Description

Navigating the complex world of insurance in healthcare can be frustrating for both providers and patients.

In this episode of Healthy Careers, host Maddie Traylor sits down with Nikki Hudson, Director of Payor Relations at Emerge Ortho, to discuss declining reimbursement rates, payer negotiations, and value-based care strategies.

With 20 years of experience in healthcare administration, Nikki shares insider knowledge on building strong relationships with insurance companies, advocating for better patient outcomes, and developing solutions that balance profitability with quality care.

Whether you're a healthcare executive, physician, or a patient struggling with insurance challenges, this episode provides valuable insights into the financial side of medicine and how to navigate the payer landscape effectively.

Key Takeaways:

• Declining reimbursement rates require strategic solutions. Learn how healthcare organizations are navigating financial pressures while maintaining high-quality patient care.
• Building relationships with payers is crucial. Advocacy, communication, and understanding insurance contracts can lead to better negotiations and patient outcomes.
• Value-based care is reshaping the industry. Healthcare leaders must adapt to new payment models that emphasize patient outcomes over volume-based billing.
• Private equity is impacting healthcare. Discover the effects of corporate investment in medical practices and how it’s changing the business of healthcare.
• Insurance challenges directly affect patient care. Physicians and administrators must work together to ensure patients receive the treatments they need without financial obstacles.

Episode Highlights:

00:43 Meet Nikki Hudson: Building Relationships in Healthcare
01:46 Challenges in Healthcare: Declining Reimbursement Rates
06:05 The Game of Healthcare Administration
17:14 Personal Experiences with Healthcare Policies
20:00 Patient Struggles and Physician Advocacy
22:23 Personal Experience with PRP and Surgery
23:44 Building Relationships with Insurance Companies
24:32 Value-Based Care and Innovative Solutions
30:23 The Role of Mid-Levels in Healthcare
33:26 Private Equity in Healthcare
35:26 Advice for Aspiring Healthcare Administrators
36:48 ConclusionKeywords:

Healthcare payer negotiations,
Declining reimbursement rates in medicine,
Value-based care in orthopedics,
Private equity in healthcare,
Patient advocacy in insurance claims,

Connect with Nikki Hudson:

• LinkedIn: Nikki Hudson
• Visit Emerge Ortho