In this episode of VBCA Podcast, the host discusses the challenges faced by healthcare startups, particularly those focusing on value-based care. Key points include the necessity of building a solid patient base, leveraging community partnerships, and balancing patient volume with quality care. The episode also introduces a new segment, 'Tough Calls in Healthcare,' where the host provides advice on tricky negotiation scenarios, such as payer reimbursement dilemmas and contract amendment concerns.
The episode concludes with 'Should This Really Be Happening?'—a segment highlighting outrageous and frustrating stories from the healthcare system, including exorbitant trauma fees, denied emergency room claims, and the misuse of automated insurance denial systems.
00:00 Introduction to Healthcare Startups
01:17 The Reality of Value-Based Care
02:48 Strategies for Patient Acquisition
04:13 Balancing Patient Volume and Quality
05:16 New Segment: Tough Calls in Healthcare
05:58 Case Study: Payer Reimbursement Dilemma
08:05 Case Study: Unilateral Amendment Clause
10:14 Case Study: Pay for Performance in Rural Hospitals
12:11 Case Study: Bundle Payment Models
13:54 New Segment: Should This Really Be Happening?
21:21 Conclusion and Call for Stories
Sound Bites
"Value-based care sounds amazing, in theory."
"Losing a major revenue source is daunting."
"A unilateral amendment clause is a red flag."
#healthcareinnovation #healthcareprofessionals #negotiationstrategies #valuebasedcare #managedcare #startups
