Welcome back to the Healthcare STARcast! In this episode, we dive deep into the ever-evolving landscape of Medicare Advantage compliance and population health management. Host Subbu Ramalingam sits down with industry expert Regan Pennypacker, Senior Vice President of Compliance at ATTAC Consulting Group, to unpack the heightened regulatory environment, the impact of new and upcoming compliance rules, and the practical strategies that drive organizational performance and member outcomes.

Together, Regan and Subbu discuss key friction points between compliance and operational teams, best practices for breaking down organizational silos, and the increasing importance of innovation, even in compliance. You’ll hear firsthand about the unique challenges and opportunities presented by special needs plans, the expansion of AI in healthcare, and how forward-thinking leaders can proactively prepare for future CMS rules without waiting for final confirmations.

Whether you’re a compliance leader, a plan operations executive, or simply curious about the interplay between regulation and real-world care delivery, this conversation offers actionable insights and inspiration for navigating today’s complex healthcare landscape.

Timestamps:

00:00 Improving compliance training strategies

06:01 Evolving role of compliance

07:55 Starting in Medicare compliance

12:50 Industry collaboration and CMS feedback

16:34 Monitoring clinical decision making

17:23 Updating prior authorization guidelines

22:19 Navigating compliance and risk adjustment

25:28 Risk adjustment and compliance roles

30:08 Effective compliance training tips

32:40 Reviewing public comments to CMS

35:14 CMS and wellness guidance trends

38:10 Adapting to CMS guidelines

44:14 Addressing transportation barriers

47:35 Helping organizations with compliance challenges

50:13 Supporting FDRs and ACO compliance

52:48 Leadership style and innovation

55:32 AI governance and ethical adoption

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/

ATTAC Consulting Group - https://www.attacconsulting.com/

Media Partner - TopHealth - https://tophealth.care/

“Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”