The Hospital Finance Podcast

<p>In this episode, Venkat Mocherla, Co-Founder and President of Midstream Health discusses the margin hospitals already earned but never see.</p>

← Back to All Podcasts From CFO to Cancer Research — A Conversation About Challenging Assumptions In this episode, Ted Giovanis, President of the Jayne Koskinas Ted Giovanis Foundation for Health and Policy, discusses from CFO to cancer research, a conversation about challenging assumptions. Highlights of this episode include: What drives hospital CFOs to keep taking on entirely new challenges One thing about how healthcare operates today that we should fundamentally rethink A question about healthcare we’re still not asking Return on investment when it comes to scientific research that may take years to pay off Which is more expensive for healthcare, trying something new that might fail or continuing to do things the way we’ve always done them? What lessons to apply for improving healthcare and cancer research Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome Ted Giovanis . Ted has been the president of the Jayne Koskinas Ted Giovanis Foundation for Health and Policy, which conducts research in metastatic breast cancer and health policy. He is also a professional race driver and team owner in the International Motorsports Association Racing Series. Examples of health policy research that their foundation has conducted include research on the value of hospital tax exemptions relative to hospital-provided charity free care, how to explain health plan prices and quality information to individuals with varying degrees of numeracy and literacy, and defining meaningful quality measures, including the weighting of those measures into aggregate measures for communication to patients. While in practice, Ted was involved in several legislative efforts that resulted in the establishment and implementation of several payment mechanisms, including the Medicare Geographic Review Board and Section 508 reclassification process, the policy for the payment of the certified registered nurse anesthetists, and the long-term care payment systems for various states. Most notably, Ted discovered and prosecuted the Medicare budget neutrality error, which was the basis of the rural floor budget neutrality appeal and related settlements that at the time was the largest settlement Medicare had lost. In this episode, we’re discussing from CFO to cancer research, a conversation about challenging assumptions. Welcome, and thank you for joining us, Ted. Ted Giovanis : Oh, thanks, Kelly. Thanks. Good to be here. Kelly: So, let’s go ahead and jump in. So, you’ve been a hospital CFO. You’ve helped shape healthcare policy, been part of a landmark court case, written books, and now race professionally and fund cancer research. What drives you to keep taking on entirely new challenges? Ted : Well, that’s a really good question. So, I can tell you as far back as I can remember, I’ve had this drive to achieve. Maybe it was the fact I was an only child, and we didn’t have any money. But to achieve, you need to be very goal-oriented. And in this sense, I’m the typical Capricorn. I set goals and I locomote towards them. I started in healthcare and finance and worked my way up, setting goals all the way along the line. And somewhere around 1978, I became acquainted with a guy named Mike Vance, who was an influential thought leader and author. And he was the one that instilled in me a commitment to a lifetime of continuous learning and growth. And ever since then, that’s sort of what I’ve been doing. That curiosity has led me to ask a lot of questions that others wouldn’t ask, which brought me to the lawsuit, ironically, and has also led me to cancer research. So, asking questions prompts you to try to find the answers. And if you don’t know the answers, you talk to other people and you try to find them from them. So, you look up to people that can give you the answers. So as a bonus, as it turns out, as you age, learning more and staying mentally active is a big plus. A long time ago, Henry Ford once said, “Anyone who stops growing is old, whether that happens at 20 or 80.” I just turned 80, and I don’t plan on stopping anytime soon. And Henry Ford also said, “Anyone who keeps growing becomes more valuable, regardless of physical capacity.” So, I hope I’m becoming and learning and growing and becoming more valuable. Kelly: Yeah, I love that committing to a lifetime of learning and growth. That is great advice. After decades in healthcare finance, what’s one thing about how healthcare operates today that you think we should fundamentally rethink? Ted : Well, I think there’s one thing we need to rethink. It’s actually how to lead there’s a lot of people in healthcare today that are talking about being patient-centered, patient-centric, but too often they don’t think patient-centric in the way they make decisions. So, we need leaders willing to challenge the status quo. And more importantly, willing to be introspective, look within oneself of how they can improve. And remember, remember the definition of insanity is doing the same things over and over again and expecting something different. And I think that’s what we do a little bit. I support now much research. And so, I can use that as a little bit of an example. The goal of most healthcare research is ultimately on our side, is to help patients, to find cures, to determine better treatments. If we look at healthcare organizations, there’s things that they can do to lead and to streamline things, including in the administrative cost area, in the near term. To me, indirect costs are something that we can manage now. In many cases, they’ve got out of control. There’s a lot more to do all the way along the line, but I think indirect costs are something that we can deal with to get started. Kelly: No, I love what you said about challenging the status quo. I think that is really important, especially in healthcare. Ted, you’ve often said that breakthroughs start with asking better questions. What’s a question about healthcare that you think we’re still not asking? Ted : That’s a good question. The question we’re really not asking is, do we really understand how X or how something works, or are we assuming too much? I mentioned before, putting patients at the center, that to do that well, we need to understand what those patients are experiencing virtually at every level, from diagnosis, treatment, to billing, and follow-ups. So, for me, I’m looking specifically at breast cancer and within breast cancer, specifically at metastasis. How does it spread? Why does it spread? And we’re down into the minutiae of intercellular communications. But as a country, we don’t fund research in basic science to find out these kinds of things and to find out how things work. We tend to ask questions we think we know the answers to, but rarely do we throw money behind something that we truly don’t know or understand. And so, I think we’ve got that a little backwards. If we know how things work, then we can model it and we can experiment in the model to identify a path to diagnosis, treatments, and prevention. We really need to change our thinking. And I’ll paraphrase it in racing. There’s a concept called ocular driving. You drive where you look and where you can see. The farther you can see ahead and anticipate, that’s where you’ll go. The same thing is in healthcare with our thinking. We need to change our frame of reference and our thinking. And so that’s sort of the framework that will let us design patient flows of the future. And those patient flows need to be adaptable. Because the one thing is for sure, care will change again within the next decade. And so, adaptability and resilience is going to be key. Kelly: Yeah, no, I love what you said about we have to change our thinking. I think that’s very true. As a former CFO, how do you think about return on investment when it comes to scientific research that may take years to pay off? Ted : I’ve learned that the best return on investment comes from understanding how things work first and then leveraging on that knowledge. That’s true in racing and it’s true in research. And I’m sure it’s true in healthcare organizations and in the provision of care. In racing, it’s how you get an edge on your competition. At first, you look for the bigger things, and of course, you take care of them. But over time, it’s the small adjustments, the steady improvements that combine to improve your performance. We take the same approach to research. We invest in foundational science and talented people who ask the right questions or challenge the status quo. It’s investing early before answers are no, and that’s important. Those investments may take some time to pay off, but they create the knowledge that foster future breakthroughs. And we need to be good financial stewards. It’s about making investments today that make some things possible tomorrow. So that’s sort of the mantra that we’ve adopted in our foundation, knowing how it works. Kelly : That makes a lot of sense. So, which is more expensive for healthcare? Trying something new that might fail or continuing to do things the way we’ve always done them? Ted : I think, Kelly, first of all, it comes back to maybe it’s another problem with our thinking, and that we are afraid of failure. Finding out you’re wrong isn’t a failure. It’s information. It’s learning. It tells you where to adjust before you’ve invested years heading in the wrong direction. So, research, metaphorically, is like moving a football down the field. You can’t score without first moving the ball and without investment at the beginning of a drive, so to speak, you’ll never reach the end zone at the other end. Every study, every experiment, every lesson learned hits another first nail. So, if you want to look at that metaphorically, that’s the way it is. Or I’ll give you another one. If we’re going from Richmond, Virginia, to San Francisco, California, which is in a direct line, better figure out your one degree off early, or you’re not going to be anywhere near San Francisco. Today, much attention and funding go towards research that’s already near the gold line. Folks like me think we’re a little too drug-centric. And that’s where the glory is, down that end of the field. That’s where the ROI is. But we need to invest earlier, where scientists are asking fundamental questions about how diseases work. How do they come to be? And that’s where the discoveries begin, even if the path isn’t always obvious. And that’s really the problem that we have with moving into the basics of how things work, we just don’t see or cognize what the payoff is. So, with today’s limited resources, on the other hand, it’s expensive to be wrong. And I understand, but that’s why we need to take a chance to learn to take thoughtful risks early. And it helps us move down the field more efficiently and ultimately delivers better, more effective care for patients. And that’s sort of how we work in our foundation. Kelly: Yeah, I agree. Most of us are driven by that fear of failure. I completely can relate to that. For you, racing…it’s a constant search for small advantages. What lessons from your race career apply to improving healthcare and cancer research? Ted : Racing, again, has taught me that success rarely comes from one big breakthrough. It comes from continually getting better. And yes, granted, you need to take care of those big opportunities and fix big problems, or to take advantage of them. But it’s the small refinements to improve your performance, too, because I’ve always said with me as far as driving, my comparative is always me versus me. Because if I focus on improving me, me versus the other guy will take care of itself because you’re looking for small improvements in yourself that they’re not looking. So, healthcare works the same way. We need more ideas we also need continuous improvement, rethinking things that others overlook. And then healthcare hasn’t really dealt appropriately in effect with the big or small things. I mentioned indirect costs earlier. That’s one place to look, but it’s– and it’s good because it doesn’t involve bricks and mortar or new equipment. So, it’s something that we could effectively change. Kelly: Yeah, I agree, like the continuous improvement piece, that is certainly key in racing and in healthcare. If you could give one piece of advice to healthcare leaders trying to build a better system for the next generation, what would that be? Ted : Well, I don’t know if it’s– I don’t know if there’s just one piece, but I’ll give them a couple. I tell them to never stop learning and never assume you have all the answers. Be introspective enough to challenge your own assumptions. Commit to continuous improvement instead of defending the status quo. That would be sort of another one. And we have what we call in racing situational awareness. Know where you are, where you’re going, and be aware of everything that’s around you. So, you have a context for where you sit, so you know what’s happening on the playing field, so to speak, or on the racetrack. Be adaptable because healthcare will continue to evolve. Be resilient because meaningful change will take time. And you’ll have to play through that time as it happens. And maybe most importantly, adopt a collaborative mindset, recognizing that no one person has all the answers. And that’s sort of implicit in being introspective because you’re admitting in a way being introspective that you don’t know everything. And these things will make you not just better at what you do, but better at who you are. So, there are these kinds of things. These would be the things that you will take with you if you adopt that. I mean, what I do personally, I read a lot. I read a lot of everything, all different types of topics. And what that does is it gives me more, what I said, situational awareness. I understand the context of things that are happening. And so, it allows me to interpret better. Kelly: No, that’s some great advice. Thank you. I love the never stop learning. Well, thank you so much, Ted, for sharing your insights with us on from CFO to cancer research, a conversation about challenging assumptions. And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that? Ted : They can go to my LinkedIn page, Ted Giovanis , or on Instagram. I’m on there to Ted Giovannis, or I have a website, tedgiovanis.com , and it’ll tell you all the kinds of things that I’m involved in. You can message me through the social platforms. Kelly : Awesome. Thank you for providing that. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts . The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at contact@besler.holdings . Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post From CFO to Cancer Research–A Conversation About Challenging Assumptions [PODCAST] appeared first on Besler Holdings .

<p>In this episode, Beverly Neal-Clinton, Marine and Co-Founder of servehealrecover.com discusses revenue recovery that pays for itself by fixing hidden leaks.</p>

← Back to All Podcasts Locking Down Corporate AI Usage Webinar In this episode, Jason Nadal, Besler Holdings’ and Sypher Security’s Information Security Officer, will provide us with a glimpse into the next Hospital Finance Academy Webinar, “Locking Down Corporate AI Usage,” live on Wednesday, October 7th, at 1 PM ET. Highlights of this episode include: How companies deal with artificial intelligence and how they should make the decision to embrace this technology What the benefits and detriments of AI usage are What tools out there to help protect your company and your data What other challenges you have in keeping aware of AI usage How you manage third parties not directly under your control The key takeaways Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome back Jason Nadal , Besler Holdings’ and Sypher Security’s Information Security Officer. In this episode, Jason will provide us with a glimpse into our next Hospital Finance Academy Webinar, “ Locking Down Corporate AI Usage ,” live on Wednesday, October 7th, at 1 PM Eastern Time. Welcome back, and thank you for joining us, Jason. Jason Nadal: Hi. Thanks for having me. Kelly: All right. Well, let’s go ahead and jump in. So, we know artificial intelligence is everywhere now. How should companies deal with this and make the decision to embrace this technology? Jason : Well, if you run a company right now, somebody on your team is likely already using AI. So ideally, that would be via an approved path that you have already set up, but maybe it’s just a browser tab they opened up at lunch, putting something in Google and getting AI results. Either way, the question is not, “Should we use AI?” It’s already embedded in a lot of the approved corporate tools that are already out there. So, the question is, “Do we know what we allow, what we forbid, and how do we keep that promise when the tools keep changing under our feet?” So those are the kinds of conversations that security and IT folks have when leadership asks for a practical plan around AI. So, over the next 10 minutes or so, I’ll walk through some of the benefits and risks. We’ll get into that a bit deeper during the webinar that’s upcoming, but this will give you a methodology of control you can actually run, some of the categories of tooling that support it, and the challenge of feature creep in tools that you’ve already approved. And we’re also going to look at how a vendor and open-source software assessment has to catch up. Kelly: Yeah. I mean, it is really everywhere. It’s embedded in everything now, it seems like. [laughter] Yeah. It’s a lot to keep up with. So, what are the benefits and detriments of AI usage? Jason : Sure. There’s a lot of benefits, and there’s definitely a lot of detriments as well. So, AI earns its value when it shortens the work that you’re already doing, especially that work that used to waste a lot of your time through just tedium, repeated tasks, and things like that. So, I find it really shines at drafting, summarizing, searching or researching, coding assists, and also triaging helpdesk tickets. So those are real-time gains when the data and the use case match the risk. So, in healthcare and adjacent work, that might be a little less clear. So, a nurse or revenue cycle analyst can summarize a long chart note, draft a patient letter, or speed up some prior auth paperwork. A cost report or appeals team can find patterns faster. So done carefully, ideally with this human oversight as to what’s produced, that is time returned to care and to accurate billing. But the downside is just as concrete. So, paste the wrong note into a public chatbot, and you may have moved protected health information, PHI, or something else confidential or sensitive, outside your control. So, a helpful summarizer can invent a fact, called hallucinations, that then gets treated like clinical or financial truth. There’s really a huge downside to that if it’s not checked over by humans with clinical experience. An automation that writes into scheduling, ticketing, or an EHR-adjacent system can turn a bad model answer into a real patient or operations problem. Outside of healthcare, the pattern is much the same. So, marketing could paste customer lists into a public model. Finance could paste financial forecasts. Engineering could paste source code or API keys, maybe in a hurry or just this one time, and leak information that you don’t really intend to leak. Legal can paste contract language. You get the benefit of speed, but the detriment of leaking your data, over trusting the AI, and a trail that, once it’s out there, you can’t really tidy it up after the fact. So, a key point to establishing governance is having frank discussions of what data is acceptable to this risk if it were to leak. I really can’t say that one enough. Kelly: Yeah, I mean, I know that in marketing we use it quite a bit, but I mean, you all help us really understand what we’re really in for there. So, I know there’s a lot to keep in mind. So how do you lock this down without pretending people will stop being curious? Jason : So yeah, you do need this methodology. The first thing I’d say, write an AI usage statement. This is your company’s position on how AI is used. Let it have plain language that’s easily readable. And this company position will include what interactions are allowed and what are not. Who’s able to use what classes of AI? What data classes may never leave the building? It may not just be PHI or employee data. It could be financials, as we said before, or just confidential mergers and acquisition information. So, what AI interactions require a human in the loop? What happens when someone isn’t sure? They should always be trained to ask before they just paste data in somewhere. Publish this conspicuously, train on it, and make sure that people know what’s appropriate to do with their AI. Refresh it when the landscape moves. So, if you don’t have a written position, every employee is going to have their own assumptions on what is good or bad. That’s not really empowerment. That’s just risk that’s out there unmanaged. I’d also recommend don’t write this usage statement from scratch. See what others in the industry, especially your industry, are doing, and tailor what’s out there to yourself. Secondly, you should assess the AI that is in question, the AI that you want to use in any given situation. When a third party uses AI in a product that you buy, treat that as part of vendor due diligence. Ask the vendor, “Where are these models running?” Ask whether the prompts or the outputs of those prompts are retained with them or are they used for training. Ask about sub-processors. Maybe that vendor is using somebody else to do their AI work. Ask also whether AI features can write back into your system. Don’t just accept a blanket, “We’re AI-powered,” as a checkbox. You need enough clarity to decide, yes, this is an acceptable risk. No, this isn’t going to work for us. Or yes, but we need these conditions in place to feel good about the risk of using this tool. And keep logs. Review those regularly. What is not AI today might become AI tomorrow. I’m sure all of us have seen an application that we’ve used online that just, after approved, suddenly has new AI functionality. So, train your users to notice new AI functionality added to the products that they already use. Third, you want to control access to your systems. And there are different types of access that you need to be aware of all three of these and looking into where AI touches all of these. First off, private access. This is ideal if you’re using sensitive data. Your employees would then be using AI that is hosted locally within company boundaries. Private model and private instance, your network. You can still govern who can use it, what data they may feed it, and how you log that use. Just because it’s private doesn’t mean it’s unsupervised, but at least you can keep the inner boundaries of where that data can go. Next up would be public access, people reaching third-party AI sites out in the open internet. So, you decide who can get there under what policy and how that policy stays current when new sites appear every week. So, blocking everything forever, that’s rarely an answer. But blind open access is worse. Pick that controlled path and make sure you maintain who has proper access to it. And internal access is different from private. So, this is AI that’s baked into platforms you’ve already approved. Productivity suites, especially CRMs, ticketing, EHR add-ons, collaboration tools, all of these are things that we’ve seen ripe targets to add AI functionality to. Again, the purpose is to make them easier to use, but you need to make sure you maintain the risk of that if it wasn’t there when you initially assessed that vendor. So, it could be somebody just flipped a feature flag or a vendor released a sidebar assistant. It’s not really a new public chatbot to evaluate from scratch, but there could be changes to what models are being used and the risks associated with that. So, you should treat it as a change to an approved system. You should have that same change management, the same risk review that you do for a new vendor, the same data classification questions. So, if you’re only policing public websites, you’re going to miss that AI that arrived inside your door because you’ve already let it in. Fourth, control AI access to your data. The data classification is very important. Label what your data type is. Is this file public? Is this one confidential? Is this one regulated because it’s PHI? Ask the impact question out loud. If this data type was released, what would be the impact to our company and to its reputation? So that framing is a lot clearer to executives than just jargon. It puts them in a place where they’re actively thinking about, “Our internal secrets, if they got out to the public, how would this affect our reputation? How would this affect us financially?” If the impact is high, that data probably doesn’t belong in a public prompt, and it may not belong in a loosely governed private one either. And fifth, the last one, input sanitization. Now, this is an interesting topic out there because of how bad actors can try and subvert the normal use case. So, at a high level, this means that people and attackers are going to try to override instructions. They’re going to try and steer AI agents off policy or try to trick them into doing things that the designer never intended. So you don’t need to exploit the recipes yourself to take this seriously, but you need defenses that assume prompts and retrieved content can be hostile. Agents should have the least privilege, and that high-impact actions or actions to highly risky data always need human confirmation. So, think about that misuse at scale. So compromised agents or automations can be turned into attack infrastructure: scraping your data; it’s spam. They could create helpers for stuffing passwords in to try and guess. Any of the sort of modern botnet abuse that you see out there with malware can also be used with AI. So, if an AI agent can browse, if it can send email, or if it can call APIs with broad credentials, we’ll treat that like any other privileged information. You want to limit the scope of what it can touch. You want to monitor what it can do, and you want to make sure you have the ability to revoke those permissions really fast when something looks wrong. Because AI attacks work a lot faster than standard kind of malware attacks where you have a bad actor that’s on the phone trying to do impersonation of people, for example. Kelly: That’s all great advice, Jason. So, with all that being said, what tools are out there to help protect your company and your data? Jason : Sure. Well, what’s good is that there’s a lot of options out there. I want to emphasize that those tools don’t replace your methodology. They help support it. So, you got to stick to what fits your stack of infrastructure without turning this into just a shopping list. But here’s some examples. So, AI filters and firewalls are great because they can inspect your prompts, looking for kind of manipulated input. They can look for policy violations, sensitive patterns, and unsafe instruction attempts before the data leaves. DLP, or data loss protection, for prompts and uploads. That is aimed more at people, what paste, and what files they attach to AI tools. You can look at secure gateway controls for some of the public sites. That’s how you allow or block access to third-party destinations, like a whitelist. And you can keep that list maintained. You want to log and monitor your AI use to know who used what, when, and with what data sensitivity signals, and whether that matched policy. And you can also look at identity and single sign-on gating for the private models. So even though it’s private AI, you’re still going to need to have authentication, authorization, and preferably single sign-on. So, access follows that same identity and policies that you have for that as your other internal tools. Now, again, none of these replace judgment. But they make the policy enforceable, and especially they make the exceptions more visible by bringing them to your attention. Kelly : No, thank you for sharing those tools with us. Those are great. So, what other challenges do you have in keeping aware of AI usage? Jason : [laughter] Well, here’s the challenge that keeps security teams awake, existing approved tooling. So, we said that before with the vendors. And we’ll get into that more with the webinar as well. But it’s a real risk when you have something already approved and they just added AI, either publicly or even silently. Last year’s CRM didn’t have a generative AI sidebar. And this year’s update does. EHR add-on ships smart summarize. A collaboration suite turns on meeting transcription and AI notes by default. So, these are all common situations we’ve seen. Feature creep means that your old approval letter is incomplete. So, you have to build a habit of, whenever an approved vendor ships AI, reopen that assessment. Don’t wait for an incident to discover the new button. And train your people to look out for things that appear. Kelly: Yeah, it sounds like training your people is probably the most important thing there to look for those things. So, you mentioned third parties. So how do you manage third parties not directly under your control? Jason : That is also a very tough one. So, the key couple of ones that come to mind would be with product engineering and with procurement. So here you have, on one side with product engineering, you have code tools. A lot of times, open-source packages are included there. And procurement, again, here’s the vendors that have AI functionality kind of baked in and not at the forefront, where they’re just adding it in later. So for managing the third-party risk, look at every SaaS contract and every integration to determine whether AI is somewhere in that path, where that data is going, and who the sub-processors are. Look into what happens if the vendor’s model provider changes terms overnight. Put some AI questions into your vendor questionnaires and your security review checklists, and actually make decisions based off of those. On the other side of things, when you’re looking at managing your embedded open-source software libraries, a lot of modern products pull in the AI-related dependencies that you might not know just from the package that you’re pulling in. So, some model SDKs, vector libraries, agent frameworks, those dependencies inherit the supply chain risk like any other library, plus some new ones. You could have unexpected outbound calls, default logging or licenses that don’t match your appetite for risk. You want to have inventory on those. You want to dig deeper and have some tooling that looks into those dependencies and also analyze risk of those. Pin versions so that you know that the version that your libraries are using is the one that doesn’t introduce more than you had already identified. Look out for vulnerability advisories. Don’t let an AI SDK become that side door into production data. Kelly: Yeah, I mean, it sounds like managing the third parties is a whole job all in itself. So, Jason, what are the key takeaways here? Jason : Well, I’ve got several here. If you remember nothing else from the discussion, these would be the ones to look at first, right? You want to write that AI usage statement. What’s allowed? What’s forbidden? Make sure you ask first. You want to assess AI wherever it shows up: new vendors, old vendors, look for new feature flags. You want to separate your public, private, and internal access and govern those. Change management. You want to classify your data with an impact question. What’s the reputation and company harm if these data types were leaked? You want to sanitize your inputs and constrain any agents. You want to assume bad actors will get access to it and don’t give free rein. Make sure that scope is limited for attacks. Use tooling categories to help enforce and observe. There are your filters, DLP, logging, identity, gateway controls, all the extra tooling. You want to revisit approved tools when AI appears. Again, that’s with vendors or with software libraries, so look at that for that feature creep in your vendor tools. And you want to extend your vendor and open-source review to AI dependencies. Third-party vendors and libraries would both count there. So, AI is going to keep showing up in places you already trust. This lockdown isn’t about scaring people off the tools, but it’s about knowing the rules and enforcing them where you can. And stay curious enough to notice when the product on your feet grew some extra tentacles overnight. So that’s the biggest takeaway you should go back to your leadership with. Have these conversations about what you have, how you’re using it, and manage those risks for AI. It’s critical before an incident happens. And you want to work with your security team on their security incident playbook to make sure you have reactions to some of these bad actor situations or rogue agent situations. Kelly: That’s all great advice. Thanks for sharing those key takeaways with us. And thank you so much for joining us, Jason, for giving us this glimpse into the Hospital Finance Academy’s free Webinar, Locking Down Corporate AI Usage . Join us live on Wednesday, October 7th, at 1 PM Eastern Time. And as a bonus, you can also earn CPE. Thanks again, Jason. Jason : Thank you. Kelly : And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts . The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at contact@besler.holdings . Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post Locking Down Corporate AI Usage Webinar [PODCAST] appeared first on Besler Holdings .

← Back to All Podcasts Healthcare Has a Revenue Problem, But It’s Really a Decision Problem In this episode, Angelica Landers, Healthcare Executive & Growth Strategist, discusses how healthcare has a revenue problem, but it’s really a decision problem. Highlights of this episode include: Before a hospital or healthcare organization launches a new service line, what financial questions should leadership answer first How to determine whether the service is actually worth offering Will the service actually make money? How to determine whether your payer mix can support a service line or business model before you invest significant capital into it How healthcare organizations can build stronger relationships with their payers to improve reimbursement and resolve issues What a true service line profitability analysis looks like What the financial and operational questions you want answered before you ever get to the purchase price When a healthcare organization is trying to grow, how do to decide whether to build internally, acquire another organization, or partner with someone else Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome Angelica Landers . Angie is a healthcare executive and growth strategist with more than 18 years of experience working at the intersection of healthcare operations, sales, M&A, revenue cycle, technology, and startup growth. Her experience spans provider organizations, MSOs, DSOs, digital health, telehealth, healthcare technology, and high-growth startups. She has directed 58 concurrent M&A integrations, managed revenue cycle operations generating up to $45 million in monthly collections, sold more than $500 million in managed services agreements, and built scalable operating models for healthcare organizations navigating growth and transformation. Angie brings a unique perspective that connects the financial decision to the operational reality behind it. Her work includes acquisition strategy and integration, revenue cycle transformation, payer and reimbursement strategy, healthcare commercialization, P&L and financial analysis, operational scalability, strategic partnerships, and startup growth. Through Alleviate Strategy & Solutions, Angie advises healthcare executives, investors, founders, and growth-stage organizations on the systems behind performance, helping them make better decisions about growth, acquisitions, technology, operations, and revenue. In this episode, we’re discussing: Healthcare has a revenue problem, but it’s really a decision problem. Welcome, and thank you for joining us, Angie. Angelica Landers: Thank you for having me, Kelly. I’m so excited to be here today. Kelly: Yeah, we’re excited to have you. Well, let’s go ahead and jump in. So, healthcare finance isn’t just about collecting the money. It’s about making better decisions before the service ever happens. Before a hospital or healthcare organization launches a new service line, what financial questions should leadership answer first, and how do you determine whether the service is actually worth offering? Angelica : When everyone first proposes this question, everyone automatically assumes demand or growth equals revenue. And when everyone assumes this, before everyone can get their answers out, the CFO walks in and asks the most difficult question, but I would say the most correct question. Will this service actually make money, given our payer mix, our cost structure, and our referral patterns? Or, in just the shorthand question, is this a profitable demand? Will we make money, or our ROI off of implementing this new service? So, a service line can have strong community need, excellent clinical outcomes. Your neighbor practices might be doing this, and you might have heard of their uplift in revenue. You might have heard of their growing patient population. But are those transferable to your practice is the question. Before launching any new service, leadership must determine whether the opportunity creates that sustainable economic value within their practice. So, the goal is not simply to generate revenue. The goal is to generate revenue that exceeds the cost of care. By the time a claim reaches your billing department, leadership has to make these decisions beforehand that determine whether that claim is profitable or payable. So many healthcare organizations, to start with demand is great, but we should also look at margin. Kelly: Right. No, I mean, I love what you said. I wrote it down. Will the service actually make money? It’s a great question. Angelica : Yeah. Kelly: So how do you determine whether your payer mix can support a service line or business model before you invest significant capital into it? Angelica : Yeah, so I would start with the obvious question, is there really a revenue opportunity? There’s a series of analyses and just questions that leadership should go through, grouped together with their committee, their investors, and really go through each variable of economic value. So, starting with, obviously, what service to offer? Everyone is being innovative in the healthcare industry. Within tech, the startup rise of telehealth, value-based care, I mean, all of this brings different payment models, different strategies, different positions you can bring to your practice. But the key question here is, does this service create strategic and financial value, again, to your unique situation? Not every clinical service creates that economic value. Some services just generate direct profit. They create downstream referrals, straighten payer relationships, even support other strategic growths. So, looking at just the variable of, ‘How much does this service make by revenue position?’ isn’t the entire story. Leadership should evaluate community need, of course, competitors’ offerings, strategic alignment. But a service with moderate demand and strong reimbursement may outperform a high-demand service with weak reimbursement. I would say look at both the economical value and also the community need and demand that comes with it. Kelly: That makes a lot of sense. And I think the bottom line that I kept– and the word I kept hearing over and over again was value. So that’s definitely key. So beyond negotiating the contract, how can healthcare organizations build stronger relationships with their payers to improve reimbursement and resolve issues? Angelica : So, payer collaboration does not end after a payer contract is executed. It’s just the beginning. Your payer contract director should not be the only one talking to your payers. This is a collaboration between RCM, your payer contracting department, and really with a dotted line to finance through RCM. Within each contract, you are assigned a provider relations advocate, which is the bridge between your practice and the insurance company. Many organizations only contact payers when there’s claims denying or, obviously, when contract negotiations are up for renewal. But high-performing organizations treat payers as strategic partners. You can contact your provider relations advocate when there’s prior authorization problems, when there’s an increase to your denial trends, when you’re having coverage or network access issues. But they can also help you leverage strategies that you’ve never heard of, like good-faith appeals, payout negotiations. They can also help you while you’re transitioning through billing companies, or also help you with provider education when you’re dealing with referrals and orders coming from or referring providers. When problems occur, there’s always a relationship in place. And that’s why it’s smarter to do this early on in the contracting phase. The best reimbursement strategy is often operational excellence, not aggressive contract negotiation. Kelly : Yeah, and I mean, those relationships are key there. It makes a lot of sense. So, healthcare leaders often know their revenue. But do they really know what it costs to deliver that revenue? What does a true service line profitability analysis look like? Angelica : So, this is referred to as a cost analysis. The main question we ask when performing this analysis is, how much does each service actually cost to deliver? Only after understanding this margin should expansion decisions be made within leadership. One of the most dangerous questions in healthcare is: what’s our revenue, or where is it coming from, or what is that profit margin? Without asking what is our cost per unit of care, we’re not really understanding that profit margin just yet. Many organizations obviously know their charges, their collections, their net revenue, but they’re not doing the deeper analysis of cost. So, cost per patient, cost per visit, cost per procedure. A true service level profitability analysis includes revenue, direct cost, indirect cost, and even deeper dives into those fees of those indirect costs that ultimately get calculated into the cost of care. Cost analysis also includes what volume is required to break even. So how many patients, study visits, or procedures are required before we start losing money? Also, we would like to include in that analysis what is required to generate that profit margin. So, it’s not so much if we schedule it, but do we have the staff, the tools to render that service? And all of that is included in that indirect cost that we perform during that cost analysis. Kelly: Yeah, that sounds like a pretty important process. I know that the profit margin is really important. So, Angie, when you’re evaluating a healthcare acquisition, what are the financial and operational questions you want answered before you ever get to the purchase price? Angelica : Oh, Lord, this is probably one of my favorite topics: merger and acquisition. So, a common mistake, organizations buy revenue. So usually during the due diligence process, normally we take out, obviously, the Aged Trial Balance report or your AR report, and everyone starts looking at those numbers. What does the revenue look like? But I would argue it’s not just about the revenue; it’s also about the capabilities. So, when you’re thinking about buying or even partnering for an added revenue growth to your practice, or obviously service lining, revenue can appear different after acquisitions. So again, after mergers, relationships, staff can leave, referral patterns can shift, key physicians can retire. There’s so many variables that we take into consideration during that due diligence period. The real value of an acquisition pretty much lies in its capabilities, people, market, position, and operational strengths. So, during that sale, you must ask yourself, why are they selling? Understand the motive behind the sale. Help determine whether buying them in the future or buying them in their current state is optimal. We should also ask ourselves, how dependent are their key physicians and key stakeholders to this acquisition? Again, if all services are being rendered by one physician or two, how strong is that operation’s post-integration if that physician decides to leave or has a different sentiment about the acquisition itself? So, we like to review people, culture, which is a big part of merger and acquisition. But then, obviously, we get into the financial part, which is the revenue. Financial questions we might ask is, obviously, the EBITDA qualities. So, is this repeatable, right, next year? Or was it an added revenue added specially for this year, right? A one-time gain, a temporary cost reduction, or just variables that are temporary. We want to get as close as to the repeatable EBITDA for year after year, which is one of the financial hurdles that that we watch for. Service line margins. So again, those cost analyses are so important here, determining the strength of the AR. So again, what are those challenges that they’re experiencing? Is the corrections to these denials an easy task? Are you fighting an uphill battle within regulation with these denials? Or is it simple corrections that could be made with just a human touch, right? Refiling of a claim. So, reviewing these in a much broader light, and I would say in a deeper, not just the balance sheet, right? Interview the people that are in charge of your daily cash flow to better understand how much of the receivable balance is actually collectible. And you would find that most of those conversations will be a lot more insightful than sitting in a room with the CFO that’s negotiating the deal. Kelly: Yeah, it sounds like there’s a lot of really valid, important questions in there that you need to ask. And when a healthcare organization is trying to grow, how do you decide whether to build internally, acquire another organization, or partner with someone else? Angelica : I would say it has a lot to do with the answers to the analysis that we talked about today. I think if you really determine that there is demand, that there is a lower cost to service than the reimbursement that you’re bringing in all of those variables in there, to me, make the decision of building, buying, or partnering such a louder than ever. Partnering, I think, would be best for a practice that is trying to test the waters. Some of the analyses are not definite and don’t bring you the best warm and fuzzy feelings about moving forward of investing the capital. Partnering, I think now more than ever, the market is open to joint ventures to, again, jointly pursue deals that their vendor partners may have the capabilities that they’re lacking so that they can close the deal jointly as a joint venture. Again, I think the bottom line here, it’s determined on rather the capital is there, the investment is apparent after your cost analysis, your market analysis, and your geographical analysis. And then that will then better position you to rather invest the capital or maybe test the water with a vendor partner. Kelly: Thank you, Angie, so much for sharing your insights with us on healthcare has a revenue problem, but it’s really a decision problem. And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that? Angelica : Yes, you can email me at Angelica, A-N-G-E-L-I-C-A, at alleviate, A-L-L-E-V-I-A-T-E-S-A-S dot com. Kelly : Awesome. Thank you for providing that. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts . The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at contact@besler.holdings . Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post Healthcare Has a Revenue Problem, But It’s Really a Decision Problem [PODCAST] appeared first on Besler Holdings .

← Back to All Podcasts The Growing Denials Crisis and What Healthcare Leaders Can Do In this episode, Noah Breslow, CEO of Revecore, discusses the growing denials crisis and what healthcare leaders can do. Highlights of this episode include: Why denials are becoming such a significant challenge for health systems What the financial implications are on health systems Why so many organizations struggle to prevent denials before they happen What the biggest reasons denials continue to slip through the cracks How health systems can shift from reacting to denials to preventing them How AI and automation can help identify and address denial risks earlier What roles dedicated denial prevention processes play in improving outcomes What revenue cycle leaders should do now to strengthen their denial strategy Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome Noah Breslow . As CEO of Revecore, Noah brings more than 20 years of executive leadership experience with a focus on driving growth, innovation, and transformation in complex, highly regulated industries. Most recently, Noah was a partner at Bain Capital Ventures, or BCV, where he led their portfolio support team, built out data-driven investment tooling, and helped incubate two startups at the forefront of applying AI in the insurance claims processing and wealth management industries. Prior to BCV, Noah served as chairman and CEO of OnDeck, a pioneering online small business lender where he built the business from its earliest stages, took it public, and ultimately facilitated its acquisition. Earlier in his career, Noah held leadership roles in product, engineering, and marketing. He holds a Bachelor of Science in Computer Science and Engineering from MIT and an MBA from Harvard Business School. In this episode, we’re discussing the growing denials crisis and what healthcare leaders can do. Welcome, and thank you for joining us, Noah. Noah Breslow: Thanks so much, Kelly. It’s really great to be here. Kelly: It’s great to have you. Well, let’s go ahead and jump in. So why are denials becoming such a significant challenge for health systems? And what are the financial implications on health systems? Noah : Yeah, it’s a trend that’s obviously been there for a long time. But it’s getting worse and worse. So, denials have really moved from a back-office kind of nuisance to a real top-line, front and center margin issue. So, research from McKinsey shows that nearly 3% of net patient revenue is written off due to clinical denials alone. And then if you add in underpayments, the cost of appealing those denials, timely filing issues, you might get another percent or two as well, hitting hospitals. So, I think you have a big financial set of changes going on, and we can get more into that. And then you’ve also got the fact that payers have gotten a lot more sophisticated. So, they’re using AI to do AI-driven claims review, deny claims in a more automated way, in a more nuanced way, maybe than they did before. And we’re seeing just denial trends going up across the board. Kelly: Yeah, I mean, I know denials are a huge issue with such significant financial implications. So, Noah, why do so many organizations struggle to prevent denials before they happen? Noah : It’s got a variety of reasons here. I think organizations struggle to prevent denials, not because they don’t intend to stop denials. So, 47% of organizations cite improving clinical denials as a top priority, yet only around 36% have standardized processes to actually do it. So even though they want to make this an issue, actually implementing the process and the infrastructure to better manage denials is more of a challenge. The other thing about denials is you can obviously engage in that firefighting motion, right? You get a claim denied, you appeal the claim, you go back and forth to adjudicate that one claim. That’s a very different thing than fixing that root cause of the denial upstream. And I think most organizations are better positioned to do that firefighting on a claim-by-claim basis than really do that systemic analysis. “Why is this denial happening? What process do I have to fix on patient intake, or on clinical documentation, or on billing and coding to make sure that that denial doesn’t happen again in the future?” And that fragmentation is a huge challenge for hospitals. Kelly: Yeah, it seems like doing that hard work is key there. So, what are the biggest reasons denials continue to slip through the cracks? Noah : Yeah, I think it’s a multidisciplinary thing. So, you need kind of that combination of data intelligence, the reporting that says, “Hey, we’ve been submitting claims to this particular payer and these types used to get denied at this rate, but we’re seeing this uptrend in these particular types.” You have to connect that intelligence piece. What’s actually happening, and trend analysis, but then you need really human expertise to go, “Okay, why is this trend happening? What could I change upstream to maybe prevent this denial from happening in the future?” And that’s a very multidisciplinary thing. It could involve changing processes. It could involve retraining staff. It could involve system changes, collecting different pieces of information at different points in the process. So, I think it’s that multidisciplinary way to integrate the data on the back end and the intelligence gathering with the process engineering upfront to prevent those denials from happening in the future. Kelly: Yeah, I love what you said there about the combination of data intelligence and human expertise. That totally makes sense to me. Probably to others as well. So, you know how can health systems shift from reacting to denials to preventing them? Noah : Yeah. There’s a few different ways I think health systems can go from reactive mode to prevention mode. First is organizational. You have to set up processes and teams inside your revenue cycle organization that are dedicated, that make it someone’s full-time job to making those structural changes to prevent denials from happening in the future. So, organizations with those dedicated processes to prevent denials have a much higher appeal success rate than organizations who don’t have those dedicated teams. And then the other piece of it is around timing. If you imagine you go to the doctor’s office and they hit your knee with a hammer, and it takes you two months to kick, your reflexes are pretty slow, right? And so, two months later, that procedure happened a long time in the past. The patient has already gone home. The documentation may be locked down. And so working on your feedback loop, that rapid cycle from the moment that denied claim comes in to the trend analysis to going upstream and working to make those changes, it’s a governance question as much as it is a technology question, and denial trends should be front and center in revenue cycle leadership meetings, not something you check in on once a quarter. Kelly : Completely agree. And I love what you said about the reaction mode to prevention mode. That makes a lot of sense in this specific example. So, AI is all the hype. How can AI and automation help identify and address denial risks earlier? Noah : Yeah. So, AI is a tool that payers frankly have a head start on over providers. I think they’ve been implementing AI at scale now for a few years. Providers are starting to catch up, but it’s a little bit of an arms race, and providers really need to deploy AI, I think, to be the best position to handle increasing types of denials in the coming years. So, AI’s real value is pattern recognition at scale, right? Finding those connections across payers, service lines, procedure types that are driving recurring denials faster than someone could just reviewing claims one by one on their own. And so getting that AI deployed to find those patterns is critical. And the other piece, it is a moving target. So, the claims that are denied this year may not be the ones that are denied next year. There are always new types of denials coming in, and some of them can be addressed very basically, right? They could be administrative denials. They could be missing documentation. Those are more sort of straightforward process issues, but there are a lot more subtle ones in terms of the way procedures are coded and billed, the way procedures are bundled together. And that’s where, again, having that human expertise to complement the AI is so important. Kelly: Completely agree. And I mean, it does really seem like providers really need to get on the AI trainer in a major way. So, what role do dedicated denial prevention processes play in improving outcomes? Noah : It’s massive. They have that dedicated team focused on improving outcomes We see it all the time in our client base at Revecore. Some of our customers, maybe the smaller health systems that don’t have those dedicated teams focused on denials, they’re, again, more in that reactive mode, but our larger customers often do have specialized denial teams or executives focused on those. And we’ve seen some of our more sophisticated clients not only have dedicated teams, but have dedicated analytics. So, they’ll know to the analyst level on their team what their overturn rates are by procedure type, by payer, and then they start to actually optimize. So folks on the team who are better at getting certain types of denials overturned will focus there. And then other areas might be gaps that need to be addressed by training or hiring new skill sets. So dedicated team, specific measurement of payer-specific trends, procedure-specific trends, and training and upskilling are all a big part of this. Kelly: I love what you said about the dedicated team. That really is key here. So, Noah, what should revenue cycle leaders do now to strengthen their denial strategy? Noah : I think the first step is– forgive the phrase. The first step is admitting you have a problem. And you have to get honest about that infrastructure gap. 64% of organizations lack the infrastructure to prevent denials. You can’t do any of this without these processes, dedicated teams, workflow systems, tracking mechanisms. And so, you have to sort of assess what you really have to fight denials and then start to up-level it if you don’t have all of those pieces in place. I think the next thing is really making denial a frontline activity in your revenue cycle team. So, segmenting by payer, by service line, by root cause, making it a recurring executive topic. One healthcare revenue cycle leader I know has daily stand-ups with their team where they read out on the latest trends of denial. So, it’s not a weekly meeting, it’s not a monthly or quarterly meeting. It’s literally every day they’re talking about this. And then I think really looking at that delay between hitting your knee with the hammer and then having a kick, right? So when you see a new trend, measuring your time as an organization from detecting that trend to making that upstream fix, I think if you can do that and work on shrinking that time down, getting really agile and fast with your processes and with your changes, that is the ultimate weapon because denials are always going to be a moving target. It always impairs economic interest to deny some fraction of claims. And so, you have to be moving to where that puck is going every year, every month, every quarter. Kelly: Wow. Yeah. I mean, I love what you said about the daily meetings. That is certainly an impressive dedication to this issue. Well, thank you so much, Noah, for sharing your insights with us on the growing denials crisis and what healthcare leaders can do. And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that? Noah : Yeah, no, thanks, Kelly. It’s been great to be here. And if folks want to learn more about what Revecore does to help health systems manage denials and get them overturned and get hospitals the revenue they deserve, they can visit us at our website, https://www.revecore.com , R-E-V-E-C-O-R-E, dot com. Or they can reach out to me directly. I’m just noah.breslow@revecore.com. Kelly : Awesome. Thank you for providing that. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts . The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at contact@besler.holdings . Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post The Growing Denials Crisis and What Healthcare Leaders Can Do [PODCAST] appeared first on Besler Holdings .

<p>In this episode, Jake McCarley CEO and Co-Founder of Alluvium, discusses why patient access is the missing link in the revenue cycle.</p>

← Back to All Podcasts Modern Identity Defense for Healthcare Series—Passkeys in Practice In this episode, Eric Englebretson, Besler Holdings’ VP of Information Technology, provides us with a glimpse into our next Hospital Finance Academy Webinar, the second in the Modern Identity Defense for Healthcare series, Passkeys in Practice , live on Wednesday, September 16, at 1 PM ET. Highlights of this episode include: What we can expect in this second installment in this series? Why passkeys specifically? How MFA isn’t solving the identity security problem What actually is a passkey? What makes passkeys phishing-resistant? HIPAA and compliance rules What’s next? Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome back Eric Englebretson , Besler Holdings’ Vice President of Information Technology. In this episode, Eric will provide us with a glimpse into our next Hospital Finance Academy Webinar, the second in its Modern Identity Defense for Healthcare series, Passkeys in Practice , live on Wednesday, September 16th, at 1 PM Eastern Time. Welcome back, and thank you for joining us, Eric. Eric Englebretson: Thank you for having me yet again. Kelly : All right. Let’s go ahead and jump in. So, Eric, the last time you talked about identity attacks in healthcare. What can we expect in this second installment in this series? And why passkeys specifically? Eric : Well, Kelly, because if part one was about why attackers go after identities, part two is going to be about the single biggest fix we’ve seen in at least 15 years. Passwords are, and I can say this without hyperbole, one of the worst security tools we have for protecting a digital identity. And honestly, passkeys are the industry’s answer. Google, Microsoft, Apple, Amazon, PayPal, if you’ve logged into any of those lately, you’ve probably already been nudged to create one. And this session is going to take the mystery out of what’s actually happening when you do. Kelly : Yeah, no, I’ve seen a lot more passkeys myself lately, so this will be interesting for me too. So, we already have MFA. Isn’t that solving the identity security problem already? Eric : So, it does help, but it doesn’t solve it. SMS codes can get intercepted via either SIM swapping and just general insecurities in the protocols behind text messages. The one-time codes you get from apps like Google Authenticator, those can still be phished and replayed if someone tricks you into typing your password and code into a fake site. And then, of course, push-based MFA has what we call and what we identified in the last session as MFA fatigue where people just approve prompts to make them stop. That’s literally how Uber got breached, in fact. Passkeys sidestep all three because they’re inherently multi-factor: something you have, the device, plus something you are or know, like a biometric or a PIN. So, it’s one seamless step, nothing to fatigue approve and nothing to get intercepted and replayed. Kelly: Very, very interesting. So, Eric, in plain English, what actually is a passkey? Eric : And this is so fun because at its core, it’s really complicated, but it’s a pair of cryptographic keys. Don’t let your eyes glaze over when I say that. I’ll explain a little bit more in the session. And ultimately, of those keys, one lives on the website server and one lives on your device, and they never trade that secret part back and forth. So, think of it like a locked suggestion box. Anyone can drop a message in using the public key portion, but only the person holding the private key can open that message box and, in this case, sign something to prove that it’s really them. The signature is what gets checked, not a password, not your private key. So, the important bits don’t go back and forth where they could be intercepted. Kelly: I mean, it sounds easy enough. So, what actually makes passkeys phishing-resistant? I mean, it sounds like a big claim given how easily we can be tricked into giving away passwords and authenticator codes. Eric : It actually is a big claim, but I think it holds up. So, each passkey you create is bound to a specific domain, and that’s one of the important bits. So, if somebody builds a pixel-perfect clone of Microsoft.com at, let’s say, micronsoft.com and you don’t notice, your device actually won’t even offer the passkey. It actually simply won’t even respond. When implemented properly, there’s no password to type, so there’s nothing to divulge and put in the wrong place. And that one property right there basically neutralizes phishing and the adversary-in-the-middle attacks, which we talked about and were the star villains of our last session. Kelly: Very interesting. So, healthcare has HIPAA and compliance rules around all of this. Do passkeys actually check that box? Eric : So, this is great. They don’t actually just check it. They exceed it. So, HIPAA Security Rule requires verifying that a person accessing e-PHI is who they claim to be, but they don’t mandate a specific technology. So, passkeys deliver cryptographic proof of identity, and that eliminates the number one credential theft vector. And that also aligns with, and I’ll explain this as well in this session, something called NIST SP 800-63B. Again, don’t let your eyes glaze over. And basically, they have what are called authenticator levels. And these meet or even go up to the next level depending on whether or not you’re using hardware keys. And then for HHS’s own 405(d) program, they’ve been recommending FIDO2 and passkeys as a priority mitigation for healthcare specifically for quite a while now. So yes, definitely, this far exceeds the things that we need for HIPAA. Kelly : Well, that is great news. And I’m looking forward to learning more about that. So, this all sounds almost too good. What’s the catch? Eric : That’s a really fair question. I get it a lot. So, in this case, we’ve got– we’re building a front door that is genuinely rock solid, made out of metal. The catch is actually a backdoor here, account recovery. So as an example, let’s say you’re storing all your passkeys on your phone. If your phone dies and you lose your passkeys, what’s guarding your way back in? Because you’ve got to have one, right? Well, usually it’s a password reset email plus an SMS code. Well, that’s the absolute weakest link protecting the strongest lock we’ve ever built. We’ll dig into exactly how to close that gap in the full session, but that’s really the only downside. Kelly : Okay. Good to know. So, if someone only takes one thing away from this episode before they join us for the live webinar, what should it be? Eric : Ultimately, it’s that passkeys aren’t just a nice-to-have. For healthcare organizations, they’re one of the most practical wins available right now against phishing, credential stuffing, and the account takeover attacks that dominate breach reports. In the full session, we’ll walk through the different types of passkeys, where they actually live on your device, device-bound versus synced trade-offs for enterprise deployments, and really an overview of creating and using one. I think it’s going to be well worth your time. Kelly : Yeah. I think so, too. I think this is going to be a great webinar. Well, thank you so much for joining us, Eric, and for giving us this glimpse into Hospital Finance Academy’s free webinar, Passkeys in Practice , that’s going to be live Wednesday, September 16th, at 1 PM Eastern Time. And as a bonus, you can also earn CPE. Thanks again, Eric. Eric : Absolutely. Kelly : Wow, sounds like things are always changing in this space for sure. Well, thank you so– Eric : Absolutely. Kelly : And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts. The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at update@besler.com. Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post Modern Identity Defense for Healthcare Series—Passkeys in Practice [PODCAST] appeared first on Besler Holdings .

← Back to All Podcasts The Money is in the Note, Not the Claim In this episode, VerifyMedCodes Co-Founders Nathan Turock and Angelo Selitto, discuss why the money is in the clinical note, not the claim. Highlights of this episode include: What it means when they say “the money is in the note, not the claim” What problem VerifyMedCodes solves How the deterministic approach is different “You can’t defend a code you can’t reproduce.” How to catch issues before the claim goes out, missing modifiers, unsupported codes, and linkage problems How hospital finance leaders should be thinking about readiness How to process a clinical note without patient data ever leaving the building Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome Nathan Turock and Angelo Selitto . Nathan is CEO and co-founder of VerifyMedCodes. He leads strategy, partnerships, and go-to market, focused on helping hospitals and RCM teams turn clinical documentation into defensible, denial-resistant revenue. He founded Verify Med Codes to close the gap between what clinicians document and what actually gets paid. We have Angelo, who’s co-founder and chief architect of VerifyMedCodes. He’s a healthcare integration architect with 13-plus years’ experience across Epic, FHIR, HL7, Identity, and Clinical AI. And he’s delivered production CDS hooks and FHIR for value – based care and led ambient AI documentation rollouts across 33, 000 providers. He designed the VerifyMedCodes deterministic PHI-safe coding engine. In this episode, we’re discussing the money is in the note, not the claim. Welcome, and thank you both for joining us, Nathan and Angelo. Nathan Turock: Thank you for having us. Angelo Selitto: Thank you for having us. Thank you for the intro, and wonderful to be here. Kelly: All right. Well, let’s go ahead and jump in. So, VerifyMedCodes started as a coding engine. What problem did you set out to solve, and why do you say the money is in the note, not the claim? And Nathan, I’m going to toss this one over to you. Nathan : Okay, that’s great. The money is in the note. The way it all works, if we’re going to make it easier for the audience, the progress note that the doctor writes is actually what gets paid by the insurance companies. The way it’s set up in the United States healthcare system is the doctor writes the note, then it goes to a coding or billing agency, and they have to put in all the codes that have been created since the ’50s and ’60s by the insurance industry to make sure it’s accurate so they get paid. The problem with that is the insurance companies have made it so convoluted and so difficult to find all the proper codes. And I won’t get too into the weeds, but you have your ICD-10 codes, your EM codes, your RAF scores, your HCCs, etc. And it gets very difficult for the physician, hospital, provider to get paid what they’re owed. We created this to make it transparent. So, it goes right from the doctor’s note, we code that the English language, then we code it into the medical nomenclature of actually the entire globe, and then we code it into the coding system that has been created by the insurance companies in the United States to maybe not pay exactly what they should. So, we’re going for clear transparency because I believe that the healthcare provider should get paid what they’re worth, and they shouldn’t be convoluted or changed up by the insurance company just because they want to put all this coding into play. Kelly: Right. No, I love that y’all made that transparent. I know there’s a lot of complexities in the coding world. So, a lot of AI coding tools make compliance teams nervous because they can hallucinate a code. How is a deterministic approach different, and why does same note in, same codes out matter for revenue integrity? And Angelo, I’m going to toss this one to you. Angelo : No, it’s a great question. And a probabilistic AI coder can read the same note twice and give you two different code sets. And for revenue integrity, that’s the whole problem. You can’t defend a claim you can’t reproduce. So, our deterministic core is same note in, same codes out every time. And that’s the type of defensibility that we want to offer, right? Is that we have the history, we have the evidence-based, we are giving you the information because of what the note stated. It’s not a hallucination. It’s there in the documents. So, we’re really just carrying it forward, and you’re going to reproduce the same information because the same defensibility and the same information always surfaces. So, it’s just the AI can do its suggestions. It could offer and flag, basically recover anything that was missed and offer options. But in the end, the AI doesn’t have the final say. And I think that’s the difference between fast and defensible. Kelly: Yeah. No, I love what you said about, “You can’t defend a code you can’t reproduce.” I actually wrote that down because I really thought that that was very interesting that you said that. I love that. So, Nathan, where are hospitals leaving the most defensible money on the table today? Is it risk adjustment capture, denials, or is it somewhere else? Nathan : It’s in all those, to be perfectly honest with you. The denials is your holy grail, capturing the right amount of money for the service that you provided. The reason being is the insurance companies like to deny a lot. I know everybody out there in podcast land has never heard of an insurance company denying anything. Kelly: Right. Nathan : Exactly. So, with that being said, I’m going to sort of piggyback off of what Angelo said and to make this very digestible. Angelo loves when I say it’s an incredibly complex tool that we’ve created, but it’s an A plus B equals C or A plus B plus C equals money. Coding system A is the progress note, which is written in the English language. B is the medical terminology that we’ve also coded into a large LLM. C is all the codes from the insurance companies that we utilize their language against them so they can’t deny. So, we have A plus B plus C equals the correct dollar amount. It’s deterministic. It’s accurate. It’s to the point. So, where they’re leaving money on the table is a couple of different sectors. The first one is first pass rate, which means that the note goes through cleanly and insurance says, “Yep, it’s good to go. We’re going to pay you for it.” The second one is– the big one is denials, which when an insurance company says, “Nope, you don’t have enough data on that. We are denying this for XYZ reason,” it costs money to reprocess that note again. So, we decrease the first– or increase the first pass rate so it’s a better coding system that goes through insurance and they pay. We decrease the denials because we’re using their language, their wording, and their codings directly against them, directly correlated to the progress note. And there’s also a whole lot of other scores like RAF scores, which is risk adjustment factor, and HCC scores that get very, very complicated, that would drive most coding people nuts and gets lost a lot in the shuffle. With the technology that we have now and with how we coded this, it can’t miss. It’s A plus B plus C, LLM. It’s like a giant calculator. I know, Angelo, it’s a lot more complicated than that. But basically, it’s a giant calculator that makes sure the provider, the healthcare provider, the doctor, the hospital, what have you, gets paid what they’re owed by the insurance company. First pass rate is up, productivity for getting the claim through is increased, and denials go down. Simply put, it’s a giant calculator to make sure the doctors get paid what they’re owed. Kelly: Yeah, no. I love that A plus B plus C equals the money that you’re owed. So that’s awesome that you guys came up with that. So, Angelo, you catch issues before the claim goes out, missing modifiers, unsupported codes, linkage problems. What does that look like on a real claim? Angelo : That’s pretty much the bread and butter, right? We catch the missing modifiers, the unsupported codes, linkage problems before the claim goes out, just like you said. And it really looks like a straightforward office visit, 34-year-old, appendicitis. The engine builds the full claim, the diagnosis, six procedures, the levels, the EM. It then scrubs before submission and catches two things the payer would have bounced, one procedure, maybe a lab, an 82565 that needed a modifier 59. And without it, the payer bundles it, and you don’t get paid for it. The EM might have needed modifier 25 to sit alongside the procedure without the denial. There’s denial risk scores at 10 %. Both items flagged with the payer denial reasoning spells it out. And we basically are doing that double-check work. We’re doing that assessment before it goes out. And we also do it before an RCM tech might even see it. So the real capture is that we’re able to surface these as options as well. So, in the deterministic engine that we have, it’s not saying this is the end-all be-all. It’s a really nice system that allows you to see all of the options and see what is missing and what could have been created to build and bundle the exact claim that you guys were looking for or want to execute. Kelly : Wow, I mean, that sounds pretty impressive there. With CMS interoperability and prior authorization requirements landing in 2027, how should hospital finance leaders be thinking about readiness? And Nathan, I’m going to let you take this one. Nathan : Okay, pretty much this is the transparency, and CMS is your Medicare, Medicaid. And that goes out to all the insurance companies throughout the United States. So, they want to make sure that this is extremely transparent. It’s fire-based exchange. The clean data is moving between the payers and the providers. So, there is an awful lot of data, and we’re not going to go read all the CMS data points that they’re making up. With that being said, all the hospitals and all the providers and everyone else have to have cleaner capture across the board in 2027. So, the crunch time Angelo specializes in and the team specializes in is that we can help integrate all this into whatever system that they’re running now, either with Epic or any other EHR system that is on the market right now. Simply put, it’s got to be more transparent, easier to decipher, and cleaner data that flows through all this, or CMS isn’t going to pay you, which is going to be a bigger headache. Kelly: Yeah, I mean, I know transparency is key here, especially. So, PHI safety is a real concern with AI. How do you process a clinical note without patient data ever leaving the building? Angelo, can you help us with this one? Angelo : Yes, I sure can. So, the concern is real. Most AI coding tools ship the raw note to the cloud, and we don’t, or maybe it’s not to the cloud. It might be a homegrown LLM or AI that they built internal. The deterministic engine runs locally with full access to the note. So, before anything touches an outside model, we do a structural transformation. Every clinical concept is preserved, but the patient identifiers are replaced with typed placeholders. We also have a way of the– basically a backwards communication. So, if something, if they have a question about the local progress note, there could be a communication to say, “Is this a name, or is this–?” maybe it’s the name of a medication, which is another big issue that happens within PHI redaction is that it misses or it hides the name of a medication or anything, a building. And so, what leaves the building is the PHI-free representation, the medicine, not the patient. So, 99.5 % of the clinical content is preserved, and the identifiers don’t travel. That is probably the most impressive piece that we built because it uses a very interesting method to get that data and to transform it, and it’s fail-closed. So, if the gate is ever unsure whether something is safe, if it blocks it, uncertainty defaults to do not send. That’s to a 100 % onshore, and the AI helps us reason, but the medicine never sees who the patient is. Kelly: Very interesting. I know PHI safety is a real concern across the board. Nathan, if a finance leader listening wants to start small, what is the first step? Nathan: The first step is just to go on our website and check us out. So, it’s verifymedcodes.com . And the great thing that I designed the website is Angelo comes from the tech side. I’m still in healthcare, but I’m on more of the finance side. So, they can go onto our website and look at the slider scale that we have that can tell how much money that they’re losing on the first pass rate in productivity, in denials, and so on and so forth. They contact with us. We are actually doing right now a 100 notes for free. So, they can send us our 100 worst notes, and we can actually– Well, we’ll process it for them. It doesn’t cost them a dime. And we’ll show how our system is better, faster, more efficient, and will make them more money. So, as a finance person, and I designed this because that’s where I sit in the healthcare sector. I want to know why it’s going to make me more money, why it’s going to make my facility more productive, how much money am I leaving on the table, and how much I’m saving, but want a freebie of a 100 notes or so. So that’s what we offer. We offer the easiest process across the board. So once again, go to verifymedcodes.com, look at our finance calculator, contact us, send us the notes, and we will prove what will work. Kelly : That sounds like a great offer. Well, thank you so much, Nathan and Angelo, for sharing your insights with us on the money is in the note, not the claim. And if a listener wants to learn more, contact you to discuss this topic further, how best can they do that? Nathan : Well, they can contact me at nturock, that’s N as in Nathan, last name Turock, T as in Tom, U-R-O-C-K, at verifymedcodes.com. Or, once again, go to the website, verifymedcodes.com , and all our contact information is there. And, Angelo, you can tell them where your contact info is. Angelo : Yes, thank you, Nathan. Contact info is same. It’s on the website as well. You could also contact me at Angelo, A-N-G-E-L-O, dot Selitto, S-E-L-I-T-T-O, at verifymedcodes.com. Kelly: Awesome. Thank you both for writing that. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes our episode of The Hospital Finance Podcast. For show notes and additional resources, visit us online at besler.holdings . The Hospital Finance Podcast is a production of Besler Holdings; Built on partnership, Driven by success. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at contact@besler.holdings . Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post The Money is in the Note, Not the Claim [PODCAST] appeared first on Besler Holdings .

<p>In this episode, Theresa Hush, CEO at Roji Health Intelligence, discusses the impact of value-based care's failure to progress in achieving the economic sustainability of the healthcare system and if or what can change the course.</p>

<p>In this episode, Kevin Torf, Co-Founder & Managing Partner at T2 Group discusses the revenue walking out your door, capturing wellness spend at the point of care.</p>

<p>In this episode, James Jacobi VP of Employee Benefits at Hilb Group discusses something that hits every CFO and finance leader in healthcare directly, the runaway cost of employee benefits.</p>

← Back to All Podcasts Modern Identity Defense for Healthcare Series: Defending Against Identity Attacks – When MFA Isn’t Enough Webinar In this episode, Eric Englebretson, Besler Holdings’ Vice President of Information Technology, provides us with a glimpse into Webinar, the first in its Modern Identity Defense for Healthcare Series: Defending Against Identity Attacks – When MFA Isn’t Enough live on Wednesday, August 12, at 1 PM ET. Highlights of this episode include: What is this webinar about? MFA still effective? How the attacks are evolving What session tokens are and why you should care about them Why healthcare is a frequent target Warning signs that an account may be compromised Next evolution beyond traditional MFA Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness.We’re pleased to welcome back Eric Englebretson , Besler Holdings’ Vice President of Information Technology. In this episode, Eric will provide us with a glimpse into Besler Holdings’ next Webinar, the first in its Modern Identity Defense for Healthcare Series– Defending Against Identity Attacks – When MFA Isn’t Enough live on Wednesday, August 12, at 1 PM Eastern Time. Welcome back and thank you for joining us, Eric. Eric Englebretson: Thank you so much. I’m happy to be here. Kelly : Well, great. Well, let’s go ahead and jump in. So can you provide a quick overview of what you’re going to be reviewing during this webinar? Eric : Absolutely. So, the thing that I think is very important for us to cover is that identity has become one of the most targeted areas in all of cybersecurity right now. It used to be that attackers focused on servers or the corporation’s network, and once they’d gotten in from there, they would pivot to get at the thing they’re really after, which is often a company’s data. In the age of cloud computing and remote work, defenses have generally gotten better because traditional defensive methods of defending the network give way to security practices like something called Zero Trust, whereby any interaction with an organization’s resources must be authenticated no matter where a location request might come from. And so, the next logical step is identity attacks. And why is that? Like I said, since attackers focus used to be on breaking into networks and servers, the payoff might be limited. A compromised web server hosting a hospital website might not have any access to any data at all, really, but in today’s integrated environments, one compromised user account. Now that can give an attacker access to email, collaboration tools, patient systems, financial applications, and cloud services, depending on your role. In most organizations, your identity becomes the new perimeter, and that’s why attackers increasingly target people and accounts instead of infrastructure. This is going to be a two-part series covering modern identity security, why attackers have moved to trying to capture identities as a first attack rather than compromised servers, what we can do about it. And in part two, one of the biggest new advancements you’re probably already using in a few places, passkeys. Kelly : Awesome. Sounds like you’re going to cover a lot during this webinar. I’m really looking forward to it. So, we hear a lot about MFA and how attackers try to bypass it. So is MFA still effective? Eric : Absolutely. So, MFA really remains one of the most important security controls that has come to us in the past 10 or so years, and it really does stop the vast majority of common attacks, including password reuse, credential stuffing, and other attacks similar to those. The key message here is that MFA is definitely not broken. The message is that attackers have evolved and they’re now looking for ways to get around it. It is just that effective. They’ve got to work around it now rather than just simply trying to use a username and password. And that means organizations need additional layers of protection alongside of MFA. Kelly: Yeah, so we know that MFA is still effective. So how are attacks evolving to work around it? Eric : Modern attackers often focus on stealing authenticated sessions rather than stealing passwords. In some phishing attacks, victims enter their credentials and complete MFA successfully, but the attacker captures the resulting session that’s created. Think about it this way. Is it easier for a thief to steal your hotel room key or to try to convince the front desk to issue a new one? In most cases, it’s easier for the thief to steal your room key. After that, they can just come and go as they please, usually without so much as a second glance. We’ve put so many guardrails around the authentication process that attackers are now moving on and looking at what’s behind that, something called sessions and tokens. Kelly: So, what are session tokens and why should people care about them? Eric : So, session tokens and they are kind of background… so this is kind of we enter that realm of nerdy a little bit, but stick with me. Session tokens are what keep you log in after you’ve authenticated. They’re the reason that you don’t have to enter your password and MFA code every single time you open an email or click a new page. They’re incredibly useful, but that makes them also incredibly valuable to attackers. If an attacker does steal a valid session token, they may be able to act as though they’re already authenticated without having to have your password again. And that is what makes them so important, and that is why people should care. Kelly: Yeah, no, that makes a lot of sense. Why is healthcare such a frequent target for identity attacks? I mean, we’ve been hearing so much about this lately. Eric : Absolutely. So, the main reason for that is that healthcare combines highly valuable data with extremely time-sensitive workflows. Clinicians and staff are constantly dealing with alerts, messages, urgent requests, and attackers understand that environment, and they design their hacking and phishing campaigns specifically to exploit human pressure and urgency. Healthcare isn’t targeted because it’s careless. That’s actually quite the opposite. It’s targeted because its mission creates very unique opportunities attackers can try to exploit. Kelly : Yeah. I guess having that– always having that sense of urgency probably doesn’t help us in that way, right? Eric : Absolutely. Kelly : Yeah. So, what are some warning signs that an account may be compromised? Eric : So, a few of the things that you should look out for some of those red flags include unexpected MFA prompts, alerts about sign-ins from unfamiliar locations. If you are looking at your inbox forwarding rules, which I recommend that everybody does every once in a while, if a forwarding rule you didn’t set up has appeared and it’s forwarding to some account you don’t know about, that is definitely a big red flag, or just anything that seems off to you that might signify unusual account activity. And one of the most important things you can do here is just to simply report those to your IT staff, help desk, or security staff, whatever your normal workflow is, immediately. Early reporting can often stop a small incident from becoming a major breach. Kelly : Yeah, no, that makes a ton of sense. Just be more vigilant. So, what’s the next evolution beyond traditional MFA? Eric : And that is an excellent question. This is something I’m going to cover in part two. The future is phishing resistant authentication. So, there are technologies, and I’m going to use another nerd word here like FIDO2 security keys, Windows Hello for Business, and Passkeys are designed to prevent attackers from stealing or reusing credentials and session information. In part two of the webinar series, we’re going to explore how passkeys work, why companies should adopt them, and how they can dramatically improve both security and user experience. Kelly : Wow, sounds like things are always changing in this space for sure. Well, thank you so– Eric : Absolutely. Kelly : Yeah. Well, thank you so much for joining us, Eric, and for giving us this glimpse into our next free Webinar — Defending Against Identity Attacks – When MFA Isn’t Enough . Join us live on Wednesday, August 12th at 1 PM Eastern Time. And as a bonus, you can also earn CPE. Thanks again, Eric. Eric : Absolutely. Kelly : And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts. The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at update@besler.com. Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post Modern Identity Defense for Healthcare Series–Defending Against Identity Attacks – When MFA Isn’t Enough Webinar [PODCAST] appeared first on Besler Holdings .

<p>In this episode, Jack Risenhoover, healthcare attorney and chair of Velocity Health, discusses a modern CFO playbook for using “other people’s money” to support AI, 340B, and patient engagement initiatives.</p>

← Back to All Podcasts Building Trust in Clinical AI–What Hospital Leaders Need to Know About Evidence‑Based Decision Support In this episode, Dr. Claudine Lott, Physician Executive for Commercial Transformation and Implementation at Elsevier, discusses building trust and clinical AI, what hospital leaders need to know about evidence-based decision support. Highlights of this episode include: What ClinicalKey AI is How AI enhanced clinical decision support tools can help organizations improve both clinical efficiency and financial performance How AI-powered tools can support clinicians in real time to reduce errors, avoid denials, and strengthen the overall revenue cycle ROI opportunities for health systems adopting AI-powered clinical intelligence How AI-powered tools remain evidence-based, transparent, and aligned with clinical best practices The most common misconceptions hospital leaders have about implementing AI and clinical workflows Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome Dr. Claudine Lott . She is a board-certified family medicine physician who is passionate about developing and implementing tech-based clinical solutions that improve both patient outcomes and provider experience. As physician executive for commercial transformation and implementation at Elsevier, she supports the development and deployment of their reference products for healthcare providers, including ClinicalKey AI . Dr. Lott received her medical degree from the University of Massachusetts Medical School and completed her residency at White Memorial Medical Center. She served as a primary care physician at the federally qualified Santa Cruz Community Health Center, where she was promoted to site medical director. She then joined Healthcare Startup Crossover Health, where she contributed to the development and expansion of their virtual care model, as well as the creation and deployment of their Patient Engagement Technology Platform. Since joining Elsevier in July 2023, Dr. Lott works cross-functionally to support key initiatives, including customer implementations, product development, and change management. In this episode, we’re discussing building trust and clinical AI, what hospital leaders need to know about evidence-based decision support. Welcome, and thank you for joining us, Claudine. Dr. Claudine Lott: Thanks for having me on. Appreciate it. Kelly: Well, it’s great to have you. And let’s go ahead and jump in. So, what is ClinicalKey AI, and how are its new capabilities designed to reduce clinician burden and improve documentation accuracy? Claudine : So ClinicalKey AI is Elsevier’s flagship generative AI tool that’s designed for clinician use to quickly surface the latest evidence at the point of care to support clinical decision-making. And just to take a step back and provide some context, so here at Elsevier, we’re an almost 150-year-old publishing company. So, for almost 150 years, our role has been as a provider of scientific information and clinical evidence that clinicians can use in their decision-making and in their patient care. And as we’ve moved into more and more clinical solutions, that’s always been kind of our guiding North Star. And so with generative AI coming on the scene, we’ve really thought about, okay, how do we use this emerging technology in our role as a provider of clinical evidence, scientific information to really further that goal of getting clinicians what they need to make decisions and take the best possible care of patients as quickly, accurately, and effectively as possible. And rather than just sort of slapping generative AI on everything because that’s sort of the new thing to do, how do we really leverage this new tool to solve that problem? So ClinicalKey AI is a conversational search tool. The clinician’s able to ask a question in natural language, almost like they might ask a colleague. And then the system goes and searches a curated set of content that we’ve given to it. So that includes much of our Elsevier clinical content, but also some non-Elsevier sources as well, and searches for information and then surfaces that for the clinician. So, it’s not replacing their clinical knowledge or decision-making, but it’s really supporting them by getting the information that they need and we’ve been developing and iterating on this tool for several years now, constantly thinking about how do we make it better and more suited to this clinician use case. So constantly thinking about how we expand our handpicked content sources, thinking about making sure that we always have traceability so clinicians can see where the information is coming from, citation verification, and always thinking about technology upgrades. So, things like privacy, security, and supporting HIPAA compliant use. Kelly: Wow, that ClinicalKey AI technology sounds really fascinating. So how can AI enhanced clinical decision support tools help organizations improve both clinical efficiency and financial performance? Claudine : So clinically, the biggest win is what we might call speed to evidence. So, we’re in a situation now where patients are increasingly more complex. Medical knowledge is expanding exponentially. And so, getting that information that is really tailored to the clinical situation as quickly as possible is going to enhance clinical efficiency so that AI enhanced decision support can really surface the most relevant trusted information. In seconds, really supporting those consistent decisions under time pressure and given all those other complexities. In terms of how that clinical efficiency translates into financial performance, I think this is something that we’re going to see continuing to evolve as more and more organizations are integrating these types of tools. So certainly, it makes sense that improving clinical efficiency, improving the quality of care is going to translate into financial performance, but sometimes that ROI can be a little bit difficult to quantify. So, I think that we’re going to see those benchmarks continuing to evolve as more and more institutions are implementing these tools. Kelly: Yeah, and I love what you said at the beginning, that speed to evidence. I love that. So, what should hospital healthcare system operation leaders look for in the first six to 12 months to know an AI tool is truly delivering clinical value? Claudine : Yeah, I think this is a great question and something that a lot of both vendors and organizational leaders are really thinking about. Because again, these tools are still new. We’re still seeing how they affect healthcare and how they affect the clinical workflows. And so, we’re still really figuring out how we quantify this sort of clinical value. So, thinking about sort of what can you look for at that 6- or 12-month point to know if your tool is delivering that clinical value. For things like time-saving, improvement of quality of care, those things can be hard to really quantify. And also some of the benefits of generative AI tools, as we mentioned, is that helping clinicians provide faster and better care, it leads to a better experience for those clinicians, for that care team, really addressing that sort of fourth leg of the quadruple aim. But again, that’s something that can be hard to quantify. So, in thinking about, okay, what are some of the metrics that we can sort of look at those sort of checkpoints to see the value that these tools are providing? Certainly, usage metrics are one aspect in terms of just seeing how many providers are using the product, how often are they using it. But that’s only sort of one aspect of it. Given that there’s more of a– there may be more of a qualitative improvement, some customers and organizations that we’ve seen have chosen to use surveys. So, for example, we had one customer who was utilizing ClinicalKey AI, who did a survey to ask their users after they had trialed it for a given period of time to rate the improvement in their ability to conduct patient care, their confidence in their clinical decision making, and their time saved. And so, they were able to, through that sort of surveying of the users, to sort of quantify the improvements they were seeing in all those areas in that way. And this is also a place where having a clinical champion really involved in the implementation process and in the adoption of these tools can help because checking in with those champions can really connect you to understand, again, some of those sort of improvements in experience that can be a little difficult to quantify. And I think it also comes down to for organizational leaders thinking about what is the problem that the generative AI tool was implemented to solve. So, as I kind of mentioned before, we don’t just want to throw a tool at clinicians just to give them something AI because AI is sort of new and exciting now. We really want to think about, “Okay, what problem are we solving with this?” And from there, then at those checkpoints, I think you have a place to go back and say, “Okay, here’s the problem we were trying to solve. What progress have we made on that?” And use that to kind of quantify the value? Kelly: Yeah, I know it is difficult to quantify that value there, at least for now. So, it sounds like you guys are making progress with that. So how can AI-powered tools support clinicians in real time to reduce errors, avoid denials, and strengthen the overall revenue cycle? Claudine : In real time, AI-powered decision support can reduce errors by helping clinicians quickly sort of cross-check their decisions against trusted evidence, or by getting them information that they need to make that decision quickly, especially in an environment that’s high-pressure and time-constrained. In thinking about aspects of revenue cycle management like coding integrity, managing denials, having that grounding in clinical evidence is so vital. Having that documentation that’s based in clear and trusted evidence that’s traceable is really going to provide that sort of grounding and foundation for the decisions that are being made and then the documentation that’s going into that. And that’s going to really support those aspects of the revenue cycle. Kelly: Yeah, thank you. That makes a lot of sense. So where do you see the strongest ROI opportunities for health systems adopting AI-powered clinical intelligence? Claudine : So, I think there’s three sort of big ROI opportunities that I see. So first of all, speed, as we’ve discussed, just making decisions more quickly frees up more time for patient care, can help with reduction of administrative burden, and just really free up clinician time. So that just speed is a huge part of it. And then I think the second part is the accuracy and that strong evidence base that I mentioned. So, making sure that decisions are based in strong clinical evidence and that that is really documented in a well-supported way, that’s going to not only support patient care but also those aspects of revenue cycle management that we mentioned. And then I think another opportunity is thinking about standardization. So, there’s definitely an art to the practice of healthcare. So, we may still see some variation in the way that different clinicians might approach the same problem. And having an evidence-based tool has the potential to support more sort of consistent practice patterns across settings. So, I think that standardization and ability to make sure that all care team members have access to evidence on which to base their decisions is another significant opportunity. Kelly: Sure. Sounds like there are quite a few really strong opportunities there that you shared with us. So how is Elsevier ensuring that AI-powered tools remain evidence-based, transparent, and aligned with clinical best practices? Claudine : So, as we mentioned, we really anchor clinical key AI in peer-reviewed, copyright-cleared medical evidence. So that includes full-text journal articles as well as journal abstracts, clinical practice guidelines from different organizations, full-text medical textbooks. And we’re constantly thinking about curating that content set, what we need to add, what we want to expand on, how we want to adjust it to make sure that it’s really providing what clinicians need. And we also keep the content current. So, we have a content pipeline that updates every 24 hours. So, the outputs are really reflecting the latest evidence and guidelines as much as possible. And we’ve really tried to build in that transparency, that traceability, so that the clinician can really see down to the paragraph where that information is coming from. So, they can have that trust. They know that the citation is not being hallucinated or made up by the AI. They can have that trust in where the information is going from, and they can also do a deeper dive if there’s a topic that they want to explore further. So, it really gives them that ability as well. And we use a clinician in the loop approach with a rigorous evaluation framework to continually test the system, follow up on feedback that we get with users, and really just make sure that we’re maintaining and constantly improving the quality of the insights we’re providing. Kelly: Well, it sounds like that trust is very important to your team there, and that’s appreciated. And you all take that responsibility very seriously. Claudine : Definitely. Kelly : Yeah. So, Claudine, from a physician executive’s perspective, what are the most common misconceptions hospital leaders have about implementing AI and clinical workflows? And what advice would you give them as they evaluate solutions? Claudine : So, there’s three main points about successful adoption of clinical generative AI tools that we’ve seen from our teams and customers, as well as what we’ve been hearing from others in the industry. So, I think these are a great starting point for organizational leaders who are considering implementing a generative AI tool. So first and foremost, as we mentioned before, really knowing the problem that you’re solving with the generative AI tool. So, if you have a generative AI tool, but it’s not solving a problem for the clinician, it’s not making their experience and their care better in some way, nobody’s going to want to adopt that. Nobody’s going to take the time out of their schedule to learn and integrate something new. So really knowing the problem that you’re solving and making sure that you have a tool that fits that. And so, for us at Elsevier, as I mentioned, we’re seeing this problem of increasing patient complexity, increasing medical knowledge beyond what anyone can sort of memorize. And so, thinking about, okay in our role as a provider of clinical content, how do we use this technology to really solve that problem? So that’s the first part. The second aspect is making sure that the tool is accessible and easy to use, that it’s really embedded in the workflow. Because even if you have a tool that does solve a problem for the clinician, if you’re going to implement something that they have to leave their workflow to try to utilize, that’s not something that they’re going to want to adopt. And certainly, if you’re implementing something because you want to increase their speed and efficiency, if it’s an inefficient process, that’s not going to be helpful at all. So, for us, that consideration goes into things like making sure that our product is integrated into the EHR, having an API option, and basically just making sure that the tool is really in the workflow where the clinician is making that decision. And the last point is really coming back to this point about trust, because I think some of the misperceptions about clinical AI tools themselves are really related to a lack of understanding of how these tools work. So not understanding that a standalone general use large language model is going to answer clinical questions just based on its training. It’s not actually going to be going out and searching. Whereas a tool that pairs LLM capabilities with retrieval is going to actually be searching and surfacing information in that way. Knowing that some general use tools are drawing from perhaps the whole internet or from sources that are unclear as opposed to a tool that is really clear about where the content is coming from. Risks of using a tool that the privacy protections are not clear. So, all of this sort of lack of understanding contributes to lack of trust, and that’s going to make sure that, again, this is not something that is going to be widely adopted. And I think that here this is a place where organizational leaders need to think about support from both internal clinical champions and strong vendor partnerships. Because those internal clinical champions, as I mentioned, they’re going to have that deep clinical expertise of the workflow. They’re going to know those problems that the clinicians are facing. And they’re able to be a voice to their peers to say, okay, here’s how this tool works, here’s why it’s trustworthy, and here’s how it’s going to solve the problems that you’re facing. And that’s going to really lead to more successful adoption. Similarly, having a partnership with a vendor that’s trustworthy, that you’re able to work with them, you’re able to provide feedback and get support for your implementation and your adoption efforts are also very important. And we at Elsevier, as a vendor, really do try to be partners to our customers in that way in supporting them and helping them understand our tools, how they work, how they can benefit them. So those are kind of the three main points that I think are really helpful in thinking about implementing generative AI tools in the clinical setting. Kelly: Right. It sounds like having those champions and partners are really key to success there. So, Claudine, looking ahead, how do you see AI shaping the future of hospital operations and financial sustainability? And what role will Elsevier play in supporting that transformation? Claudine: Well, it seems like AI is here to stay, right? So, I think we’re going to, in the future, see AI continuing to lead to changes in really every aspect of healthcare. In terms of clinical decision support, I think we’re going to see these clinical generative AI tools increasingly becoming like a standard layer inside these clinical workflows, so helping clinicians find information, make those quicker decisions, supporting their documentation, but really just with an increasing integration and seamlessness as these tools become more integrated and more widely used. And I think Elsevier’s role is going to be to continue to build on what we’ve been doing all along. So again, constantly thinking about how do we deliver responsible AI solutions that clinicians can trust grounded in that evidence, not replacing their clinical judgment, but really getting them the information that they need in our role as this provider of trusted clinical content and just continuing to think about usability, what features are needed, what content is needed, and how do we continuously think about supporting the clinician with this new technology. Kelly: Thank you, Claudine, for sharing your insights with us on building trust in clinical AI, what hospital leaders need to know about evidence-based decision support. And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that? Claudine: They can definitely connect with me on LinkedIn . Kelly: Awesome. I will do that as well, and thank you all for joining us for this episode of the Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit

← Back to All Podcasts People Stay Where Their Future is Strongest In this episode, David Alemian, Creator of the Alemian Retention System, is discussing how people stay where their future is the strongest. Highlights of this episode include: How aligning an employee’s financial future with their tenure can change long-term retention behavior What distinguishes a short-term incentive from a true long-term retention structure in financial terms How forfeiture-based structures influence decision making compared to traditional benefit plans What financial modeling should hospitals use to project the long-term impact of retention strategies How hospitals can implement retention strategies without increasing net operating costs What separates organizations that successfully retain top talent from those that just continue to struggle Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome back David Alemian . David is America’s foremost expert on retaining highly skilled professionals and the creator of the Alemian Retention System. His work defines a critical reality for healthcare leaders, People Stay Where Their Future Is Strongest. He is the author of People Stay Where Their Future Is Strongest: How Organizations Retain Highly Skilled Professionals and Build Lasting Advantage . A definitive framework that explains why highly skilled professionals leave and what determines whether they stay long-term. With over 30 years of experience in financial and workforce strategy, David reframes retention as a financial discipline. He shows how workforce instability erodes margin, disrupts operations, and weakens long-term performance. His work has been featured in Medical Economics, MD Magazine, and Physician’s Practice. He has authored more than 300 articles and produced over 400 educational videos on talent retention and organizational performance. In this episode, we’re discussing People Stay Where Their Future Is Strongest. Welcome, and thank you for joining us again, David. David Alemian: Well, hi, Kelly, and thank you for having me. It’s so good to be back. Kelly: Yes, it’s great to have you back. Well, let’s go ahead and jump in. So, David, yeah, you focus on aligning an employee’s financial future with their tenure. How does that change long-term retention behavior? David : Great question. People are wired for the future. From the time we are very young children, we quickly learn to think about the future. It becomes imprinted on our brain. We’re asked, “What do you want to be when you grow up? Where do you want to live? Who are you going to marry?” It’s always looking toward the future. Employment is the same thing. Highly skilled people don’t make career changes on a whim. They think about it, and they think hard. And here’s what they think, “Is my future better here where I am? Or is my future better if I move to another organization?” Most major decisions are based on the future. When an employee considers staying or leaving, they are literally comparing two possible futures. One future is built by staying with their current employer. The other future is built by leaving and going elsewhere for another opportunity. The future that appears stronger usually wins. It’s that simple. For those who are listening to this, think about your own life and the decisions surrounding your career. Did you think about your future? Chances are very high that you did because our brains are wired for the future. What’s really kind of cool is it’s one of the things that we all have in common. Here’s the difference. Traditional retention strategies often focus on the present. They focus on culture, recognition, wellness programs, team-building activities, and workplace perks. Those things are good, and they matter, but they do not fundamentally strengthen an employee’s long-term financial future. When an organization helps employees build a stronger financial future by staying, retention becomes much more stable because the employee has a compelling reason to remain committed for the long term. People stay where their future is strongest. And that’s what I mean by that. Kelly: I love that. I mean, and I wholeheartedly agree with it, and it makes a lot of sense that focus on the future. You’re right. We do all have that in common. So, what distinguishes a short-term incentive from a true long-term retention structure in financial terms? David : Okay. Now, most retention strategies are expenses, higher salaries, bonuses, 401(k) contributions, retention payments, enhanced benefits, and similar programs all have one thing in common. Once the money is spent, it’s gone. The organization incurs the cost, whether your employee stays or leaves. A true long-term retention structure works differently. The employer funds and owns the plan. The employee never owns the asset. The asset remains on the organization’s balance sheet where it continues to grow and compound over time. The employee agrees to remain with the organization until a future date is established in the agreement. It could be 10 years from now. It could be all the way until retirement. It could be anything in between. If the employee fulfills that commitment, the employee receives a substantial financial benefit. If the employee does not fulfill their commitment and leaves early, the benefit is forfeited. The organization keeps the asset. That distinction changes everything. Instead of creating another expense, the organization creates a growing and compounding asset while simultaneously creating a powerful incentive for the employee to remain long-term. Traditional retention strategies spend money. This strategy builds an asset. Kelly: That is truly just so interesting to me, David. Thank you for explaining that. So how do forfeiture-based structures influence decision making compared to traditional benefit plans? David : Oh, but they do. This is where retention becomes truly powerful. Most traditional benefit plans provide value regardless of whether the employee stays for the long term. An employee may receive higher compensation, employee retirement contributions, bonuses, or other benefits, and still leave for another opportunity. There’s nothing holding them in place. And what happens is the organization absorbs the cost and loses the employee anyway. A forfeiture-based structure operates differently. The employer funds the plan. The employer owns the plan. The asset remains on the organization’s balance sheet where it continues to grow and compound. And the power of compound interest is amazing. The employee earns the right to receive the benefit only by fulfilling the long-term commitment established in the agreement. If the employee leaves before that date, the benefit is forfeited. The organization keeps the asset. The employee receives nothing. That creates a completely different decision-making process. Remember when I said that choosing between two futures, one if I stay and one if I leave? Kelly: Right, yes. David : The employee is no longer evaluating only what might they gain going elsewhere. They’re also evaluating what they will lose by leaving. As the asset grows and compounds, the financial consequence of leaving becomes increasingly significant. Kelly: Oh, yeah. David : Yeah. Absolutely. An employee may receive a recruiting call from a competitor offering a higher salary. The employee now has to compare that offer against a growing future benefit that could be worth substantially more. People become far less likely to leave when doing so requires walking away from something meaningful they have spent years building toward. In other words, you’re giving them something to lose by leaving. At the same time, the employer benefits because the asset continues to grow, regardless of whether the employee ultimately stays or leaves. That creates a powerful alignment of interests between the employee and the organization. Kelly: I mean, it seems like a win-win, right? I mean– David : Everybody wins. Kelly: Everybody wins. Right. So, David, what financial modeling should hospitals use to project the long-term impact of retention strategies? David : It’s actually relatively easy for a hospital, or any organization, for that matter, if they’re tracking [inaudible] turnover, to figure it out. The starting point is understanding the true cost of turnover. And most organizations underestimate turnover because they focus primarily on recruiting and hiring expenses. Those costs are only part of the picture. I mean, how do you deduct lost productivity? I mean, these are– okay, for a nonprofit hospital, that’s not a big deal. But if you’re a for-profit hospital, what you can deduct and not deduct is really important. But hospitals should also evaluate lost productivity, onboarding time, training costs, overtime, temporary staffing, management distraction, reduced continuity, and, this is key, the impact on patient care. And that’s another key issue here because, if patients have to wait too long, or if there isn’t a specialist to help that patient, or they can’t get the care they need, they go elsewhere. And the hospital loses that income that would be generated by that patient. Kelly : True. David : Those revenues. Once those costs are understood, leaders can compare them against the cost of a retention strategy. It costs somewhere between eight hundred thousand and a million on average to replace a physician, depending on your specialty and location. And for other skilled employees, the general rule of thumb is– it can cost more than double the salary to replace someone with skills. Now, you multiply that by the percentages of turnover that hospitals have– and the question is not simply, what does retention cost? The better question is, what does turnover cost? When organizations perform that analysis, they often discover that preventing turnover can generate a significant financial return. You see, turnover is not just an HR issue. Not anymore. It is a financial issue. It is an operations issue. And so many hospitals operate on such slim margins– Kelly: Definitely. Yep. David : –absolutely, that when you get rid of– when you mitigate turnover cost and literally take a portion of that cost and turn– or all of it, for that matter, and turn it into a growing and compounding asset on the balance sheet, it becomes amazing what it can do to the bottom line. And like any financial issue, it should be evaluated based on its impact on the organization’s performance and long-term profitability. Kelly : Yeah, I mean, the true cost of turnover is key. I mean, I agree with everything that you’re saying here. So how can hospitals implement retention strategies without increasing net operating costs? David : Oh, they so can because they already have a turnover cost. They know it. They track it. I’ve sat in on so many conversations where they talk about turnover cost percentages. And I’ve always heard them talk about, well, the turnover cost for this group, our nurses is X, and the turnover cost for this group is Y and so on. But I’ve never heard them talk about turnover in the cost of dollars. I actually, on my website, I have a free turnover cost calculator that people can go and visit and download. And they can adjust it to however they want it to work. But they will end up with right in the ballpark of what turnover is costing them. And that website is talentretentionplans.com. And it’s just so that they can get that if they would like to do that. Now, if you can take a portion of that turnover cost– and every financial professional will tell you, if you’re in business, whether you’re a for-profit or nonprofit, you have to know your costs. You take a portion of that and put that into this plan, and it mitigates the turnover cost. And remember, this is key. We’re not spending the money. We’re literally turning it into an asset on the organization’s books and the organization’s balance sheet. It’s one of the most important questions that hospital leaders can ask. Most retention strategies are treated as expenses. This is not an expense. Higher salaries, larger bonuses, increased 401(k) contributions, retention payments and benefits. They all require the organization to spend money today. Once that money is paid, it’s gone. And employees can still leave. A different approach is to create a retention strategy that is structured as an asset rather than an expense. Under this approach, the employer funds and owns the plan. And the employee never owns the asset. And the asset remains on the organization’s balance sheet where it continues to grow and compound over time. Now, imagine what that would do if for your key people, your doctors, your nurses, your technicians, your physician assistants, and all of the people that, shall we say, that we use to build the insurance companies, if they remained in place, and they didn’t leave, wow, look what that would do to your bottom line. And that’s where the money to fund the plan comes from. We’re simply taking a cost and turning it into an asset. And now the employee agrees to stay, and they have a serious, substantial reason to stay should they fulfill their end of the agreement. That alone creates a powerful retention incentive. But there’s another feature that makes this approach particularly attractive from a financial standpoint. Because the asset compounds over time, it can grow to a point where the employee receives a significant financial benefit that they were promised, while the organization simultaneously recovers its investment in full. In many cases organization can recover more than it invested. That means the strategy can achieve something very unusual. The employee receives a meaningful long-term benefit, the organization recovers its investment in full and then some. The plan can actually generate additional value for the organization. From a balance sheet perspective, the net cost can approach zero while improving workforce stability. That stability changes the game. Instead of asking what will retention cost us, leaders can be asking, how can retention strengthen both our workforce and our financial performance? Most retention strategies, as I said, create an expense. This strategy creates a growing and compounding asset. Kelly : Yeah, positively affecting the bottom line for sure. David : Absolutely, it does. Kelly : Yeah. So, if you were advising a hospital CEO preparing to retire in the next few years, how would you structure retention to protect their legacy? David : Every CEO wants to leave an organization stronger than they found it. It’s just the way they’re built. Kelly : Yeah, of course. David : Yeah. One of the greatest threats to a CEO’s legacy is instability after they leave. Key people depart. Institutional knowledge disappears. Performance suffers. Momentum slows. I would focus on strengthening retention among the hospital’s most valuable professionals before the transition occurs. The objective would be to create continuity, preserve expertise, and maintain organizational stability. A strong leadership legacy is not measured only by today’s results. It is measured by how well the organization performs after the leader is gone. Retention plays a major role in making that possible. The most successful leaders don’t simply build organizations that perform well today. They build organizations that continue performing long after they leave. Kelly : That’s their legacy, right? They’re part of it. David : Legacy. Yeah. Kelly : Right. So, what separates organizations that successfully retain top talent from those that just continue to struggle? David : Organizations that continue to struggle with retention often focus primarily on current conditions. Organizations that succeed focus on the future. The best organizations understand that talented professionals are constantly evaluating where they can build the strongest future for themselves and their families. When employees believe their future is stronger somewhere else, they leave. They’re out of there. When employees believe their future is strongest right where they are, they stay. That is why I often say that people stay where their future is strongest. The most successful organizations create a future that employees do not want to walk away from. They understand that retention is not simply an HR issue. It’s a financial issue on both sides of the equation. It’s an operational issue. It’s a leadership issue. And increasingly, it is a competitive advantage. Organizations that understand that principle and build their reputation strategies around it consistently outperform those that do not. In today’s healthcare environment, retaining highly skilled professionals is one of the most effective ways to improve stability, strengthen performance, and protect the bottom line. Kelly : Well, thank you so much, David, for sharing all these insights with us on people’s day where their future is strongest. And also, we’re going to link to that free turnover cost calculator that you mentioned. And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that? David : Oh, the best and fastest and easiest way is connect with me on LinkedIn. I’m the only David Alemian on LinkedIn , so I’m easy to find. And if they go to my profile, they’ll see my email address is there, my phone number is there, my websites are there, so they can find me. I’m really passionate about this. And if people have if your listeners have questions, I’m happy to spend time with them and answer any questions that they may have. Because good health starts with good healthcare, and nothing is more important than quality healthcare. Kelly : Completely agree. Well, thank you so much. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts. The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at contact@besler.holdings . Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post People Stay Where Their Future is Strongest [PODCAST] appeared first on Besler Holdings .

← Back to All Podcasts Medicare Cost Report Appeals and Reopenings—Best Practices Webinar In this episode, Kristin DeGroat, Besler Holdings’ Chief Legal Officer, provides us with a glimpse into Webinar, Medicare Cost Report Appeals and Reopenings: Best Practices, presented live on Wednesday, July 22, at 1 PM ET. Highlights of this episode include: What is this webinar about? Key takeaways Recap of the whole series Who can benefit from this webinar Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness. We’re pleased to welcome back Kristin DeGroat , Besler Holdings’ Chief Legal Officer. In this episode, Kristin will provide us with a glimpse into Besler Holdings’ next and final webinar in its Medicare Cost Report Appeals and Reopening series. This one focused on Best Practices . This will be live on Wednesday, July 22nd at 1 PM Eastern Time. Welcome back and thank you for joining us, Kristin. Kristin DeGroat: Thank you for having me again. Kelly : All right, well, let’s go ahead and jump in. So, this webinar will focus on best practices. Can you give us a quick review of what we can expect in the way of best practices? Kristin : Yes. Navigating a Provider Reimbursement Review Board appeal requires rigorous adherence to strict rules and regulations. And because of that, there are some extremely valuable best practices that you need to think about when you’re filing these appeals. The portal and the deadlines are not just suggestions, they are requirements. So, navigating those in terms of best practices and setting forth how you remember when things are due and that kind of stuff in terms of an appeal is really important. But also important is the reopening process, ensuring that you adhere to the max deadlines, and that’s the Medicare Administrative Contractors deadlines and requirements. They are different. You do things a little bit differently. So, you need to think of how you handle that and getting those filed as well. And then just in general, CMS in general, there’s so many different parts and pieces that lead into appeals and reopenings. So just trying to set yourself up for success in terms of getting these filed and following the protocols, and basically trying not to irritate the board and the MAC are very important in this process. Kelly : Yeah, that sounds like solid advice, Kristin. And we always love best practices, so this is going to be a really great webinar. So, what do you think is going to be some key takeaways from the webinar? Kristin : Kind of what I just said about the being able to categorize or set up maybe calendaring or other avenues to ensure that you’re meeting the deadlines. And also cataloging, keeping your documentation together in a way that somebody else can understand. We all get caught in the, I’ve done it, I’ve looked at it so much, then we forget that people aren’t exactly like us and don’t read things exactly the same. So, cataloging that in a way that others can understand and appreciate, I think, will be the greatest takeaway. Kelly: Yeah, that sounds like a great takeaway too. So, this is the last in our Medicare Cost Report Appeals and Reopening’s webinar series. Can you do a quick recap of the first two, and how does this one fit in? Kristin : So, the first one was a deep dive into the PRRB and the rules and the deadlines, the timeliness, the amount of controversy. Those strict requirements and then we talked a little bit about the reopening requirements. And so, all of that together then led us to, well, what are the most common issues? That was the second webinar. And we did the deep dive into the most common issues, and we gave the status, kind of case law where they were sitting right now, and what we expect, or hope, maybe, is a better word, the outcome will be for those cases. So, the third one will definitely not hit the issues and the updates. So really, if you want to learn about the most common issues, updates, that one you’ll have to go watch if you didn’t join us for the second webinar. Hopefully, you’ll join us for the taped version, so to say. But I think this third one really will kick and tie to the first one where we kind of went through everything, but this will just be a little bit different approach. So maybe the lingo might be repeated, and I might forget to give the definition for my lingo. So, I will do my best. But I invite you to look at the whole series together, because I do think the whole thing together really makes sense. Kelly: Yeah, creates that complete picture, right? Kristin : That’s correct. Kelly: Yeah. So, do you have to watch the first two or watch them in order for this webinar’s content to make sense? I mean, or are they standalones? Kristin : I don’t know that they’re necessarily standalones completely. The first one did go through in detail what we’re going to talk about in best practices. And it gave a little overview of the issues. But really, that second webinar, the diving into those issues and really telling you what the status is, where they are right now, I think really is a standalone. But in order to get there, you had to meet all of the requirements. And you have to have the best practices to ensure that you’re really not irritating your audience. You want to make sure that you’ve complied and have done things showing not to be rude, right? When the board says you have 20 days to file this, don’t do it on the 21st day. It’s just as simple as that. Just following the rules and some best practices to help get you through. The other thing is appeals aren’t new, reopenings aren’t new. So, there is a lot. 30-plus years of going through the process has really, I think, laid out for us a nice, seamless transition from, “Here’s the rules,” to, “Here’s the issues, and here’s how you keep the goodwill going with your issues and your appeals, and even your reopenings.” So we’re going to talk a little bit more about reopenings, probably, in this third series, because I think the max concerns about how we approach issues and appeals, I think it’s something that we really need to take heed of because they are the ones that are going to help you settle your cases and help push these cases through. So, I think I want to do a little bit more focus there. Kelly : Okay, that makes a lot of sense. Looking forward to that one. So, who do you recommend attend this webinar? Who is the target audience? Kristin : Really, anyone in reimbursement. If you are filing a cost report or even thinking about an appeal, and you’re probably filing reopenings, so anyone doing those that has always wondered, “Well, I wonder why I did my reopening this way, and I didn’t get a really good response,” or, “Wow, I thought this would move faster. I’m not sure what I did wrong. I thought I compiled the evidence.” So, I think really focusing on that and moving through that process. And maybe that’s it. Maybe you’re someone new to reimbursement. This would be a great way to kind of experience, okay, so this is what I need to do. And it’s not all going to be about rule following. Some of it is just common courtesy. Kelly : Yeah. That makes a lot of sense, yeah. Kristin : Oh, I was just going to say I hope everyone can join the webinar. I’m really excited about this one. I think it kind of gives you more of a– let’s me put some personal flair on it and what I’ve experienced over the years. Kelly : Yeah, love that. Well, thanks so much for joining us, Kristen, for giving us this glimpse into Besler Holdings’ free webinar, Medicare Cost Report Appeals and Reopenings Best Practices , that we’re going to do live on Wednesday, July 22nd, at 1 PM Eastern Time. And as a bonus, you can also earn CPE. Thanks again, Kristin. Kristin : Thank you. Have a great day, Kelly. Kelly : Thank you. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts. The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at update@besler.com. Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post Medicare Cost Report Appeals and Reopenings—Best Practices Webinar [PODCAST] appeared first on Besler Holdings .

← Back to All Podcasts LinkedIn Tips for Healthcare Finance Leaders In this episode, Lauren Schafer, Founder of Lake House Digital Media, discusses LinkedIn Tips for healthcare finance leaders. Highlights of this episode include: Why it is important for hospital finance executives to have a strong LinkedIn profile How a hospital finance leader can start building a LinkedIn profile How finance leaders can contribute to the overall marketing and social media efforts of the hospital Other than LinkedIn, how hospital finance leaders can help their professional profile The biggest mistakes someone can make on LinkedIn The best practices for LinkedIn Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome Lauren Schafer . Lauren is the founder of Lake House Digital Media , a boutique agency helping life sciences, tech companies, and growth-minded founders build authority that actually drives demand. Lauren blends SEO, thought leadership, LinkedIn strategy, and event marketing to help complex companies become the obvious choice in their category. You’ll walk away with practical ways to earn trust faster and turn visibility into real momentum. In this episode, we’re discussing LinkedIn Tips for Healthcare Finance Leaders. Welcome, and thank you for joining us, Lauren. Lauren Schafer: Thanks for having me, Kelly. Kelly: Well, let’s go ahead and jump in. So why is it important for hospital finance executives to have a strong LinkedIn profile or identity? Lauren : Financial leaders are just like anybody else on the leadership team, and that means having a really strong professional presence on LinkedIn is critical for correct positioning. It’s both for their current role, to build their own network, and for future opportunities, but it also is letting you build the hospital’s network, that healthcare network and presence to build more brand awareness and trust. Kelly: Most definitely. Agree with that. So how would a hospital finance leader start building a LinkedIn profile if they have limited experience on LinkedIn? Lauren : So, the biggest thing there that a lot of people miss, or they skip because they’re like, “Oh, I’m not so sure yet,” is they skip putting their photo on there. It sounds so basic, but at the end of the day, people want to know who they’re doing business with. And so, the biggest thing is make sure that you’ve got a profile picture and that it’s a current picture, right? It’s not you, maybe 20 years ago, 15 years ago, a little bit thinner, a little bit different hairstyle, but it needs to have the current position that you hold, the company that you work for, and your name, and absolutely your full professional name. So, one of my biggest pet peeves is if people do like John S., and I’m like, if they’re trying to find you, there are millions of John S’s out there. So, you need to put that full name. But then some next steps that would just kind of ease you into doing things on LinkedIn is set a timer a couple days a week, maybe two or three times a week to just log on for even 15 minutes, turn those notifications on, so if someone sees that you’re getting active and reaches out, that you don’t miss it. But also, a good next step to start expanding their network if they haven’t had a lot of experience is connect with your employees, connect with people that are on your board and your own networks. So, start leading by example. Your employees do more on LinkedIn, but also just start connecting with people and then slowly start commenting when you’re comfortable on other people’s posts. It’s going to help you get more views. It’s going to help where you’re working, get more brand awareness, and you’re going to develop relationships through that. You don’t have to have these long, drawn out thesis type of comments, but even just like, “Hey, congrats on the new role,” or, “This is a great resource for our community.” Something that is thoughtful, but it can be short and sweet to start building that relationship on LinkedIn. Kelly: That’s all great advice. And I do agree that the photo is key. So how can finance leaders contribute to the overall marketing and social media efforts of the hospital? Lauren : So, the biggest thing, especially when you’re looking at LinkedIn, it is a social media network, but it’s business-minded first and foremost. And a lot of people are looking for thought leadership. They’re looking for trust and who do I know there? If something comes up, whether they are looking potentially to apply for a job or to do business with you, to be in partnership with you. But when you start having posts on there from your brand– and even little things like the employees start to share the post. Employees’ share get two times the amount of clicks that a regular company brand page gets. So, it indicates to other people, “Hey, I like working here. I don’t mind telling people that I work here, and I’m trusting the content when I’m sharing it.” So that’s a big thing, is to get your overall marketing efforts to make sure that your healthcare institution is posting optimally at least twice a week. You don’t need to post every day. But getting that brand awareness out there and then enabling your employees to say, “Hey, we want the shares, let people know if we’re sharing some–” maybe a great new project at the hospital, some new cutting-edge technology, or just a feel-good post, maybe how you’re giving back to your community. All of that is adding more brand awareness, more trust signals, and keeping you top-of-mind, so then when people do have a choice and they need something that your healthcare institution provides, you will be top-of-mind. Kelly: I completely agree that the employees getting involved is really key to getting out the word and helping with that brand awareness of the hospital. Lauren, other than LinkedIn, how can hospital finance leaders help their professional profile and the hospital’s professional profile? Lauren : So, a couple of things on there. You’ve got LinkedIn as a great resource, sometimes to amplify the other efforts that you’re doing. So, if the hospital, for example, has put out a press release, or if they put out some new thought leadership on an experimental– anything that they’re trying, some new technology, sharing it on LinkedIn is great. If they’ve got those resources that are on the webpage from the hospital, if they’re on a podcast, something like this, where they’re sharing new developments and things, to share those both from your website, if they’re on podcasts, to make sure that you’ve got a presence where people are looking now. And people are looking so much at AI now. So, AI is indexing posts on LinkedIn now, and it’s one of the most cited LinkedIn places, when people are putting those questions in Google or in the search engines, and those AI answers are coming back. So, it’s making sure that your healthcare institution is where people are at. If there’s video, do you have a YouTube channel? They’re free to start. Or if there is something new, a ribbon cutting with you or one of your partners, share that. You want consistent signals, both on your website, for it to be up-to-date. You want to reach people where they’re at, whether that is searching online, whether it’s on LinkedIn, or even simple things like having just a good community newsletter. As much as I would love for people to be on LinkedIn all the time on social media, because it’s what we do, the one place that they are sure to check almost every day is their work email. And it is, one, just sending a newsletter, sharing latest developments, any big staff changes, community involvement. People open their work emails, and it’s a great place and an easy place to make sure that your institution is staying top-of-mind. Kelly: Yeah, those are such great ideas, Lauren. Thank you for sharing those with us. What are some of the biggest mistakes someone can make on LinkedIn? Lauren : Oh, that’s a great question, Kelly. I would say, first and foremost, having either no photo or an outdated one. So, let’s say that you have a photo that you really like, but it’s maybe 10 to 15 years old, and maybe you’ve got a little bit more gray hair, or maybe your weight is different, either way. But let’s say that someone connects with you, that maybe they want to do a new project and they’re interested and is your hospital a good partner for them? And you set a time to meet at a conference, or you set a time for coffee, and you show up and you look nothing like your picture, regardless of the integrity you have, the trust, all the things about your reputation, that first impression of you is going to make them hesitate because you don’t look like your picture. So that is my biggest pet peeve. But then a few other things is if people comment or ask you a question, if you have posted, but then you check out for a couple weeks, if you don’t respond to their comments, that’s a big mistake that people make, because then people will be less likely to comment on your post the next time. And then one other one, and then I’ll wrap this one up, is people forget that even though LinkedIn is a business platform, first and foremost, it’s a social media platform. And so, their algorithm still will reward social interactions and conversations. It’s a two-way street. So, a lot of people go on, they’ll just post, “This is the great thing we’re doing. Look at what we’ve got new. These things are all great. Look at my promotion.” But then they post, and then they check out of LinkedIn. And other people that are congratulating them or asking questions feel ignored when you don’t respond back, or if they post something, you don’t reciprocate by commenting back. So, a big mistake that people do make is forgetting that it is a social network first and foremost, even though it’s a business platform. But to be able, it’s a two-way street. Kelly: Definitely is. And those are some great mistakes that you pointed out. On the flip side, though, what are some of the best practices for LinkedIn that you can share with us? Lauren : So, a lot of people that are on there are leaders in the business community. They are leaders in healthcare, and they are on there in a business mindset, right? So, some of the best practices is to make sure, are you posting thought leadership on there? Let’s say that your institution is growing, or if they’re investing in a certain area, and here’s why, and here’s either an unmet need in your community that it’s going to answer, or whatever the value is to your community and to those that you want to be in your network, the more that you can share thought leadership and show value is a great– this is a great place to do it, not only for those on LinkedIn, but again, it’s being indexed by Google. It’s being indexed and cited on AI. So, a lot of things, even if they’re just on LinkedIn, can suddenly show up in a quick excerpt that is back on an AI, an AI question that somebody asked. But it’s also another great practice is to highlight your staff. If you’ve got someone new coming in on your leadership team, it’s going to be great to announce that you guys are expanding or that this person has joined your team, if they have a new award, a new certificate. It’s great because it both is great from an HR perspective to welcome them and show that hospitality and recognition. But on the flip side, it’s also great doing other things. If you’re very involved in something that is philanthropic in your area, it’s showing your community that a place you work cares about where they’re doing business. They care about the people in the community. And all of those things just nod to your brand recognition, your brand awareness and reputation, and making sure that you have a positive association with where you’re working out in the community. Kelly: Those are such great tips. Thanks for sharing those with us, Lauren. Any final thoughts for hospital finance leaders? Lauren : I think here’s the thing is everybody really loves to work for a successful organization, right? But people have choices where they work for recruiting. And if something happens in their lives, a lot of communities, they have a choice of what hospital or healthcare institution that they’re going to go to. So, staying top of mind is so key in this situation. Having a good association with your brand, both for employees, for recruiting and everything, but also so that you get those patients, you get the customers and clients, in that when they have a choice and something happens, and they have to make a quick decision, there’s no choice other than where you are. So, I think that’s our final thing, is there’s a lot more to it than just posting on LinkedIn as a social media platform. It’s more about growing that brand awareness so that where you are always is top of mind for everybody. Kelly : That’s wonderful. Thank you. Thank you so much, Lauren, for sharing your insights with us on LinkedIn tips for healthcare finance leaders. And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that? Lauren: Well, obviously, LinkedIn is a great place. We’re on it all the time. So, we’re Lake House Digital. Lake House is two words on LinkedIn. I am on LinkedIn as Lauren Miller Schaefer . And also, if you wanted to go to our website and get in touch, we are thelakehousedigital.com , and we would love to hear from you. Kelly: Awesome. Thanks for providing that. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts. The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at contact@besler.holdings . Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post LinkedIn Tips for Healthcare Finance Leaders [PODCAST] appeared first on Besler Holdings .

← Back to All Podcasts The Financial Safety Net for Healthcare Leaders In this episode, David Beahm, President and CEO of Blanchard and Company, Inc., discusses the financial safety net for healthcare leaders. Highlights of this episode include: What the structural gap is that most healthcare CFOs and executives aren’t accounting for in their portfolios What diversification means in practice for a chief medical officer or a hospital executive The most common blind spots for high-income healthcare professionals ETFS and paperback gold vs. physical ownership What you need to know so that your wealth is both protected and accessible Industrial demand from AI infrastructure and green energy initiatives Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome David Beahm . David serves as the president and CEO of Blanchard and Company, Inc., the largest and oldest retail investment firm specializing in precious metals and rare coins in the United States. With over a decade of executive leadership at the firm, David stewards a legacy that began in 1975, shortly after his predecessor helped spearhead the grassroots movement to re-legalize gold ownership for private American citizens. Under his leadership, Blanchard has surpassed 800,000 clients and $1.3 billion in recent sales, maintaining a premier partnership with legendary numismatist John Albanese. David is known for his “Advisory-First” philosophy, moving the industry away from high-pressure sales toward sophisticated long-term wealth preservation and portfolio diversification. In this episode, we’re discussing the financial safety net for healthcare leaders. Welcome, and thank you for joining us, David. David Beahm : Thanks, Kelly. Thanks for having me. Kelly: Yeah, well, let’s go ahead and jump in. So, hospital endowments and executive compensation packages are heavily tied to equities and bonds. And when markets correct, healthcare institutions feel it hard and fast. From your perspective, what’s the structural gap that most healthcare CFOs and executives aren’t accounting for in their portfolios? David : So, I think the gap leads to risk in what most healthcare CFOs and the executives that work with the endowments, they underestimate the concentration of risk, and they kind of disguise it a little bit with what they call diversification. But really, on paper, if they own equities and bonds, when the day’s over with, that’s still tied to the same system. So, when you see liquidity tighten or confidence break, like we saw in 2008 and then again in 2020, that correlation that just is one. So those assets individually basically are tied to one another, and they move with one another. So, the gap right there is really the absence of a counterweight, such as gold. And because some of these portfolios lack assets that sit outside of that stock and bond financial system, what physical gold can do is actually provide them with a little bit of insurance to make sure that when those traditional types of portfolios come under pressure, it’s not as critical when you own something like gold in there. So as long as you are truly diversified and have exposure to something outside of the stocks embalmed realm, you can bridge that gap. Kelly: Right. I know diversification is really key there. The word non-correlated gets used a lot in finance, but what does it actually mean in practice for a chief medical officer or a hospital executive sitting on a $50 million endowment committee? David : So, when you start looking at non-correlated assets, you start thinking about a theory, and it’s really the behavior of certain assets under stress. And so, when you see an endowment or really just stocks in general drop 20% or so in a short window, some of these assets, they just move together because people are forced to sell, people are forced to raise money for margin calls, or they need liquidity. And so, everything is fair game. So, when you look at that type of movement and gold does behave that way, gold is a source of liquidity, but it’s a little bit different because it’s not dependent on earnings or credit markets such as stocks and bonds. So, for a hospital executive managing a $50 million endowment, non-correlating assets mean owning something that will hold value or even appreciate while some of the other assets are declining. So, gold’s not going to outperform assets every single year, but it provides that insurance policy and it’s there when you need it. Kelly: Yeah, that makes a lot of sense. Thank you. So, healthcare leaders are often incredibly sophisticated when it comes to clinical risk management, but personal wealth planning is a different discipline entirely. What are the most common blind spots you see when high-income healthcare professionals come to Blanchard for the first time? David : I think the blind spot that we see is, just in general, just the retail investor, is the overconfidence in that system we were talking about a little while ago. You spend your entire college in the finance world learning about stocks and bonds. And then, the last day you learn about gold. So, nobody really knows about it in the United States. It’s not all over the world, but in the United States, it’s not owned by as many as it should. So, healthcare leaders, because they’re trained to manage risk, they need to make sure that they have an asset that will perform or at least provide insurance. So, we consistently see a few things. One is people being overexposed to paper assets that, again, are all tied to that economic system we were talking about. And then almost more importantly is liquidity– the misunderstanding that gold is not liquid, and it is liquid, especially in a time of crisis. And then the third is, what do you really own? A lot of retail investors, a lot of managers, fund managers– that’s not really clear on what they own and what exposure it is through any sort of financial asset that they may have. So the ownership, clarity, the misunderstanding of liquidity, and then again, going back to being exposed to stocks and bonds, their traditional assets, those are the blind spots that we see. Kelly: Yeah, I appreciate you sharing those blind spots with us. ETFs and paperback gold products are easy to buy inside a brokerage account. Many executives already hold them and think they’re covered. Why isn’t that the same thing as physical ownership? And why does that distinction matter, especially during systemic financial stress? David : The gold market loves ETFs. When they came into the marketplace, they added a lot of demand that wasn’t there. And partly because of what you just explained, it’s easy to get in, it’s easy to get out. What our investors do is they’re looking for a long-term hold, and really the true proxy to owning gold or being exposed to gold is actually owning physical gold. So, ETF serves a great purpose, but you do have some expenses that you don’t have with owning gold. You have management fees. You have marketing fees. You have storage insurance, which you do have with owning physical gold. But those funds that are needed to actually run the ETF or taken off of the asset. So, in our mind, physical gold is really the only way to truly have a gold position. And again, you also have mining shares out there as well, exposed to the price of gold, but not– you have to worry about management, mining collapse, geopolitical risk in that area. We just feel that physical gold that we actually send to clients or arrange for storage for them is the true way of being exposed to gold. Kelly: Very interesting take on that. So, there’s a liquidity question that comes up with physical assets. How quickly can I actually get out if I need to? How do you answer that for a healthcare executive who needs to know their wealth is both protected and accessible? David : That’s one of the biggest things misunderstood about the physical gold market is liquidity. And physical gold and silver, for that matter, are really liquid assets. As a matter of fact, just a side note, our pilots carry gold with them when they’re overseas flying combat missions, because if they go down and they need to get from one place to another, they use gold to do it. So, for a healthcare executive, the key is structure. Really, if the metals are properly allocated, which we can help with, they’re properly stored, which we can help with and documented, they could be converted to cash fairly quickly. I mean, within a few business days, depending on where the assets are. So, what I would just emphasize is not just liquidity, but it’s the certainty of liquidity. And in a stressed market, the ability to access your gold or your capital without relying on market stability is certainly a significant advantage. Kelly: Yeah, no, I totally agree with that. So silver is having a moment driven by industrial demand from AI infrastructure and green energy initiatives. How does that factor into the broader portfolio strategy? David : Yeah, so silver has been on a tear because it’s uniquely positioned right now because it’s kind of in that intersection of the investment world, but also in the industrial complex. So, it’s more of an industrial commodity than gold is. The demand for the infrastructure for the AI and energy and all the electronics. We’re having emerging technologies seemingly every few months and silver is going to play a real big role with all of that. So, from a portfolio or investment standpoint, silver has just a little bit more dimension than gold, but we view silver as a complement to gold. And what we advise is to have both in your portfolio. You can say, well, why would I do that? You’re just talking about diversification. Well, that’s truly within the precious metals complex being diversified is having some exposure to gold and silver. While they do typically run together, there are certain times where one outperforms the other. So, it adds a– silver has an element of growth potential that’s really tied to real world demand. And having the right allocation of both of those working together strengthens your overall portfolio. Kelly: Definitely. Well, thank you so much, David, for sharing your insights with us on the financial safety net for healthcare leaders. And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that? David : So first, our website, blanchardgold.com . And then also we have portfolio managers that help advise. So, we don’t just sell this product, we form relationships with people and we’ve been around for 50 years. So, we love talking to people on the phone to get a feel for what their goals are, what their drifters are, and that way we can put them into the right asset class. So, I would encourage anybody to call our 1-800 number. It’s 800-880-GOLD, 4653. So, it’s 800-880-4653. And we can help with any questions and hopefully help some of your listeners get involved in an asset that maybe they were a little unclear about before. Kelly : Wonderful. Thank you for providing that. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time… [music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts. The Hospital Finance Podcast is a production of Besler Holdings. If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at contact@besler.holdings . Subscribe Today! 945.237.1009 116 Village Blvd., Suite 200 Princeton, New Jersey 08540 Quick Links About Team Podcasts Webinars Solutions Medicare Appeals Contact Us Contact ©2026 Besler Holdings Terms of Use | Privacy Policy | Corporate Compliance The post The Financial Safety Net for Healthcare Leaders [PODCAST] appeared first on Besler Holdings .

← Back to All Podcasts How to Identify Nursing Home Abuse, Prevent Negligence, and Evaluate Care Facilities In this episode, James Morgan, Founding Partner of Lanzone Morgan LLP, discusses how to identify nursing home abuse, prevent negligence, and evaluate care facilities. Highlights of this episode include: What is nursing home abuse and neglect? Most common types of nursing home abuse and neglect. Why are nursing home residents getting neglected? How are nursing homes usually paid for caring for its residents? The difference between nursing homes and assisted living facilities. What family members can do to prevent abuse from happening in a nursing home. How do people know if a nursing home is good or bad? If someone suspects that a family member is being abused in a nursing home, what should they do? Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome James Morgan . Jim is a highly respected nursing home abuse attorney, an elder abuse lawyer in California, and the founding partner of Lanzone Morgan LLP . For more than 25 years, Jim has dedicated his legal career to representing victims of elder abuse, nursing home neglect, and assisted living facility misconduct, helping families hold negligent care providers accountable. He has helped secure millions of dollars in settlements and verdicts for elderly victims and their families while pushing the long-term care industry to improve safety and accountability. He graduated cum laude from Jacksonville State University in 1991 and went on to graduate Magna cum laude from Washburn University School of Law in 1997. Jim is currently licensed to practice law in Arizona, California, and Nevada. He’s also licensed with the United States District Court, Southern District Court of California, the United States Ninth Circuit Court of Appeals, and the United States Supreme Court. Jim has also served as president of a national organization of attorneys dedicated to suing nursing homes for elder abuse. In this episode, we’re discussing how to identify nursing home abuse, prevent negligence, and evaluate care facilities. Welcome, and thank you for joining us, Jim. James Morgan: Thanks for having me. Kelly: All right, well, let’s go ahead and jump in. So, let’s just start off with a pretty basic question. Jim, what is nursing home abuse and neglect? James : Well, that’s a good starting point. Nursing home abuse and neglect can be anything from as minor– I shouldn’t say minor, but anything that doesn’t necessarily cause major injuries but is certainly concerned about somebody’s dignity, which is maybe not being showered timely, not getting changed in a timely manner if you’re sitting in your urine and feces and you can’t change yourself and make it to the restroom. Those are dignity issues, and that’s the result of neglect. If somebody is sitting in their urine and feces for hours not being changed, it may not lead to long-term problems, but it could. And then neglect can also lead to very serious injuries, such as infections from what I just described. Also, falls, fractures, falls with subdural hematomas or brain bleeds that may lead to death. And of course, probably the number one type of case we get, which is terrible bed sores from somebody sitting in the same position in bed for hours upon hours and not getting turned and repositioned. So, neglect ranges from everything from dignity issues to very serious injuries and death. But the bottom line is nursing home neglect is when nursing home residents are not getting proper care to meet their needs. Kelly: Okay. Thank you for explaining that for us. So, what are the most common types of nursing home abuse and neglect that you see? James : The two top cases that we take are the falls fractures or falls leading to other serious injuries and bed sores. Those are by far the most common types of injuries that lead to lawsuits. And when I say bed sores, what I’m talking about are wounds that happen at pressure points in the body when somebody’s sitting in bed. So, the most common type of pressure sore that we see is on the coccyx area where your tailbone is pushing down you’re not being turned and getting any pressure relief. So, you get a terrible pressure sore on your coccyx or on your heels because those are also bony prominences where people can get bed sores if they’re laying in bed all the time. But other types of nursing home abuse and neglect cases are dehydration, malnutrition, especially if somebody’s on a feeding tube. Elopement cases. Elopement cases are when somebody wanders out of a facility. They might have Alzheimer’s or dementia, and they should be in a locked facility or somewhere where they’re kept safe, but they wander out of the facility and, unfortunately, can get injured. And then there’s probably fewer cases of, but certainly problematic, are the actual physical abuse of the residents, either just physical assaults or some type of sexual assault. So those are probably the most common types of neglect that we see here in our law firm. Kelly: Wow. That’s very sad, but thank you for giving that information to us. So why are nursing home residents getting neglected? James : Most of the neglect that we see in our cases stems from understaffing issues. Understaffing occurs when the nursing home tightens its budget to save costs and make more profit. Most nursing homes are privately owned. They’re for-profit enterprises, so people are trying to make money. And the way to make money in a nursing home is to fill every bed because that’s where you’re getting your revenue and to cut costs. And labor is by far the highest cost of running a nursing home. So very simply put, the way to make money by owning a nursing home is to fill every bed so that you can make as much revenue as possible and to take care of those residents with as little labor as possible. When that happens, it could be a recipe for making money. But unfortunately, it’s also a recipe for neglect of the residents when there’s not enough staff to meet their needs. Kelly: Yeah, labor does make sense to be the highest cost there. So how are nursing homes usually paid for caring for its residents? James : Okay, so skilled nursing facilities are primarily paid by Medicare, Medicaid, private pay, or insurance. Private insurance, or maybe somebody has long-term care insurance. But the private pay and the private insurance are the lowest number of residents getting paid paying for the nursing home care that way. By far, most of the revenue in nursing homes comes from Medicare and Medicaid. Now, Medicare pays the highest amount of money to the nursing home to care for the residents. So nursing homes want Medicare patients. So, here’s what happens. An elderly person is living at home and they have a stroke or a heart attack or a fall with an injury, and they go to the hospital. And they’re in the hospital for a few days, recovering from whatever happened. And the doctor says, “We really don’t want to send you directly home. You need some physical therapy to gain some strength. You might need to be on an IV antibiotic for a little while. We want to send you to a nursing home for some rehab.” Okay? If that person has Medicare, Medicare is going to pay for that nursing home stay. Nursing homes love this because Medicare pays the highest rate of reimbursement. So if a nursing home had its way, every bed would be filled by a Medicare patient because that’s how they’re going to make money. That’s how they’re going to make the most money. Now, the problem is that Medicare will only pay the nursing home for about 100 days of physical therapy. After that, the resident is going to have to go either on Medicaid or private pay or insurance. And so the nursing home will want to get rid of a resident right at that 100-day mark after they’ve gotten all the money they could possibly get out of Medicare. And then all of a sudden, they might tell the family, “Hey, you got to go. They’ve reached their peak. We need to discharge them by tomorrow.” They a lot of times will give you short notice. And the nursing home doesn’t– and even if the family says, “Hey, they’re not quite ready to go home. They need some more physical therapy. They need some more care.” The nursing home’s not going to want to keep them because if they end up being a Medicaid patient, then Medicaid reimbursement is quite a bit lower than the Medicare reimbursement. So, what the nursing home wants to do is get rid of that person who ran out of Medicare days, get them out of the facility, and fill that bed with another resident who’s on Medicare. So, they can keep getting the maximum reimbursement for that bed. So, what you’ll see in nursing homes sometimes are called Medicare wings, so where everybody on a certain hallway is a Medicare patient. And those hallways are typically staffed well because the reimbursement is good on that wing. And then you’ll see other wings that are what’s called long-term wings for long-term care residents whose stay is being paid by Medicaid or private insurance or private pay. There is a drastic difference between the Medicare wing and the long-term care wing. And when I say drastic difference, what I’m talking about is staffing and care. So when somebody comes to me with a case, it’s typically somebody who is in that long-term care wing because that wing is staffed less than the Medicare wing. We do not get a lot of cases from people who are on the Medicare wing because those wings are typically staffed better because the reimbursement is higher. So that was a long answer to tell you that most of the nursing homes pay comes from Medicare, Medicaid, private pay, and private insurance. Kelly: That makes a lot of sense. Thank you for sharing all that with us. So are nursing homes and assisted living facilities the same thing? James : No, no, they are not. Skilled nursing facilities– or when I say nursing home, I’m talking about a skilled nursing facility. And that’s basically a step down from an acute hospital, okay? So, when somebody leaves an acute hospital, a lot of times they will go to a nursing home, also called a skilled nursing facility, for rehab because they need more care, right, coming right out of the hospital. And the skilled nursing facilities have just what that’s described as: the skilled nursing. So, they’re going to have nurses on staff, and they’re going to have people with more medical experience at the nursing home. An assisted living facility is a step down from that. It’s somebody who doesn’t need quite as much medical care and is fairly independent, can get up themselves, can wash themselves, take a shower themselves, usually, can dress themselves, feed themselves. Assisted living facility residents simply don’t need 24-hour nursing care. But one of the big differences also is that all of those ways I described how nursing homes get paid is completely different at an assisted living facility. Assisted living facilities are primarily reimbursed by private pay. Okay? That means the families pay for the stay at the assisted living facility or long-term care insurance. Medicare does not pay for care at assisted living facilities because they don’t pay for– they only pay for the skilled nursing care, not assisted living care. So primarily private pay and primarily people who are less in need of services are the ones who are living in assisted living facilities. Kelly: Okay. Thanks for describing those differences for us. And so, what can family members do to prevent abuse from happening in a nursing home? James : The best thing a family can do to prevent abuse and neglect in a nursing home is to be present and to visit as frequently as possible. And not only that, but to visit at different times of the day. So, for example, I’ve had clients say, “I come every day after work, so I get there at 5:30 every day, and they’re dressed, and they’re ready for dinner. And everything looks good. So, I had no idea anything bad was happening until one day I went at lunch, and I saw that their breakfast was still sitting there. Nobody helped them eat breakfast. They’re not dressed. They’re sitting in a soiled diaper.” And so, what happens is that the nursing home staff will learn the routine of the family. If the family comes at the same time every day, that’s when the patient’s going to look like they’ve been taken care of. So, the family is going to think, “Oh, this is what’s happening 24 hours a day. Everything is great,” but that’s not necessarily the case. So, the family, if at all possible, needs to visit frequently and at different times of the day to see what’s happening morning, afternoon, and evening. Not only that, but you have to be a squeaky wheel. When something’s not right, you got to speak up and you got to say something. And when I say, “You got to say something,” I’m not talking about just to the CNA or the certified nurse assistant who’s providing direct care, who’s maybe changing the sheets or changing the diapers. You’ve got to make complaints to the head nurse or the charge nurse or the director of nurses or even the administrator because a lot of times these CNAs are overworked, they’re working a shift or maybe a double, and they’re going to be out of there. They’re not going to make any changes to the care of a resident systematically. They may change what they do on a particular shift. But when you need a change made, like you need your mom or your grandma’s medication given on time every day and that’s not happening, you need a systemic change there not just a change with one CNA. So you’ve got to make those complaints to the director of nurses or the administrator in order to hope that any systemic change is made with respect to the care of your loved one. And if that doesn’t work, then you make a complaint to the state and you tell the state what’s– your complaint is, and you call the state and you ask for a formal complaint investigation. And the state will go in there and they will investigate what your complaint is, and they’ll either substantiate it or they won’t. But that’s a good way to get the attention of the nursing home. Kelly: That’s really good advice. Thanks, Jim. So how do people know if a nursing home is good or bad? James : Well, I tell people my two favorite online resources for finding information out about nursing homes. And these resources will give you information on what the patient’s rights are, what the state and federal regulations are that govern the care that’s supposed to be given in a nursing home. And they’ll give you some history on the nursing homes. So, you can look up what complaints have been made against nursing homes. What complaints have been substantiated against nursing homes? How many complaints does this nursing home get compared to other complaints? I’m going to give you three total things to look for, but I’m going to tell you two websites that are super helpful to me and that I always recommend people look at. One is a California website, but it’s useful for people all over the country because a lot of the information on there refers to federal regulations, and federal regulations will govern all nursing homes, not just the ones in the state of California. But that nursing home is– I’m going to say it, and then I’m going to describe it. It’s canhr.org . C-A-N-H-R, dot org, and that stands for California Advocates for Nursing Home Reform. That website is great for all kinds of information, not just California-specific information. But the other website that’s fantastic, believe it or not, is medicare.gov. And if you go to Google and you just type– in Google, type in Nursing Home Compare or Medicare Nursing Home Compare, either one, and the first thing that’s going to pop up is Medicare’s website that talks about nursing homes. And you’re going to be able to look for nursing homes by zip code or city. When you find nursing homes, you’re going to be able to click on them, and you’re going to be able to find out who owns that nursing home, what complaints have been made against that nursing home, what the staffing is. Medicare has a star rating, one to five stars. I don’t always look at the star rating because the star rating is based on information that the nursing home provides to Medicare. But it’s helpful more for me to look at the complaints against the nursing home and see what complaints have been substantiated against the nursing home. But let me give you one more thing to look up because you asked, “How do you know if it’s a good or bad nursing home?” I’m going to tell you something to look up that’s going to tell you if a nursing home is bad, okay? And what I mean by that is they have been put on notice by Medicare that they may lose their federal funding unless they straighten up their act. So, I always tell people to go to Google and type in, “Special focus facility.” The special focus facility list will come up, and that will be a list of nursing homes that are of special focus to Medicare because Medicare has warned them they’ve got to straighten up their act, they’ve got to take better care of residents, or they’re going to lose their federal funding. They’re going to lose their Medicare funding. If you see a facility on that special focus facility list, I would absolutely not let a loved one go to that facility. That is the best advice I can give as far as knowing whether a nursing home is good or bad. You can’t tell by the outside of the nursing home. If it looks nice, to me, that just means they’re spending all their money on gardening and making it look pretty. You got to go in there. You got to see, “Does this place smell? Does it smell bad because they’re not changing the residents timely? Is it hot because they don’t have air conditioning?” Because believe it or not, not all nursing homes have air conditioning. So, other than just walking in and using your best judgment, those are the websites that I would go to to get information on nursing homes. Kelly : Wow. Thanks for providing those great resources, Jim. We appreciate that. And lastly, if someone suspects that a family member is being abused in a nursing home, what should they do? James : So back to what I said earlier, make a complaint to the director of nurses and the administrator at the nursing home, not just a verbal complaint, put it in writing. Make sure you have a letter or an email that you send to them. Or sometimes they’ll give you their cell numbers. You can put it in a text. But I always ask clients who call me, “Did you complain to the director of nurses or the administrator? And when and what did you say?” Because you need a trail of documentation showing that you put them on notice that certain things weren’t being done and certain changes needed to be made. So, I always say, “Make a complaint and be able to trace that complaint.” If that’s not sufficient for taking care of the problem, then you go to the state, and you make a complaint to the state, and you ask the state to do a complaint investigation. In California, it’s called the Department of Public Health. It’s something similar in every state, but you can go online. And you can go to that Medicare website that I told you about, Nursing Home Compare at Medicare.gov . And there will be a link to how to make a complaint against a nursing home to the state. And so, looking at those websites and getting that information and making complaints, and if the abuse is bad enough or not being addressed still or somebody’s been injured, then you can always look for an attorney and consult with an attorney to say, “Hey, is this right? Am I wrong? What can I do? Does this rise to the level of a lawsuit? Should we do something more?” But if you type in, “Nursing home abuse and neglect lawyer,” wherever you are, I’m sure you’re going to get a lot of attorneys’ offices popping up. And talk