Episode 128: Alternative Health Plans: Do You Know the Risk?
In this episode of The Business of Healthcare Podcast, Becky Greenfield, a healthcare attorney and a partner at boutique law firm Wolfe Pincavage, joins host Dan Karnuta for a discussion about the complexities and risks associated with alternative health plans that are not mandated by the Affordable Care Act. Plans like healthcare sharing ministries, limited benefit plans and short-term insurance can appear similar to conventional healthcare insurance but they lack essential consumer protections like coverage for pre-existing conditions, essential health benefits, and balance-billing safeguards.
Although these plans are attractive due to their lower costs, they can can result in significant out-of-pocket expenses and limited provider networks. The conversation also highlights the challenges the hospitals face when treating patients with these plans, including confusion over payment responsibilities and financial risk due to underpayment or denials.
Felixia Colón joins host Dan Karnuta for a discussion about how artificial intelligence is being used, and is transforming, healthcare business operations. They cover care delivery methods, staffing models, the importance of establishing guardrails prior to AI’s use and address the risks of bias inherent in AI and how that problem can be overcome.
Caitlin McVey, associate vice president of the Memorial Hermann Institute for Nursing Excellence, joins host Dan Karnuta for a discussion about Health Education and Learning (HEAL) High School in Houston which prepares students to transition directly into high-demand healthcare jobs directly after graduation.
Don Taylor, the chairman of the board of directors at the Healthcare Standards Institute Foundation, joins host Dan Karnuta for a discussion about on how artificial intelligence is being integrated into the healthcare industry and the urgent need for its governance and standardization.
David Dawson, senior vice president of Conifer Health Solutions, joins host Dan Karnuta to discuss the use of artificial intelligence in healthcare-related revenue-cycle management.
Attorneys-at-law Lawrence Laddaga and Dale Turner of the law firm Laddaga-Garrett, P.A, join host Dan Karnuta for a discussion about Medicare Advantage plans in Medicare. They discuss its history, its problems and its future.
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