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Now or Never: Long-Term Care Strategy is a podcast for all those seeking answers and solutions in the long-term care space. Too often we don’t fully understand the necessity of care until it’s too late. This podcast is designed to create solutions, start conversations and bring awareness to the industry that will inevitably impact all Americans.
Hassan Abdallah: I think the the
conversation needs to be pivoted
from why is it so complicated
coming from them? To why aren't
physicians not making health
care more personable to their
patients? And I think when when
we begin to focus on the people
involved, that we turn, quality
of care to not only being a
measurable outcome of somebody's
health, but also a measurable
outcome of somebody's knowledge
of their health care.
Caroline Moore: Welcome to Now
or Never Long-Term Care Strategy
making. themselves. with Kosta
Yepifantsev a podcast for all
those seeking answers and
solutions in the long term care
space. This podcast is designed
to create resources, start
conversations and bring
awareness to the industry that
will inevitably impact all
Americans. Here's your host
Kosta Yepifantsev.
Kosta Yepifantsev: Hey, y'all,
this is Kosta. And today, I'm
here with my guest, Hassan
Abdallah, CEO of ATLA Healthcare
Group. Today, we're talking
about how to assess quality care
from a compliance expert. Thank
you for joining us, Hassan,
would you start by sharing a bit
about your career in health
care, compliance and regulatory
affairs? But also, what does
this mean to the everyday
person?
Hassan Abdallah: Well, cuz the
first foremost, thank you so
much for having me on.
Absolutely excited to be here.
longtime listener, first time
caller, I've been wanting to say
that for a while. So I hid out
in healthcare, just a little
over a decade ago, I actually
started off as a claims auditor
for one of the big four,
specifically in the healthcare
space. And so you'll hear me a
little bit talk about that I've
been on each side of the
transaction. So my journey began
in as an auditor, so not very
welcomed. And then I actually
transitioned into a space that
was probably less welcomed,
which was as an SIU fraud
investigator, oh, nice space,
really got a ton of experience
in the managed care space around
fraud, waste, and abuse, False
Claims Act, doing joint
investigations, with other
health plans, and payers, really
living within the swamp of the
CMS regulations. And then I
moved into leadership positions
within compliance. I kind of got
on the to the transactional side
a little bit, I worked for a
private entity where I overseen
the compliance but from a
contracts and acquisition
perspective. They were one of
the few groups that got into
private equity in the healthcare
space early, very early on. And
then I became the Chief
Compliance Officer of Health
Alliance plan, which is one of
the largest plans here in the
state of Michigan, it was a very
interesting time, because I was
the youngest C suite executive
in the company at the time,
which was challenging, because
compliance is already a tough
sell to the board and to, you
know, when you're talking about
things in terms of strategy, and
then I spent about a year and a
half, at a startup in New York,
where we were the first ever we
were building from the ground
floor, as a compliance officer.
And so what it means to the
everyday individual, it's a
niche space, where our job is,
we're not lawyering, we're not
ending or litigating. Our job is
to make sure that compliance is
a living organism, throughout
the culture and processes of a
company. And what that really
means is, are their checks and
balances through the job duties
and, and the job
responsibilities of every
individual throughout the
company that ultimately uphold
regulatory laws and rules.
Kosta Yepifantsev: Fascinating.
And I say that with literally
all the endearment because I
work with compliance all of the
time. And we have this debate,
essentially, you know, are we a
company that focuses on
compliance for our payers? Or
are we a company that focuses on
quality of care for our
patients? But, you know, I
believe, Hassan that these two
metrics are intertwined. And so
from a regulatory and compliance
perspective, how would you
define quality of care? So from,
Hassan Abdallah: I think it's
important to bring up what it
means clinically, right,
clinical quality of care is the
degree to which services
healthcare services for
individuals and populations lead
to better health care outcomes.
Right. Well, compliance
perspective, what I believe it
means is, to which degree the
rules and policies that are
being put in place, help sustain
those positive health care
outcomes. And so to me, it comes
into three buckets. One is
accountability to the provider.
The second is a payer system
that one continues to make
health care accessible and
affordable, which is a constant
challenge within the US. And the
third bucket to me is ongoing
enforcement and justification
of, you know, whether it's
audits or other ones. So that to
me is the regulatory perspective
of quality of care.
Kosta Yepifantsev: In your
opinion, what are the key
indicators we should be looking
for when assessing the quality
of care in a healthcare
facility? Be it a long term
care, facility, assisted living,
or even home care?
Hassan Abdallah: Well, you know,
that last piece, a little
caveat, because home care is so
much on the rise right now
mobile, so much on the rise
right now, when we look at
traditional health care
facilities, obviously, one of
the ones that you're going to
look at is morbidity rates,
right? You know, what are they
looking at each one of these
facilities? What is the return
rate of patients for the same
type of incident or illness in
situations where there are not
chronic illnesses at a hand. And
what I mean by that is, you
know, if individuals are
consistently coming back for the
same level of care for the same
level of service, for something
that likely should have been
treated at the onset, without
the necessity to have prolonged
post acute care, trend
trajectories, those are the
metrics you really want to look
at. And I think what's really
important is, from an assisted
living perspective, it's a very
difficult space to to assess
from a regulatory perspective.
Kosta Yepifantsev: And that's
kind of not to interject, but I
was going to ask, like, how do
you regulate an assisted living
facility? Because there's no
government funds that because
the way the language first off,
you're speaking my language, and
I didn't mean to interrupt that
question, but I just had to tell
you, I totally like resonate
with everything that you're
saying. And I follow it, and I
understand it. But assisted
living lives outside of the
traditional long term care
space, even though it is
considered long term care. So I
am fascinated with what with how
you would regulate that type of
entity.
Hassan Abdallah: And there's so
many factors, right, there's a
political factor, you know, the
administration that's currently
in place is always going to play
a factor into that the way the
House and the Senate are moving
legislatively is going to play a
factor into that, which is
another conversation because the
politics of health care within
the US is another you in another
mountain to climb. But I think
in this living, it's so
difficult, because
unfortunately, the amount of
people who need health care
services in a traditional or non
traditional setting far
outweighs the number of
resources that the government
and payers have to oversee the
we are we are in a even in 2023,
even with the advancement of
technology that we have, we are
still very much in a pay and
chase system, meaning we are
paying on claims and hoping that
we have enough data metrics or
AI or smart data in place to
tell us, hey, these six months
of claims for this provider 18
months ago, probably shouldn't
have been paid. And by now that
guy is probably in Barbados or
or world, you're chasing him.
And so it's going to continue, I
think to be difficult to that in
this post COVID enforcement
world as a whole whole nother
space that's really going to, I
think change the trajectory.
Ultimately, I think it leads to
specifically when it comes to
home care and assisted living
that state agencies are going to
have an increased
responsibility. And unless that
comes with an increase in
federal funding to support those
agencies continue to have this
struggle and physicians who are
in it for the wrong reasons, or
private equity that's coming
into the space where armies will
continue to benefit from the
lack of enforcement
Kosta Yepifantsev: as a
regulatory and government
compliance professional, what
are the most important
regulations our listeners should
be aware of when evaluating Long
Term Care Options?
Hassan Abdallah: It's a great
question. I think, first and
foremost, we have to recognize
some of the more recent
legislative changes, which is
like the no surprises billing
act, right. So we need to look
there and understand that now.
healthcare entities are required
to show you what healthcare is
going to cost you. And that
should be one of the most, you
know, the first and foremost
thing you should be seeing when
choosing a provider. The other
laws that need to be understood
by provider or by patience is
when it comes to the
transparency and billing
requirements, whether it's the
False Claims Act, or otherwise,
is that when you get an EOB an
explanation of benefits, you
should be looking at those. Most
people don't I'll be honest with
you, I know I've gotten them and
usually they end up in the trash
or most people don't understand
them. And your explanation of
benefits is what tells you as a
patient, hey, this is who you
seen. This is the service that
was built and so If you see
something there that you believe
you didn't receive, call your
health plan, you should be
talking to them. And then, you
know, that's the flip side of
this conversation is that our
health plans equipped to be able
to provide that level of service
and knowledge. And so I think
those two things are really
probably at the precipice of
what consumers or patients
should be aware of when you
know, entering into any
healthcare relationship.
Kosta Yepifantsev: Why does it
have to be so complicated? Why
does the EOB have to literally
be like, you know, a Latin
written text?
Hassan Abdallah: Man, it's a
million dollar question. Ya
know, it's interesting. At the
top, I mentioned that I
recently, you know, did some
work a little over a year with a
startup. And it was completely
focused on being a patient
first, technology based, you
know, company, and we're seeing
this trend, right? It's, we want
to make it fast, want to make it
easy on people to see it. The
difficulty is, your average
person doesn't understand CPT
codes, you know, they see this
IX of numerology in numbers and,
and then the medical language
that's in there, it's like e&m
visit for the you know, and then
they're, they went in there, and
they're like, do it, I had a
cold, and I just wanted to go in
to get a checkup. Um, you know,
I think it's a mix. One is payer
requirements, force physicians,
to be very copious in their
notes and documentation to which
they provided service. So I
think that's the one piece the
other piece of it is, in order
for government payers to pay on
these claims, they then need to
see an equivalent sufficient
line of documentation coming,
but by the time it reaches the
patient, they're so far out of
the loop or don't understand the
communication. And so I think
the the conversation needs to be
pivoted from, why is it so
complicated coming from them to?
Why aren't physicians not making
healthcare more personable to
their patients? And I think when
we begin to focus on the people
involved, then we turn quality
of care to not only being a
measurable outcome of somebody's
health, but also a measurable
outcome of somebody's knowledge
of their health care.
Kosta Yepifantsev: That's
impressive. And it ties in to
the next question when we're
talking about kind of the
compliance metrics taking away
from the quality of care. So I
want to talk about Medicare and
Medicaid regulations. Because
obviously, majority of people in
the United States received their
long term care from Medicaid.
And as we become more of an
aging population, more
individuals are participating in
Medicare, which has another set
of regulations. So arguably,
they're some of the most
complicated and far reaching in
the care industry. At the end of
the day, do you believe that
these regulations truly protect
patients and ensure they
actually receive high quality
care?
Hassan Abdallah: I think they're
very much intended to do that
doesn't It doesn't always lead
to it. And it's going to be very
interesting to see what happens
between now and 2030. Because by
2030, CMS is planning to phase
out itself from the payer
system. And I think in order to
do that, there are a couple
things that need to happen.
First, CMS needs to very clearly
articulate a vision and
landscape for value based care
so that we can move away from a
fee for service type schedule.
The second piece is that CMS has
to accelerate the incentives for
providers who are providing
value based care. Unfortunately,
what has happened in the
Medicare space, specifically, is
there are more providers who are
willing to move towards a
capitation payment system than a
fee for service system? Because
ultimately, they're still making
the same amount of money. Right,
and they're not holding any
higher standard. Exactly. And I
think the last thing is that
health equity has to be a
central feature to the value
based system. And what I mean by
that is, CMS has to play a
critical role in the legislative
build up of how commercial
payers are more accessible,
unfortunately, that the higher
on ones to people with more
money. That's the reality of it.
I mean, you even see it when you
get a new job, and you're
offered a health plan. You see
that some of the employers who
use more than one payer, you see
there's a package a that $70 a
month for a family and a package
C which is you know, usually
your Blue Cross Blue shield's
that gives you all the bells and
whistles, but it's $2,700 a
month for a family And until
that gap closes, health, quality
of care health care outcomes
will continue to be as
disparaged as the gap of health
equity and excesses,
Kosta Yepifantsev: I'm gonna go
down the rabbit hole and stop me
if it gets too complicated or
too technical, I don't think
you're gonna have a problem with
it. But I am curious. You can
quantify compliance. Like, you
know, you get suffered, I work
with managed care. So I
understand how health plans and
how they integrate with the
overall Medicaid system. So I
know when they say we want to
see X, Y, and Z, you do XY and
Z. value based care, though, is
a, it's somewhat subjective,
because I don't know how you can
quantify with specific outcomes
and metrics, the overall health
of a human being. And that is,
and I'm fascinated to hear what
you think about that, like, how
do you actually quantify is it?
Is it hospital visits? Is it the
amount of medications that one
person's take that one person
takes? Is it the amount of falls
that one person may sustain
within a period of time? How
would you quantify value based
care?
Hassan Abdallah: So right now,
value based care is looking at
essentially, two, essentially
two factors, or they are I would
think so is that efficiency and
effectiveness? Right? Yes. Now,
when you look at efficiency,
physicians look at this is how
quickly can I see someone?
Right? In and out? Yes, we're
going to have the same 15 minute
Spiel with every single patient.
But then that leads to things
like in the billing world, what
they call impossible days,
because then they're seeing 70
patients in a eight hour
timeframe. Yeah. And then
effectiveness, the measurement
of it is what is it? The amount
of encounters that are being
built? Is it the linkage to a
specific prescription? So for
me, value based care has to be
metric around the ability for
physicians and health care
entities to provide care, that
leads to less consequential
health care services after that
initial visit. And again, this
is all going to be dependent on
the type of service that the
person is being visited. Sure,
but I think one of the, the
difficulties you have in any of
these health care models is we
are still looking for a
healthcare model that
incentivizes whom? The
physician, right, and that's,
and that, to me is the challenge
is, I'll give you a brief
example not to sidetrack too
much. No, please. I recently had
a physician client in a
consultation or an intake, who
during COVID made an egregious
amount of money. And he said the
one thing that every physician,
Clive, almost half of those are
almost always said, which is
everybody's doing it this way.
And then I thought about that
statement after 10 years in
healthcare, and I said, is
everybody doing it this way?
Because everyone's greedy, or
everyone's just naturally
fraudulent? Or is it doing it
this way? Because the system
incentivizes it to be correct,
correct? When it does, yes, I'm
not saying there aren't bad
players in the physician game
there are we know that there are
in the legal field in every
field, but many of them, many of
them start out following the
model that was provided to the
right. And it is hard to
ascertain, you know, or to
differentiate whether or not
from a fraud perspective if they
truly had intent and knowledge
to deceit, the payer system. And
so when we relate this to
quality of care, we really need
to be thinking about who are we
truly incentivizing from value
based models? Is our following
value based models incentivizing
healthcare entities or following
value based models, ultimately,
incentivizing people that who
need these services? Because we
know this as well,
unfortunately, America has
ranked 11 in quality of care in
all first world countries.
However, we're ranked number two
in the cost of health care. But
what's that? Who's number one?
Yeah, that's a good question. I
would have to go back and check.
Kosta Yepifantsev: Okay. Anyway,
sorry. Those disparities are
saying. It says that
Hassan Abdallah: that disparity
tells you a lot is that if the
cost of healthcare to the person
continues to be on the rise, but
health equity, meaning the
access to quality health care
continues to drop, the gap
continues. Are Are we really
creating payer systems that
incentivize better quality of
care? Are we creating by the
healthcare systems that simply
incentivize physicians and
health care entities
Kosta Yepifantsev: We have this
discussion to nausea within our
organization. And, like, for me,
maybe call me call me a rogue
player or call me somebody
that's unorthodox. But I've just
never really put a lot of
credence on documentation. I
know, that's like the cardinal
sin of all health care. But in
terms of like, my capacity for
billing and claims and things
like that, yes, there's a long
list of processes and checks and
balances, to make sure that
we're properly billing. But in
terms of like daily
documentation, in terms of what
I want my staff to be doing, our
staff to be doing. Documentation
is not at the top of the list.
But But the reason that I say
that is because there are a lot
of companies, that documentation
is the number one thing on their
list. So people provide care
second, but they document first.
Hassan Abdallah: So it's such a
so so just interesting story I
could share recently, we are
retained to represent the
physician in a fair hearing,
where he was going to have his
clinical privileges terminated
after a decade at this entity,
because his discharge summary
documentation was under par for
a certain period of time. Right.
Now, let me let me equate this
for you. The guy was there for
over a decade, he had served in
leadership capacity, he had led
certain initiatives within the
hospital to help promote better
health care outcomes, patient
access, right. When we got in
there, and I first read this
initial complaint, my first
thought was we're show me where
the patient harm is because my
thought was right, no discharge
summary leads to the seceding
physician to not have adequate
notes to provide care. Right,
there was not a single instance
of when any record of his
discharge summary with bind you
what they were hitting him on
his he had to get it done within
48 hours, there were some days
he got it done in three, you're
sure that's different, just
makes sense. But there was not a
single iota of evidence brought
forward that this led to patient
harm, or anything else. So what
does that tell you? I'll tell
you what it told me. What it
told me is that this healthcare
entity is likely incentivized,
right? By this division of the
hospital is likely incentivized
by their ability to meet this
compliance metric of X
percentage of discharge summary
is being done within a certain
period of time. But where does
that get driven from? It gets
driven from the fact that the
payer system is so focused on
the minutiae of documentation in
areas where it is not related to
patient care, but it's getting
done. So therefore, you got to
pay on it. And therefore, we got
to make sure we're doing it. And
there's so much resources and
time putting into that, that the
patient themselves is the one
dealing with the consequences.
Kosta Yepifantsev: And Hassan to
take it once even one step
further. I would say that they
probably need that discharge
summary, almost acting as an
authorization to bill for any
type of remaining service
guaranteed. And then and you
know, under there's a financial
incentive.
Hassan Abdallah: Absolutely. And
you think about to like the
consequences, then physicians
have to deal with like, yeah, I
that the first half of our
conversation may make me sound
like I'm not empathetic to them,
but I am because it's stressful.
I mean, my wife is a PA, right?
And they're coming home from
shifts during COVID. And she was
more stressed about what she
did, or didn't write down, then
dealing with the she's an ICU
PA, dealing with the people who
are dying in front of right or,
or more worried about that than
bringing home COVID to me and my
daughters. It really does make
you think is like, you know,
physicians are put under an
enormous amount of stress.
Because even if they wanted to
focus to your point on providing
care first, their business
aspect, the economics of their
practice, may take a hit.
Kosta Yepifantsev: It puts their
job at risk. Yeah, yeah. Our
whole career
Hassan Abdallah: about a guy who
was there for a decade you know,
it's totally up Yeah. And now,
potentially losing his license,
potentially being out of work
for a year. It's it's crazy to
me,
Kosta Yepifantsev: as someone
that works in compliance, do you
have any advice for how to
advocate for our loved ones
receiving care? And what rights
do we have? And how can we
ensure that these rights are
upheld?
Hassan Abdallah: Yeah, so
advocating for our loved ones
for care, I think the most
important thing is, you know,
and I'm gonna take this from
perspective of coming from a
minority community. So I live in
the city of Dearborn, Michigan,
Dearborn, Michigan is home to a
majority of an Arab American
population, many of whom are
first generation, like myself,
who had parents who came here
long, long ago, never spoke the
language. My dad came here in
51. You know, he worked on the
assembly line of Chrysler and,
and that was our upbringing. And
so I think the first thing is,
is we truly have to understand
that health care, their
healthcare relationship is a two
way street. And what I mean by
that is, unfortunately, it is
not built right now, to where
they are thinking about things
like communication with the
patient first. And so you have
to really build relationships
with your physician and
healthcare community, the rules
and laws that are available to
you is like one, you should be
able to always access any type
of request or need you have on
medical records. There should be
no impediments to that. The
other piece is understanding
that, who to go to if you have
issues, if it's not someone at
your local state agency,
understanding who to call like
here, it would be the Michigan
Department of Health and Human
Services, understanding, you
know, those avenues. But more
importantly is your payer is
having understanding who to
contact at your payer system,
whether it's for an appeal or
grievance if this situation may
arise. And I do want to tailor
this to those in the minority
communities is that for those of
you listening, who may be in the
minority community that are
English, speaking first, like
myself, be the advocate of
change and hope for those who
are not you, it really does take
a very intentional effort by
those of us who are relied on
within those communities, so
that we can provide additional
services, whether it's simply
translating something for
somebody, or being the reason
why people you know, have more
knowledge and resources, that's
something we do as a consulting
group, quite a bit of as we try
to offer as many free resources
to people in our community,
people, we have no expectation
of ever being clients simply
because we all play a role in
better health care outcomes
within this country, whether
we're providers or not. And as
compliance professionals, that
means continuously finding ways
to make information accessible
and easy to understand.
Kosta Yepifantsev: You and I
have a very, I have a feeling
that we live a very similar
life, at least professionally,
in terms of PII trying to help
people that don't understand the
health care system. Because you
know, you and I can talk about
this all day long to understand
what each what each other are
saying we understand all the
abbreviations, we understand,
you know, all the different
terms that come up. But there's
a lot of people that look at an
explanation of benefits, like we
were saying earlier, and like,
what is this? And I think it's
naturally complicated, because
there are, the system doesn't
just say, okay, you know, this
is John, John 65 years old, John
suffers from these types of
medical illnesses, or over the
course of his history. And it's
probably going to cost us
$75,000, to make sure that John
has his basic needs met, every
year for the next 15 years. They
don't budget like that. They
say, Okay, here's John, and you
bill for every service that you
provide to John, and we'll pay
you and then we'll do and then
make sure your documentation is
in line or will recoup your
money will charge you back. And
so these benefits, these
explanations have so many
billing codes and terminology
that's foreign to most people.
And so the fact that you spend
the time helping your community
and just helping people in
general, being able to navigate
this, I think that that's one of
the driving forces to change. I
think that the you tell you tell
10 people the next time, you
know they have a friend that
reaches out to them, they at
least have some general
understanding of what you told
them. And I think as more people
understand that this system
doesn't have to be this
complicated.
Hassan Abdallah: Yeah, you know,
I'll tell you like a very normal
occurrence for me on any given
day any given First, it starts
with my mom. My mom is English
was their second language.
Still, as she has been here 45
years, primarily speaks the
Arabic language. It wasn't until
maybe just over a decade ago,
that language access requirement
laws started requiring these
entities to actually translate
these documents into a language
where 5% or more of their
population speaks. I mean,
that's, that's crazy. You know,
and, wow. And so, then this
really means is like they're
getting a paper, they have no
idea where it's coming from what
it means. But here's, here's, I
think the residual impact of
this right? Is it causes
nervousness. It causes this kind
of low grade fear that single
time I go to see a doctor,
something is coming to me that I
don't understand. I don't know
what it means. It has numbers on
there. I don't I didn't expect
it. I don't know if I have to
pay it. I didn't expect it. I
thought I was Medicaid eligible.
I thought this was covered. So
now what does this mean? So what
does that lead to is then people
become hesitant to go get care.
And I'll tell you, my mom is a
traditional Southern Lebanese
woman, she's as old school as
they come, she still believes
that Vernors and soup are the
best remedy to any illness,
which she has a good argument
for. But point being is that in
minority communities, this is
what it has led to is that they
you know, when you talk about
the discussion of quality care,
you also have to think about
what does that mean to different
people in different populations?
Good point, because quality of
care to an affluent, or to mid
income level, people who do
speak the language means okay,
am I in good health? Are they
providing the service that leads
to better health? To other
people? That may mean as simple
as something is? Can I make an
appointment? Yeah. Oh, having to
call a family member to come
provide translation services for
me?
Kosta Yepifantsev: Yeah, no,
that's a that's a fantastic
analogy. And like we were
talking about in terms of health
equity, I think it's very
important. So let's move on,
what do you believe is the
future of healthcare compliance
and regulations? And how will
this impact the quality of care,
especially for the senior care
sector?
Hassan Abdallah: That's an
excellent question, especially
in specifying that sector. So
future of government health care
compliance, I think you have to
look at trends, healthcare
compliance consistently has been
evolving. And I talked about us
continuing to be in a pain Chase
system. But I do think that AI
is going to play a considerable
role in the data mining of
living claims. And the ability
for AI and other data centric
platforms or software's to
identify claims on the pre pay
side, is going to play a
significant role in healthcare
being less costly, because if
you can stop claims from leaving
the door before you pay them,
and then make sure that there
are certain compliance
requirements being met, it
drives down the cost for the
payer, it drives down the cost
for the government, which
naturally drives on cost of
health care. Overall, from an
auditing perspective, I think
that CMS pushing back from its
role between now and 2030 is
going to lead to a very specific
state by state agenda that is
going to be specifically
tailored for that state's
populations, which then leads to
the implications of political
elections, because we all know
that health care is a really
sexy sell during campaign
season. And because of that, you
know, a lot of legislative
advocacy or promises and
otherwise are made. And so that
as it pertains specifically to
the senior care centers, is one
most most I would say, I
statistically can reference this
but from what I've seen is more
and more seniors are leaning
towards specialty care
facilities or home care,
include, I'll tell you, my
mother included for their type
of care. And so depending on how
the government reacts to the
governance of homecare related
services, is going to be a
really telling a metric if it's
anything like has happened in
the past, meaning when new
health care services have come
up, whether it's mobile care,
wound care, laboratory care, it
usually leads to a new agency
being created. The agency having
a derivative authority from the
Department of Justice or the OIG
some cyber relation in there,
and then combining that
relationship with delegating
authority to health plans. and
state agencies to maintain
compliance.
Kosta Yepifantsev: Fascinating.
I mean, I'm just fascinating. I
could sit here and talk
literally hours about this. But
I know that it's going to this
is going to serve a wide range
of people. And I think it's
really giving people an opening,
kind of opening the door, to
better understand how our
industry works, how our system
works, even though on somewhat
of a technical level, but it's a
necessary technical level,
because I think you and I have
both established in this episode
that it's because of the
complicated nature and because
it kind of happens behind the
scenes, somewhat in the shadows,
even in terms of you know,
billing departments, being in
the basement, punching in claims
all day long, you know, on, on
up to four forms. It's because
of the nature of the business
that most consumers are like,
Yeah, I'm not, I don't know
anything about it. I don't know
how it works. I don't know how
much I'm gonna pay. I just like
I walk in, I get sick, I get
question marks. And honestly,
they're probably more anxious
and suffer even worse health
outcomes, because of the
anxiety. And not to mention,
obviously, the equity part of it
where people from different
social, economic socio economic
groups probably suffer even
higher levels. So we always like
to end the show with a call to
action, what are some actionable
steps we can take today, to
ensure we're choosing the best
long term care options for
ourselves or apparent,
Hassan Abdallah: I highlighted
this a little bit briefly before
but you shouldn't have a
relationship with with your
primary care physician. What I
mean by that is choosing a
physician who is accessible. If
you have a language restriction,
a physician whose office can
support you, by Him, him or
herself or their staff, to with
those language access
requirements, I think that's
such a key piece with the
growing diverse communities that
we are building here across the
United States. And I think more
than, than all of that is
understand what your health care
plan provides you. And this is
you you know, as much as we want
to try to challenge the system,
we also have to understand the
system. What I mean by that is
you brought it up is that some
people before they get care,
they think, man if I get if I
take an ambulance ride right now
that's 800 bucks that I don't
want yeah. So let me let me
think twice about that. So
understanding the system is very
important too, because and
reaching out to individuals like
yourself, like our group and and
I think even you know, the true
call to action here, Costa is to
people like you and me as people
that are in the positions of
knowledge, our knowledge is
power. And so when you have the
knowledge you have to use that
knowledge to benefit those that
we know otherwise wouldn't be
able to at least that's what I
feel as a part of our obligation
in this profession. And so I
think continue to find ways to
serve those communities and you
know continue fighting the good
fight we got to take little
little chips at it you know,
much like how probably was with
you in the in the in the hockey
rink, because, you know, when
that fight comes, dropping,
loves to take it head on and you
know, sooner or later hopefully,
we'll continue to create better
health systems.
Caroline Moore: Thank you for
joining us on this episode of
Now or Never Long-Term Care
Strategy with Kosta
Yepifantsev.If you enjoyed
listening and you wanna hear
more make sure you subscribe on
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Long-Term Care Strategy is a
Kosta Yepifantsev
production.Today’s episode was
written and produced by Morgan
Franklin.Want to find out more
about Kosta? Visit us at
kostayepifantsev.com