Connecting Quality, Compliance, and Population Health in Managed Care with Charles Baker
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Connecting Quality, Compliance, and Population Health in Managed Care with Charles Baker
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Welcome to The HEALTHCARE STARcast, the show that breaks down the complex world of healthcare to reveal the real strategies and mindsets driving excellence. In this episode, host Subbu Ramalingam sits down with Charles Baker, Vice President at ATTAC Consulting Group and an expert who has worn many hats in the industry, from clinical social work to executive compliance roles. Charles shares his unique journey from the hospital floor to the executive suite, offering fresh perspectives on population health, risk management, and how healthcare organizations can break out of silos to tackle today's biggest challenges.
Together, Subbu and Charles dig into the realities of compliance, quality improvement, Medicare Advantage pressures, and the evolving landscape of risk adjustment and RADV audits. You'll hear actionable insights for health plan leaders and providers, a no-nonsense approach to regulatory changes, and practical ideas for bridging the gaps between compliance, operations, and patient care.
Whether you’re leading a health plan, driving quality initiatives, or reimagining care delivery, this conversation is packed with timely advice and big-picture thinking to help you navigate change and deliver real value for patients and communities.
Timestamps:
00:00 Rethinking Community-Focused Mental Health
05:53 "Insurance's Role in Community Health"
10:05 Breaking Silos in Compliance Strategies
11:18 Proactive Data Management for Medicare Advantage
16:17 Regulatory Compliance Cadence Analysis
19:32 "Medicare Advantage and RADV Focus"
21:24 HMO Cost Control Evolution
27:50 Healthcare Consulting & RADV Support
30:54 Ensuring Audit-Ready Clinical Documentation
35:10 Policy Presentation: Key Opportunity
36:49 Holistic Teamwork for Data-Driven Decisions
Show Website - https://healthcarestarcast.com/
Subbu Ramalingam - Show Host - Linkedin - https://www.linkedin.com/in/subburamalingam/
FloWise Leadership - https://flowiseleadership.com/
ViVega Business Services - https://www.vivega.co/
Media Partner - TopHealth - https://tophealth.care/