Connecting Quality, Compliance, and Population Health in Managed Care with Charles Baker
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 Health05:53 "Insurance's Role in Community Health"10:05 Breaking Silos in Compliance Strategies11:18 Proactive Data Management for Medicare Advantage16:17 Regulatory Compliance Cadence Analysis19:32 "Medicare Advantage and RADV Focus"21:24 HMO Cost Control Evolution27:50 Healthcare Consulting & RADV Support30:54 Ensuring Audit-Ready Clinical Documentation35:10 Policy Presentation: Key Opportunity36:49 Holistic Teamwork for Data-Driven DecisionsShow 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/
--------
39:20
--------
39:20
From Data to Purpose: Unveiling Subbu’s Journey to Healthcare Leadership and Clarity
Welcome to the inaugural episode of The HEALTHCARE STARcast, where your host Subbu Ramalingam invites you to go beyond the usual healthcare metrics to uncover the heart - and the purpose - behind the people leading change in the industry. In this episode, we get to know Subbu, a seasoned leader in star ratings and risk adjustment, whose journey spans continents and roles, from fintech innovations in India to driving population health initiatives and nonprofit work in the US and abroad.Subbu shares his personal stories of how diverse backgrounds, challenges, and values have shaped his passion for healthcare. You’ll hear about the profound impact of combining data, technology, and mission-driven leadership to improve both the business and human side of medicine. Subbu opens up about the principles that guide his work, the importance of clarity and prioritization, and why true transformation in healthcare requires collaboration across silos.Whether you’re a healthcare operator, an executive, or just fascinated by the stories of those making a real difference, this episode sets the stage for thoughtful conversations on leadership, clarity, and the ongoing evolution of healthcare.Timestamps:00:00 From Finance to Healthcare Transition04:15 Medicare Advantage Evolution & Skills08:28 "Journey from Veterans to Tech Healthcare"12:26 Balancing Local and Global Healthcare17:28 Pioneering Yoga's Western Influence19:14 "Mastering Time Management & Clarity"22:20 Star Ratings and Population Health Management26:09 Culture and Strategy in Health Systems31:32 Medicare Star Ratings Timeline32:49 CMS Risk Adjustment Audits Intensify37:31 Streamlining Healthcare for Better Outcomes41:34 Preparing for Audits and Budgeting44:30 "Medicare Audits and AI Insights"48:25 "Healthcare Star Cast Launch"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/
--------
40:44
--------
40:44
The Healthcare STARcast - Show Promo
The Healthcare STARcast is where healthcare’s true leaders shine. Hosted by Subbu Ramalingam, a seasoned healthcare executive, this podcast goes beyond STAR ratings and risk scores to reveal the strategies, innovations, and mindsets driving real-world healthcare excellence.Every episode delivers clear insights, bold frameworks, and practical ideas designed for healthcare executives, operators, clinicians, and innovators ready to lead at the next level. Whether you're improving quality, scaling value-based care, or reimagining patient outcomes, The Healthcare STARcast gives you the edge to lead with confidence. Stay tuned!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/
The Healthcare STARcast is where healthcare’s true leaders shine. Hosted by Subbu Ramalingam, a seasoned healthcare executive, this podcast goes beyond STAR ratings and risk scores to reveal the strategies, innovations, and mindsets driving real-world healthcare excellence.Every episode delivers clear insights, bold frameworks, and practical ideas designed for healthcare executives, operators, clinicians, and innovators ready to lead at the next level. Whether you're improving quality, scaling value-based care, or reimagining patient outcomes, The Healthcare STARcast gives you the edge to lead with confidence.
USA