Healthcare Data Silos Cause Problems Throughout the Healthcare System

If you talk to any healthcare provider, and most patients, about healthcare data sharing, you quickly discover that one of the biggest problems patients and providers face is healthcare data silos. What do I mean by that? Imagine you see your primary care physician. Your PCP determines that you need an evaluation by a specialist. They put in a referral. You go see the specialist like an orthopedic surgeon, and that provider determines you should try a conservative treatment by another sub-specialist, like a physical therapist. Fast forward 2 months, and you follow up with your PCP. The PCP asks you how things have been going, and you say you don't feel any improvement. So, your PCP tells you that they believe you would benefit from a physical therapy course of treatment.

Now you're annoyed. "How did you not know that I've just finished up 8 weeks of PT treatment?" you might be thinking. Here's the problem: your PCP put in the referral for the original specialist, but then had no idea about the PT. Maybe they received some kind of follow-up communication of note from the orthopedic surgeon. But your PCP has no insight into the rest of the course of care.

This is the problem caused by healthcare data silos. So, this week, I sit down with Rick Mirell from Arrow Health to talk about the challenge with healthcare data silos and some new technology-driven tools that aim to solve this problem for the industry.

What we cover in this Episode:

-The importance of open flow of data in healthcare
-The breakdown in communication and data between healthcare systems and providers
-How data can improve clinical outcomes
-The patient experience when healthcare data isn't shared well

Full episode note: https://rehabupracticesolutions.com/better-outcomes-157

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Rethinking State Licensure in Healthcare for the 21st Century

State-based licensure for healthcare professionals has been the status quo for over a century. But in an era defined by digital health and telemedicine, is this 19th-century solution still fit for purpose? In this episode, I explore the historical context of state licensure, the modern-day challenges it poses to telehealth, and practical solutions for breaking down regulatory barriers. Drawing insights from my experience as a state licensing board member and recent academic research, we dissect the structural flaws that limit patient access, drive up costs, and stifle innovation in healthcare. Here's the original post on state licensure in healthcare that fueled this episode.

What we cover in this Episode:

-The origins of State-Based Licensure
-How Technology has Changed the Healthcare Regulatory Landscape
-The Real-World Impact of State Licensing in healthcare & the Barriers it places to providing/receiving care
-Possible solutions or alternatives for State-based healthcare licensing
-How value-based care and regulatory policy are intertwined

Full episode note: https://rehabupracticesolutions.com/better-outcomes-156

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

This episode of The Better Outcomes Show explores how artificial intelligence (AI) transforms healthcare delivery and decision-making. Drawing from a structured review of 288 peer-reviewed articles published between 1992 and 2021, we break down key themes, trends, and implications for clinicians, health systems, and patients. From diagnostics to health services management, we’ll look at where AI is already making an impact—and where the field still needs to grow.

What we cover in this episode:

-The rapid growth of AI in healthcare research and its emerging significance.
-Five core applications of AI in healthcare: health services management, predictive medicine, patient data handling, diagnostics, and clinical decision-making.
-How AI supports clinicians by improving diagnostic accuracy, predicting disease spread, customizing treatments, and streamlining administrative tasks.
-The leading countries in AI healthcare research and the current state of international collaboration.
-Key trends in AI research, including machine learning, deep learning, natural language processing, telemedicine, and COVID-19-related applications.
-Identified gaps in research, such as the need for cost-benefit analyses and considerations for low-resource settings.
-The importance of ethical considerations, data quality, and workforce skill development in AI implementation.
-The necessity of balancing AI support with preserving physicians’ critical thinking to avoid over-reliance or “de-skilling.”

Full episode note: https://rehabupracticesolutions.com/better-outcomes-155

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

Resources mentioned:

The role of artificial intelligence in healthcare: a structured literature review (https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-021-01488-9)

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Have You Ever Thought About Buying Cheap Lottery Tickets?

I've bought a lot of cheap lottery tickets over the years. Not the kind you scratch off to see if you hit it big. I'm talking about the little bets, risks, or asks I've made over the years. They cost very little but can have a huge upside. In this episode, I’m sharing a lesson that’s shaped a lot of the opportunities I’ve had in my career — the idea of making small bets and being willing to hear the word “no.”

My dad used to say, “If you don’t ask, the answer is always no. If you do ask, the worst they can say is ‘no,’ and then you’re right back where you started.” For whatever reason, that stuck with me. Over the years, I’ve taken what I call “cheap lottery tickets” — small risks or asks that didn’t cost much but had the potential for a huge upside. That mindset has opened doors for me in consulting, in buying a practice, and in landing projects, I never thought I’d be part of. And sure, I’ve heard “no” plenty of times — stacked up a mountain of kind rejections, really — but it only takes one or two “yeses” to change everything.

We often think someone was just lucky to get a certain opportunity, but we don’t see the 100 rejections that came before it. I think what we call “luck” is often just someone’s willingness to keep putting themselves out there.

What we cover in this Episode:

-How small risks potentially create big opportunities
-Why hearing "no" isn't the end of the world (or the end of the road)
-Understanding risk tolerance in healthcare business
-Why persistence often looks like luck from the outside

Full episode note: https://rehabupracticesolutions.com/better-outcomes-154

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Many Practices & Clinics Struggle to Use Healthcare Data in Practice

I did an episode in the past on healthcare data, however, that episode focused on the high-level impacts of data on healthcare business in general. After that episode, I received messages and emails asking specifically how to Use Healthcare Data in Practice, especially for smaller, independent healthcare clinics and organizations. So, this week, I sit down with Alex Bendersky to talk about healthcare informatics, managing your healthcare data, and how to Use Healthcare Data in Practice to make better decisions.

What we cover in this Episode:

-Understanding the type of data healthcare practices gather
-Simple and practical ways to Use Healthcare Data in Practice to make clinical decisions
-Strategically thinking about healthcare data
-The benefits that data provide us as clinicians
-The business case for managing and using healthcare data
-How to use healthcare data to communicate the value our treatments and services bring

Full episode note: https://rehabupracticesolutions.com/better-outcomes-153

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Why do PTs feel like they're being forced to see patients at a loss?

Recently, I've seen a few articles and social media posts in the physical therapy world discussing the downward pricing pressure (declining reimbursement rates) even while some payers (UHC often is the target here) report profits in the billions of dollars per quarter. And, at first sight, you can totally appreciate where these clinicians and writers are coming from. I mean, why cut payments to providers when your organization is raking in record profits? As many clinicians and practice owners put it: they feel forced to see these patients at a loss because of the declining reimbursement rates.

Now, the reason for declining rates may vary on paper, but it really comes down to two things: 1) incentives and 2) the reimbursement model for healthcare in the US. And both of those things are tied together. I dedicated a whole chapter in my book about the problems with a fee-for-service model in healthcare, but here are the basics: when clinicians get paid for their time (or the codes they bill), they're incentivized to bill as much as possible, in as little time as possible. Payers, on the other hand, only have two levers to pull to cut costs: 1) deny services altogether (or gait them with authorizations and the like) or 2) pay less for those services. That means that it's only natural that, under that environment, payers will place barriers to the service (preauthorizations, etc.) and reduce their fee schedule (the amount they pay clinicians for those services). And that's why PTs feel the squeeze, or the downward pricing pressure, affecting their practices.

But here's one thing that we rarely talk about when it comes to insurance and reimbursement rates: who's forcing us to see these patients at a loss? I mean, UHC isn't storming clinics and coercing them into signing provider contracts. The truth is that contracting is a choice, a choice that many clinics and practices are making. In this episode, I break down the reasons why practices may consider contracting with a payer. The pros and cons of being "in-network" providers. And how to combat some of the downward pricing pressure in healthcare.

What we cover in this Episode:

-Understanding fee for service reimbursement models
-Why patients still get surprise bills because of the lack of transparency
-How clinicians come to the decision to sign contracts with payers
-The levers that payers have to control costs and profits
-Why value-based care can be difficult for smaller, independent practices
-How value-based care aligns with incentives
-Making the decision to stay in or leave a payer network
-Why we need to think more deeply about the value our treatments and services bring

Full episode note: https://rehabupracticesolutions.com/better-outcomes-152

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Are there times when saying goodbye to team members is the right thing to do?

"I would be a bad boss if I told you to stay here. As much as we love having you on the team, you need to do what's best for you and your family." Over the last few months, I've found myself saying this a couple of different times to team members who were in a place where they felt that a change was necessary. Saying goodbye to team members can be hard. Either for personal reasons or professional reasons.

It's easy to become defensive, or take it personally when a team member approaches you about potentially leaving the team.

Was it something I did as a leader?

What am I doing wrong that they don't want to stay?

Of course, you can explore those questions if you're experiencing a great deal of turnover. But, typically, if it's you, those team members will just leave. There's no discussion; simply a notification: "This is officially my resignation notice". But, if you find yourself in a situation where a team member approaches you about potentially leaving, and you end up in a conversation about priorities, life goals, and continued fit, then I'd venture to say that you're doing just fine as a leader.

I remember approaching a boss several years ago and the conversation basically went like this: "I've been offered this position in an academic program, full benefits, retirement, the works. The problem is, I really love the team here and the work we're doing is meaningful." I'll never forget what my boss said to me: "Rafi, I'm not saying this because I want you gone, but you'd be foolish not to seriously consider the offer." We then had a real discussion about my life priorities, career goals, and how this team fit into that list. Now, I went on to stay with that team until our consulting project was over, but the lesson from that conversation has stuck with me since then. I'm still learning this and working on it myself, but I have come to believe that being a "good leader" is essentially the same as "being a good person". And that starts with looking out for the best interest of those on your team...even if that means that they end up leaving the team for other opportunities or roles. Not every boss I've ever had would have had that conversation with me. But, I'm forever grateful that I've been blessed to have learned from some great leaders over my career who modeled this style of people-first leadership...

I read in a book once that your clients won't remember you in 20 years, but the people who will remember you are the people you worked with, and especially the people you managed or led. If you want to have a real impact in your industry, perhaps a way to do that is by being a good leader to your team, and letting them spread their wings and hopefully they'll create positive waves wherever they end up.

What we cover in this Episode:

• Building a strong work culture that promotes conversations rather than notifications
• Challenges in recruiting and retaining healthcare team members
• How these conversations are different than letting a team member go due to performance issues
• Looking at saying goodbye to team members as a way to continue to build a strong work culture
• Leading in a human way
• A bit of my backstory and career history

Full episode note: https://rehabupracticesolutions.com/better-outcomes-151

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Do people really understand their healthcare bill?

I talk about this all the time on the show, but healthcare is one of the only areas of the economy where the distribution of information is extremely one-sided. What do I mean? I mean that, for the most part, patients receiving care may have a general idea about how much their care will cost, but very few actually have a specific dollar figure upon which to base their decisions. On top of that, unless they are healthcare-trained professionals, they also lack a complete understanding of the treatment options, potential outcomes, and the like. The same holds true for their healthcare bill.

For the most part, people have a general idea of what they need to pay for healthcare services. The problems start to appear when insurance denies claims or treatments require preauthorizations or the like. The resulting bill often comes as a surprise, and can in many cases be rather large. In fact, surprise medical bills have become such a large issue, that the No Surprises Act of 2022 was enacted to try and counter the trend.

This week, I sit down with Frank Lobb, author of The Big Lie in my Healthcare Bill: Why I Don't Owe What My Insurer Fails to Pay". In this book, Frank tackles the topic of insurance denials leading to surprise medical bills.

What we cover in this Episode:

-Who actually pays in healthcare
-How healthcare bills result in true financial burden for patients across the country
-How Insurers structure contracts with providers
-The challenges that come from big healthcare & the push for efficiency
-The Value that Insurers State that they Bring to the Market
-Frank's story of Insurance Denials and Being Unable to Pay out of Pocket for Treatment
-How an Engineer Came to Write a Book About Healthcare Bills

Full episode note: https://rehabupracticesolutions.com/better-outcomes-150

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!