding #ProviderSupport #CliniqonCare #HealthcareSolutions #PatientCareExcellence #HomeHealthRCM #HospiceBilling MSN

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I had the incredible opportunity to host Yoni Shtein, CEO of Laguna Health, at #AHIP2024 in Las Vegas. Yoni’s journey from private equity to healthcare is deeply inspiring, driven by personal experiences and a passion for making a real difference in the industry. 💡 Yoni shared insights about Laguna Health’s cutting-edge conversational AI technology for care management. Here are the key takeaways from our conversation: 🚀AI in Healthcare: AI's potential is vast, but it's essential to balance optimism with caution, addressing cybersecurity risks and ensuring accuracy. 🚀Opportunities & Challenges: Identifying specific pockets of opportunity and concern is crucial for leveraging AI effectively in healthcare. 🚀Making a Difference: Yoni’s call to action encourages all of us to contribute positively to the healthcare industry, highlighting its profound impact on society and individual health. Click this link to learn more about how to innovate in the healthcare industry: https://lnkd.in/e8tfy2MF #outcomesrocket #AHIP #AI #innovation #healhcare #industry #caremanagement

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As AI technology rapidly integrates into healthcare, the voice of our frontline professionals—nurses—highlights a crucial conversation we must have about patient safety. Nurses at Kaiser Permanente's rally in San Francisco urge a careful, transparent approach to AI deployment, emphasizing that patients are not algorithms and care cannot be automated without robust precautions. It's critical we advocate for thoughtful AI integration that prioritizes patient safety and enhances, not replaces, human care. #PatientSafety #AIinHealthcare #HealthcareInnovation #AI #artificialintelligence

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#Oregon Health Authority launches Oregon Health Forward alongside the Transparency, Accountability, and Belonging Initiative (TABI) tacked on to the recently released updated #strategic plan. Plenty of #BHAG’s along with partnership & possible grants from the #CDC Foundation. Plans a big Culminating Event next fall. Interestingly, population based payments for rural Oregon hospitals (ala Pennsylvania & Vermont) are under consideration. #HealthcareReform #HealthcareTransformation #SDoH #Medicaid #HealthcareCosts #HealthcareQuality #PopulationHealth #BehavioralHealth #PublicPrivatePartnership #PublicPrivatePartnerships #MentalHealth #TripleAim

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