Lucy Zielinski

Lucy Zielinski
Lucy specializes in helping health systems and medical groups achieve top financial and operational performance through physician-hospital alignment, including clinically integrated networks, practice transformation, coding and revenue cycle improvement, and physician leadership programs.

Recent Posts:

Turning Conflict into Collaboration: How to Manage Workplace Disagreements

As their organizations make major adjustments to operations, healthcare leaders should be prepared for increased levels of workplace conflict. Fortunately, taking the right approach can turn a conflict into an impetus for positive change.

Healthcare organizations are experiencing change at a rapid pace as technological innovations and alternative payment models greatly impact operations — and people. As a leader, you can expect these changes to create workplace conflict. But you also should be assured that you can manage this conflict, and make it a productive rather than disruptive force, by using the following approaches.

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How to Plan For and Profitably Operate Telehealth Services

“By failing to prepare, you are preparing to fail.” ― Benjamin Franklin

The COVID-19 pandemic has forced every industry to rethink how they do business — and the healthcare industry is one of the most heavily impacted. In this ever-changing set of circumstances, providers are challenged to determine the best way to adapt the delivery of care.

One tool they increasingly are turning to is telehealth services.

The appeal of telehealth right now is obvious. Patients appreciate being able to receive healthcare without risking exposure, while physicians appreciate being able to provide safe and convenient care.

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Lumina Health Partners Launches No Cost Webinar Preparing Healthcare Providers to Use Telehealth Visits to Treat Patients

By Lucy Zielinski | Posted in Insights, News

Chicago, Ill. – Lumina Health Partners is launching a no cost webinar for healthcare providers to guide them in launching telehealth services. This webinar, taking place on March 26 at 10 a.m. CT will offer practical solutions on establishing telehealth services as well as information on how to properly document, code and bill for such services.

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Managing Today’s Ambulatory Revenue Cycle

There are many mechanisms healthcare organizations can use to accelerate their financial recovery efforts post-COVID-19. 

When examining these mechanisms, financial leaders' questions often boil down to two essential concerns: How effective is it? And how long will it take for us to see results?

The revenue cycle lands at the top of the heap when it comes to quick but highly effective ways to accelerate revenue. It also plays a critical role in improving the patient experience and health of populations while reducing the cost of care. 

By improving revenue cycle efficiencies, healthcare financial leaders can gain a vital "quick win" in their financial recovery timeline.

I recently taught a 2-day HFMA seminar on Revenue Cycle Essentials and KPIs (key performance indicators). Here, I’ll summarize the challenges revenue cycle leaders are experiencing today, as well as key factors for success. 

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Your Healthcare Team Is the Key to Value-Based Care

Value-based care (VCB) requires a keen focus on the Triple Aim: achieving better quality and patient outcomes while bending the cost curve. This is not done in silos; VBC is a team sport that requires collaboration across providers in all settings of care, from the doctor’s office in the ambulatory setting to the hospital to the post-acute setting, including effective transitions from one setting to the next. Coordinating care across the continuum and across all settings is key.

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Patient Risk Scores Are the Key to Value-Based Payment

The U.S. healthcare system is steadily transitioning from fee-for-service (FFS) reimbursement to fee-for-value (FFV) payment. This change has already started to affect medical practice revenue, and it will have an even bigger impact in the years ahead.

Unfortunately, most physicians and practice managers understand only part of the FFV equation. Under FFV, they know the quality data they report to payers will affect their reimbursement, but many do not understand exactly how payers use these data to adjust payment.

What is the missing piece of this equation? Patient risk scoring.

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6 Considerations to Turn Referral Leakage into Patient ‘Keepage’

Most health system executives have referral leakage on their minds. They wonder why their patients seek care elsewhere, especially after they have spent millions of dollars to draw them to their facilities through ad campaigns, purchased high-end equipment, and invested in employed medical groups that lose money in operational isolation.

Perhaps we should reconsider our use of the term “referral leakage.” It implies that patients are somehow confined. Confinement is one of the top reasons the public largely rejected HMOs. In contrast, in acknowledgement of patient consumerism and demand for choice, emerging payment models are often based on “attribution.” Attributed PPO patients may vote with their feet, and they often self-refer. The concept of referral leakage implies entitlement—and having a sense of entitlement may be a part of the problem.

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Risk Scoring and Population Risk Adjustments

By now, almost all healthcare providers have been affected by the shift to value-based care and are either working with or are aware of HCC coding.

It is practically impossible to participate in Medicare and not be subject to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Consumer Assessment of Health Providers and Systems (CAHPS), or other programs that adjust payment based on quality and cost.

With this change, it can be difficult to manage the clinical documentation and diagnosis coding that impacts the population risk-adjustment factors that improve financial opportunity.

Unfortunately, most physicians and practice managers understand only part of the fee-for-value (FFV) equation. While they know the quality data they report to payers under FFV will affect their reimbursement, many do not understand exactly how payers use this data to adjust payment.

What is the missing piece of the equation? Patient risk scoring.

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Change Management and Conflict Resolution

Healthcare organizations are experiencing change at a rapid pace; hospitals are merging, large medical groups are forming, and clinically integrated networks and integrated delivery networks are acquiring hospitals and physicians.

These business transactions also have a direct effect on the most valuable asset any healthcare organization has: its employees. Although the human side of these transactions is seldom talked about, failing to address employee issues can be expensive in both cost and reputation, and can lead to unresolved conflict.

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Happy—and Healthy—Holidays Begin with Population Health

Several years ago, I was working with a client reviewing quality and cost measures when we identified an individual who was a “frequent flyer,” or high utilizer, of the emergency department (ED). Upon further investigation, we learned that this person was seeking shelter and a hot meal, and he found the ED to be the best place to access both.

Each time this individual visited the ED and the providers asked him what was ailing him, he would vaguely declare, “I have pain!” It took many conversations to get to the root of his suffering: homelessness.

His misuse of the ED posed a problem to the healthcare providers who tended to his needs each time he paid a visit because it inflated the cost, or the medical spend, for this patient. They were running unnecessary tests on his behalf.

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