💡HTN | Community Brain Trust | 8/8
🧵TOP THREADS OF THE WEEK
In case you missed them, here are highlights of a few interesting conversations from different channels:
Threads included below:
- How to assess the technical ability of clinicians who are seeking telehealth roles
- Can you manage clinical calendars using tools like Reclaim AI or Motion?
- Recommendations for SMS / call integration for HubSpot CRM
- Implementation timelines in Medicaid plans
- A discussion of how CVS and Oak Street interact based on the earnings call
1. Assessing technical ability of clinicians seeking telehealth roles
Q: random question - is anybody aware of decent technical competency screening assessments for clinicians seeking telehealth roles? Assessing for this via standard interview formatting leaves a lot of gaps in understanding, and I've learned the hard way enough at this point that a misunderstanding of a team member's technical competency can lead to extremely challenging management of fully remote teams.
– Desmond Watt | via #random
Thread Summary: A discussion of how to assess a clinician's technical competency to succeed in a clinical role on a fully remote team. Some ideas on addressing these issues in onboarding or a pre-recorded video response from the candidate
Ellen Su: Spitballing here, but could you ask them to submit a pre-recorded video response to some standard interview questions as part of your screening process? The skills involved in setting up, filming, and submitting a video clip may help filter down to the folks who either know how to do it or are willing to learn/try
2. Using Motion or Reclaim AI to manage a clinical calendar
Q: Does anyone use a product like Motion or Reclaim AI to manage their calendar? Has anyone used it to manage the calendar of a doctor or other clinical staff in a practice setting?
– Efraim Keisari MD | via #random
Thread Summary: HTNers talk about whether "AI Executive Assistants" like Motion or Reclaim can be used to help manage clinical calendars. It appears they're still generally for personal use, although Reclaim is at least thinking about healthcare on the roadmap (see below).
Efraim Keisari MD: @Atiya Hasan, MD, MBA I emailed the security team and they said:
Unfortunately handling PHI and HIPAA compliance isn't something we can support at this time. We're still a fairly small team, and I have some personal experience working in the healthcare tech space and the requirements for HITRUST and handling PHI are significant. It's something we hope to be able to do and offer in the future, but customer data privacy and protection is a priority for us, so unfortunately we aren't in a position to reliably offer that for PHI at this time.
3. Recommendations for a SMS / call integration for HubSpot CRM
Q: Hi friends,
Can anyone recommend a good SMS text and call integration for HubSpot CRM? There are quite a few options in their marketplace. Ideally we’re looking for one platform that handles sales agent calls and texts, and has analytics based on agents.
– Lexie Magyar | via #buildersask
Thread Summary: TalkDesk, RingCentral, and Dialpad mentioned as options with some pros / cons for each.
Christopher Young: I’ve used both TalkDesk and RingCentral in the past. TalkDesk was more $ but the much better product IMO
4. Implementation timelines in Medicaid plans
Q: After the extreme utility of @Duncan Reece’s article on the MA bid cycle, it got me thinking about this in other areas. Let's say I am the VP of Quality at a Medicaid plan. My [Mark's] understanding is that HEDIS and other quality measures are typically reported on in the first half of the year, for the prior year's performance. The time period can vary by QM but speaking generally. As the VP of Quality I'd hear about 2022 performance in the Fall of 2023. Therefore if I am looking to improve on my QM performance i might be shopping in late Q3 and in Q4 to a) try to course-correct where I was deficient last year and b) get a solution in the door for 2024.
Is this correct? What am I missing?
– Mark Liber | via #buildersask
Thread Summary: In a well-managed health plan, most of these metrics are managed and understood internally year round, even if the public reporting is delayed. More broadly, there will still be planning cycles as detailed below.
Rick Foerster: Some thoughts based on my experience:
1 - (Well managed) plans have a good idea of their performance year round and are constantly updating projections. They usually have a good idea of their soft spots, unless they are surprised some way in the year.
2 - However, planned tactics are usually implemented based off a calendar year, with budgets getting set around Q3. So it’s can be a good time to lock in next year’s investments.
3 - As year goes by, yes, there is decreasing impact to goals, so longer-term initiatives (e.g. takes months to implement) are less valuable. But there are also crises or maybe missed projections (e.g measure coming in lower than expected).
Here people are very primed for new tactics that are quick impact because a) they could miss their budget/projection, b) more importantly, people miss this bonus targets (or could get fired). People will pay an enormous premium for speed and certainty of impact.
4 - No matter what, EVERYONE seems to have sprint periods. Exact timing varies by program (e.g. Medicaid may be different than MA, different from Medicare). Q4 most for end of year measures, Q2 for mid year measures, and Q1 for any post-year work (e.g. reporting or reconciliation).
5. A discussion of the CVS / Oak Street integration
CVS earnings call was this morning, and it was a particularly interesting one (to me at least :) ). Perhaps not surprisingly given the restructuring announced yesterday, there appear to be some major headwinds ahead for the org, resulting in them decreasing EPS guidance for 2024 and pulling EPS guidance for 2025
– Kevin O'Leary | via #news
Thread Summary: CVS earnings this week prompted a good back-and-forth on two fronts: one, whether Oak Street has an ability to be a leading indicator of utilization changes before they show up for the insurance business, and two, whether CVS will be able to drive more patients into Oak Street clinics.
Rick Foerster: @Kevin O'Leary Patient acquisition is a very underrated challenge in these models as they scale.
We are talking about changing the PCP of a 65+ patient. A few may not have PCPs, but why don’t they have a PCP at 65+? Those could be some of the hardest to engage/manage patients or use a specialist for pseudo primary care. If you start to get a little too aggressive, you could affect other things downstream. E.g. nothing like hard to reach patients getting into your global risk pool!
Also, I think CVS has historically stayed away from poaching patients with existing PCPs to maintain continuity, but if that Signify home assessor is incentivized off PCP referrals to Oak… could be hard to manage.
That said, lots of smart people at Oak (many HTNers) thinking about these challenges every day. Hope they can retain them post IPO and now post acquisition.
Here we highlight a question from the Slack that needs some additional community insights - if you have a helpful thought, jump in below!
Q: who are the top examples of lifecycle marketing done well at B2B2C firms?
– Kevin Wang | via #buildersask
🤖HTN KNOWLEDGE BOT
If you have your own question(s) to ask, don’t forget that a good place to start is our HTN Knowledge Bot. It’s our smart search tool that makes it easier to access the wisdom shared within the HTN powered by ChatGPT. You can log in and use it on the website (here) or see how to use it directly in Slack here.
Check out the example ask below!
What's the difference between a PPO and an HMO?
Knowledge Bot Answer:
When it comes to health insurance plans, there are different types, including PPO (Preferred Provider Organization) and HMO (Health Maintenance Organization). Here's a breakdown of the differences:
1. Network: PPO plans have a larger network of healthcare providers, including doctors, specialists, and hospitals. You have the flexibility to see any provider within the network without a referral. HMO plans have a more limited network, and you typically need to choose a primary care physician (PCP) who acts as a gatekeeper for referrals to specialists.
2. Referrals: With a PPO plan, you don't need a referral from your PCP to see a specialist. You can directly schedule appointments with specialists within the network. In contrast, HMO plans usually require referrals from your PCP for specialist visits.
3. Out-of-Network Coverage: PPO plans offer some coverage for out-of-network providers, but you'll generally have higher out-of-pocket costs, such as higher deductibles and coinsurance. HMO plans typically don't cover out-of-network care, except in emergencies.
4. Cost: PPO plans tend to have higher premiums compared to HMO plans. However, you may have more freedom in choosing healthcare providers and may have lower out-of-pocket costs for services. HMO plans generally have lower premiums but require copayments for most services.
5. Primary Care Physician: PPO plans don't require you to select a PCP, allowing you to see any provider within the network. HMO plans require you to choose a PCP who manages your healthcare and coordinates referrals to specialists.
For more information, you can refer to these resources:
Please note that the specific details of PPO and HMO plans can vary depending on the insurance provider and the plan itself. It's essential to review the plan documents or consult with your insurance provider for accurate and up-to-date information on coverage and benefits.
Here we highlight helpful resources from across the community:
- The Retrievals: a podcast from Serial Productions via Tamra Lair. A podcast that discusses IVF treatments at a Yale Fertility Clinic, where a nurse stole fentanyl and replaced it with saline. As described in Slack, "tough to binge but such a needed conversation."
- An NY PC that is fully set up but never been operated in NY is for sale via anon. For HTNers interested in a PC in New York, check out the conversation linked here.
- Fortune's Global 500 list includes UnitedHealth Group in the top 10 via Michael Ceballos. The US based companies in the top 10: Walmart (1), Amazon (4), Exxon Mobil (7), UnitedHealth Group (10).