Modern Practice Podcast
Modern Practice is your curbside consult with top clinicians from around the country. This exciting podcast series features medical experts sharing their ideas and approaches for the latest strategic trends and clinical challenges. Hosted by Dr. Tomas Villanueva and brought to you by the Vizient Medical Leadership team.
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Episodes
Thursday Apr 20, 2023
Thursday Apr 20, 2023
Counteracting errors in clinical documentation can improve care for the patient and reimbursement for the health care organization by giving a true picture of the care offered. On this episode, we discuss how improving relationships with hospital staff, particularly clinical staff, can bring improvement in documentation.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Amber Sterling, RN, BSN, CCDS
Senior Consultant, Clinical Documentation Improvement
Vizient
Show Notes:
[01:31] Importance of working with other departments – silos have increased
[03:08] Working with the quality department
[04:23] Working with clinical teams
[05:53] Effect on revenue cycle
[06:48] Inadequate reimbursement and denial trends
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Amber’s email: amber.sterling@vizientinc.com
Vizient clinical documentation improvement site: Click here
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Thursday Apr 13, 2023
Thursday Apr 13, 2023
This episode of our award-winning podcast continues examining the impact of risk adjustment models and methodologies. Knowing the models and their updates is crucial to full reimbursement for the patient’s care.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guest:Jim Tamburini, BS, RHIT, CCS, CCS-P, CDIPSenior Consulting Director, Clinical Documentation Improvement and CodingVizient
Show Notes:
[00:47] Variables and POA
[03:03] Heart failure
[04:00] Changes in the COVID model and pediatric COVID model
[04:57] Document completely; MEAT (monitor, evaluate, assess, and treat)
[06:28] Clearly delineate POA conditions from conditions acquired after admission
[07:01] The Problem List
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Jim’s email: james.tamburini@vizientinc.com
Vizient clinical documentation improvement site: Click here
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Thursday Apr 06, 2023
Thursday Apr 06, 2023
This episode of our award-winning podcast examines the impact of risk adjustment models and methodologies. Knowing the models and their updates is crucial to full reimbursement for the patient’s care.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guest:Jim Tamburini, BS, RHIT, CCS, CCS-P, CDIPSenior Consulting Director, Clinical Documentation Improvement and CodingVizient
Show Notes:
[00:58] The importance of risk models
[01:35] Reflecting how sick your patients are
[01:54] Variables and need for correct documentation
[02:43] Vizient methodology to help documentation
[03:19] Palliative care codes
[03:57] Present on Admission (POA)
[04:19] Obesity
[04:50] Malnutrition: average hospital patient only eats 1200 calories/day
[06:32] Cardiac device variables
[07:57] Oncology models
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Jim’s email: james.tamburini@vizientinc.com
Vizient clinical documentation improvement site: Click here
Subscribe Today!
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Thursday Mar 30, 2023
Thursday Mar 30, 2023
This episode of our award-winning podcast continues an examination of the CMS Star mortality rating, its significance and what clinical practices and organizations can do to improve their mortality scores.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guests:Linda Wiseman, BSN, RN, CCDSSenior Consulting Director, Clinical Documentation ImprovementVizient
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting Director, Clinical Documentation ImprovementVizient
Show Notes:
[00:37] How to improve on mortality scores
[02:07] Risk adjusting and variable condition categories
[04:18] NIHSS scores (stroke)
[06:13] “Sludge” and the need to copy, paste and edit
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Linda’s email: linda.wiseman@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
Fact sheet on CMS Stars Ratings: 10.6.22 FACT SHEET - 2023 Medicare Star Ratings.pdf
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Thursday Mar 23, 2023
Thursday Mar 23, 2023
This episode of our award-winning podcast begins a two-part series on the CMS Star Rating. The Centers for Medicare and Medicaid Services (CMS) provide the star rating system to evaluate health and drug services for the benefit of patients, enabling them to make informed care decisions. The next two episodes will examine the star mortality rating specifically, its significance and what clinical practices and organizations can do to improve their mortality ratings.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guests:Linda Wiseman, BSN, RN, CCDSSenior Consulting Director, Clinical Documentation ImprovementVizient
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting Director, Clinical Documentation ImprovementVizient
Show Notes:
[01:30] CMS Star Ratings defined
[01:58] CMS Star mortality rating explained
[03:27] Mortality condition categories
[03:59] Exclusion criteria
[06:58] Non-compliance example with heart failure – how to code correctly
[07:55] Coding to the correct principal diagnosis
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Linda’s email: linda.wiseman@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
Fact sheet on CMS Stars Ratings: 10.6.22 FACT SHEET - 2023 Medicare Star Ratings.pdf
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Thursday Mar 16, 2023
Thursday Mar 16, 2023
On this episode of our award-winning podcast, Tom continues his discussion with two leading pharmacy experts on what medications and classes of medications are in expedited approval and what this means for patients in overall efficacy and safety, the benefits and the drawbacks.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guests:Jeni Hayes, PharmD, MSPharm, BCPSSenior Clinical Manager, Pharmacy OutcomesCenter for Pharmacy Practice ExcellenceVizient
Steven Lucio, PharmD, BCPSSenior Principal, Pharmacy SolutionsCenter for Pharmacy Practice ExcellenceVizient
Show Notes:
[00:44] Recap of approval pathways
[01:33] Examples of accelerated approval drugs and effect of delays
[03:59] Only 50 percent of accelerated approvals converted to full approval
[05:32] Challenge in keeping track of drugs in the process
[06:13] Huge cost of ineffective drugs that win approval
[07:02] Huge cost of developing drugs that end up not working
[09:55] Need for providers to look at evidence on approved drugs
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Steven’s email: steven.lucio@vizientinc.com
Jeni’s email: jeni.hayes@vizientinc.com
FDA’s accelerated approval update page: Click here
Vizient Pharmacy Market Highlights – Dec. 2022: PMO322_PharmacyMarketOutlook_Highlights.pdf
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Thursday Mar 09, 2023
Thursday Mar 09, 2023
During the COVID pandemic, the vaccine approval process went from eight years to a few months. In addition, the FDA has used several expedited approval pathways, starting in the 1990s with HIV treatments and continuing today. On the next two episodes, Tom talks with two leading experts on these various approval pathways, what medications are on the approval fast track, and other considerations regarding expedited approval today.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guests:Jeni Hayes, PharmD, MSPharm, BCPSSenior Clinical Manager, Pharmacy OutcomesCenter for Pharmacy Practice ExcellenceVizient
Steven Lucio, PharmD, BCPSSenior Principal, Pharmacy SolutionsCenter for Pharmacy Practice ExcellenceVizient
Show Notes:
[01:32] Vaccine approval path before and after COVID
[02:59] Rationale for accelerated approval; reducing preapproval research
[05:14] Examples of expedited approval recently – reducing the eight-year duration
[07:32] Rundown of various approval routes
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Steven’s email: steven.lucio@vizientinc.com
Jeni’s email: jeni.hayes@vizientinc.com
FDA’s accelerated approval update page: Click here
Vizient Pharmacy Market Highlights – Dec. 2022: PMO322_PharmacyMarketOutlook_Highlights.pdf
Subscribe Today!
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Thursday Mar 02, 2023
Thursday Mar 02, 2023
On this episode of our award-winning podcast, we continue to examine the importance of social determinants of health (SDOH), the conditions in which patients are born and live. This discussion will provide ways organizations and practices can address SDOH and improve crucial patient outcomes.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guest:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting Director, Clinical Documentation ImprovementVizient
Connie Ryan, MBA, RN, CDIPConsulting Director, Clinical Documentation ImprovementVizient
Show Notes:
[00:41] Barriers in capturing SDOH
[01:15] ICD-10 codes now include SDOH codes
[02:45] Z codes and payment
[03:35] Powerlessness
[04:25] Need to educate non-physicians on ICD-10 codes and SDOH
[05:35] At least 50 percent of inpatient clinical documentation may contain errors
[08:45] Clinical documentation in outpatient setting and assessment tools to use
[09:23] Role of Vizient in addressing SDOH
[12:10] Capturing SDOH in the future: how this can happen
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
Connie’s email: connie.ryan@vizientinc.com
Advancing Health Equity website (Vizient): Click here
Vizient SDOH programs/podcasts: Click here
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Thursday Feb 23, 2023
Thursday Feb 23, 2023
“In the long run, housing may be more important to health than hospitals.” This surprising quote points out the fact that only 20 percent of the nation’s health is the result of clinical care. Social determinants of health (SDOH), the conditions in which individuals are born and live, drive over 50 percent of a patient’s health. SDOH include circumstances such as socioeconomic status and physical environment. Addressing these factors improves crucial patient outcomes, and on this episode, we’ll discuss how documenting and reporting SDOH can help a clinical practice or organization address these factors.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guests:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting Director, Clinical Documentation ImprovementVizient
Connie Ryan, MBA, RN, CDIPConsulting Director, Clinical Documentation ImprovementVizient
Show Notes:
[02:04] Inequities existing in health care
[02:55] Example of care inequity – a lack of specialized care due to location
[04:18] “In the long run, housing may be more important to health than hospitals.”
[04:35] Over 50 percent of the nation’s health due to SDOH
[05:23] A formal definition and how coding can make an impact
[07:00] Not a new concept
[08:05] Social inequities affect care inequities
[08:50] Need for clinical documentation integrity in addressing SDOH
[09:53] Mandates are coming
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
Connie’s email: connie.ryan@vizientinc.com
Advancing Health Equity website (Vizient): Click here
Vizient SDOH programs/podcasts: Click here
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Thursday Feb 16, 2023
Thursday Feb 16, 2023
This episode of the award-winning podcast continues examining major changes in E/M coding guidelines for this year. There are a number of key revisions and deletions that could impact your practice.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Sheila Bowlds, MBA
Senior Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[00:39] Emergency department E/M Codes
[01:44] Effects of changes in emergency department E/M Codes
[02:44] Impact of social determinants of health on E/M Codes
[03:14] Shared services
[04:34] Prolonged services codes
[05:04] Summary
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Sheila’s email: sheila.bowlds@vizientinc.com
CPT E/M coding guideline changes in 2023 (AMA pdf): 2023-e-m-descriptors-guidelines.pdf
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