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Beyond the Bottom Line

Beyond the Bottom Line

Written by: Panacea Healthcare Solutions
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 Welcome to Panacea’s podcast Beyond the Bottom Line: Let’s talk healthcare, finance, revenue cycle and compliance. Hosted by, Kevin Chmura, CEO of Panacea Healthcare Solutions. Whether you’re a healthcare executive, a financial professional, or simply curious about how these essential pieces of the healthcare puzzle fit together, you’re in the right place. Our goal is simple to give you actionable insights and expert perspectives that can help you optimize your operations and drive strategic growth.2025 Panacea Healthcare Solutions, LLC Politics & Government
Episodes
  • Beyond Compliance with Hospital Price Transparency

    Beyond Compliance with Hospital Price Transparency
    Mar 24 2026
    Beyond Compliance with Hospital Price Transparency With Host Kevin Chmura, CEO of Panacea Healthcare Solutions and Guest Govi Goyal, President, Financial Services of Panacea Healthcare Solutions In this episode of Beyond the Bottom Line, Kevin Chmura is joined by Panacea’s President of Financial Services, Govi Goyal, to discuss the recent changes in the latest chapter in Hospital Price Transparency. Govi presents his thoughts regarding the latest price transparency requirements, with a heavy emphasis on machine-readable file, which received a decent amount of changes since last year. He will also touch on the events that led us to today’s landscape, while also exploring compliance pitfalls to be aware of. Episode transcript available below. Kevin Chmura Hi, and welcome to this episode of Panacea’s podcast, Beyond the Bottom Line. Let’s talk healthcare, finance, revenue cycle and compliance. I’m your host, Kevin Shimura, CEO of Panacea Healthcare Solutions. Today we’re welcoming back Govi Goyal, our President of the Financial Services Division at Panacea, to talk about recent changes in the latest chapter in hospital price transparency. Govi, welcome back. Govi Goyal Thank you. Kevin Chmura So Govi, we’ve done a bunch of these together and as usual you maintain your position as a leading national thought leader on the topic of price transparencies. So rather than maybe bringing, you know, dragging you through and asking you a series of questions, maybe I’ll just open up the floor to you. I think people want to hear what you’re thinking about. Especially as it comes to the new machine-readable file requirements. You know, we had an awkward series of events that got us to where we are today. Maybe you could touch on that and maybe just talk about some compliance pitfalls. That you can see. And so rather than me getting in your way, I’ll turn it over to you and let you take it from here. Govi Goyal Yeah, absolutely. I think awkward is a good way to describe it. The timing is really good though. It’s another year. So we’ve got another year of new price transparency requirements. This time there’s not any changes to the consumer display or patient estimation system, but there’s certainly a decent amount of changes that are happening with the machinable file, which has really been a work in progress, I’d say over these last few years, but there’s been significant activity within the last year. So, in just a few weeks here, April 1st, CMS will begin enforcement of the new requirements that were laid out. In both the proposed and final rule for 2026. Technically these are effective January 1st, we’ve got a little bit of grace period which I think hospitals are taking advantage of it. So on the technical side of things, what we’re seeing is that CMS is really getting. What’s getting rid of the replacing the estimated, the current estimate allowed amounts with four new allowed amount fields. And these fields are the median allowed amount, the 10th percentile, 90th percentile and then the count of allowed amounts. And so I think it’s really important to kind of understand this part there and you know why. What does this really mean and why is this happening? So as a kind of a refresher here, estimated allowed amounts by definition refers to the historical average payment that a hospital received for that given payer or plan and for that for that billing code. And it’s really applicable when you may not have a standard negotiate rate or you have a standard negotiate rate. But then that could be varied by other factors. So for example, you’re getting paid on a percentage charge on a DRG. We know that the gross charges could vary from patient to patient. There’s not a standard negotiated rate. So CMS came up with the estimated allowed amount, which is basically a second field for a negotiated rate when there is no standard. Or let’s say you have a scenario where you’re a hospital, you’re getting paid on a case rate for a given surgical procedure, but then there’s also the opportunity to get paid an additional amount if it’s a high dollar claim in the in the concept of stop lossless or lessor of, so that whole concept is not changing. CMS is not changing the qualifications, how you qualify a line item that would need in this case going forward for 2026 in April, now a median allowed amount. Really what’s changing here is the calculation itself. So instead of looking at a historical average, we’re now CMS is now asking hospitals to get to the median, the 10th and the 90th percentile and then also include the count of allowed amounts. So the qualification process same, the calculations are changing and I think you hit the nail on the head there, Kevin. We have to kind of go back in time. We got to get in our time machine here. We don’t have to go too far back, but if we go back about a year ago and think about the executive order. That’s really where...
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    19 mins
  • Acquisition of MedLearn

    Acquisition of MedLearn
    Feb 11 2026
    Panacea Healthcare Solutions Acquires MedLearn Media With Host Kevin Chmura, CEO of Panacea Healthcare Solutions and Guest Angela Kornegor, CEO of MedLearn Media In this episode of Beyond the Bottom Line, Kevin Chmura is joined by MedLearn Media’s CEO, Angela Kornegor, to discuss Panacea and MedLearn’s shared history, in response to Panacea’s latest acquisition of MedLearn. Kevin and Angela dive into MedLearn’s trusted education brands which include MedLearn Publishing, RACmonitor and ICD10monitor and how combining forces completes the model of software, consulting and professional level education. They explore how this will give coding, HIM and compliance teams the tools, insights and accredited education needed to keep up with complex rules while protecting revenue and focusing on patient care. Episode transcript available below. Kevin Chmura Welcome to Beyond the Bottom Line. I’m your host, Kevin Chmura, CEO of Panacea Healthcare Solutions. After eight years apart, MedLearn Media has rejoined Panacea and I couldn’t be more pleased about that and I want to share why. Today I’m sitting down with Angela Kornegor, head of MedLearn, to talk about our shared history. MedLearn’s trusted Education brands which include MedLearn Publishing, RACmonitor and ICD10monitor and how combining our forces completes the model of software, consulting and professional level education. Our goal is simple, give coding, HIM and compliance teams the tools, insights and accredited education they need to keep up with complex rules while protecting revenue and focusing on patient care. So, Angela, welcome. Welcome to Panacea. Let me be the first to welcome you to Panacea. But I guess I should do this appropriately and welcome you back to Panacea. That’s probably the way to say it, right? Ours is an interesting. History, Panacea and MedLearn. And you’re probably more qualified to talk about it than I am because you, your time spanned both the time we were one company and the time we were and now we are again. So maybe I could ask you to just give me a couple of minutes on the history for everybody that’s listening. Angela Kornegor Yeah. Well, it’s been eight years. So, it’s been eight years since MedLearn was a part of Panacea, which was great. We were together for six years. At that time, we had MedLearn Publishing, RACmonitor, ICD10monitor, which we still have, but we didn’t have the depth of content in the digital format that we have now, eight years ago. Kevin Chmura Yeah, yeah, that’s it. And so a series of M&A moves brought the company together, brought the companies together, broke them apart. And then we found our way home to each other just a month or two ago. How long has it been? Angela Kornegor It’s been a long time, but it’s just officially a month ago. Kevin Chmura Deals are hard. Deals are hard and you were great during the deal. We have said this to each other that that the deals are hard because for so many people in a deal, the day of the closing is their last day. For you and me, it’s the beginning. We were involved in the rest of it as well. You were great. So, I’m looking forward to, you know, really working with you, not just to get the deal done. So, look for the Panacea customers who are pretty, pretty tight on what we do. I thought maybe you could give me a couple of minutes on. On MedLearn, generally catch everybody up. There are those who will remember MedLearn from the past and as you just stated, you’ve evolved greatly. So, you just if you give us a couple of minutes on what you’re doing today. Angela Kornegor Absolutely, absolutely. So again, we still have our three brands. So MedLearn Publishing, RACmonitor, ICD10monitor. Our goal there is to focus on trusted deep. Content that will help with regulatory rules and all the burdensome government changes that are going on left and right to help make sure that they can A) get accredited content because that’s what they need to keep their credentials up, but we want to help make sure that they’re continuing to be the hero at what they do because it’s not an easy job, it’s tough. And these complex rules make getting their revenue, focusing on patient care a challenge. And we want them focusing on patient care because that’s what impacts all of us. Kevin Chmura Yeah, yeah, it’s interesting. You know the coding HIM in in healthcare often called mid-rev cycle and it really is it’s the core. And when you think about it’s… The core is the handoff from the clinical to the financial and that handoff is so critical and we as an industry has not. We haven’t made it easy for the folks that are professionals in that space. We don’t need to have. I spent 30 years in the back end of the revenue cycle, certainly could get credentialed in different things, but was never required to unlike coders. So, what MedLearn does is so critical to that world and we’re excited to bring it to Panacea. I think ...
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    11 mins
  • Medicaid Eligibility Under the One Big Beautiful Bill Act: Our Expert Breaks it Down

    Medicaid Eligibility Under the One Big Beautiful Bill Act: Our Expert Breaks it Down
    Jul 22 2025
    Medicaid Eligibility Under the One Big Beautiful Bill Act: Our Expert Breaks it Down With Host Kevin Chmura, CEO of Panacea Healthcare Solutions and Guest Brian Herdman, Director, Financial Reimbursement Services, KA Consulting Division In this episode of Beyond the Bottom Line, Kevin Chmura is joined by policy expert Brian Herdman to discuss how the One Big Beautiful Bill Act is set to impact Medicaid eligibility, what this critical issue means for hospitals and healthcare providers, and how these changes can affect your bottom line. Kevin and Brian dive into not only what changes providers can expect to see right away, but also those changes which will be coming into play in the next few years, and how to best prepare before they happen. They also explore what challenges hospitals can expect to see as a result of this bill’s passage, as well as if there are any positives for healthcare systems or providers. Episode transcript available below. Kevin Chmura Hi, and welcome back to Beyond the Bottom Line, Panacea’s Podcast exploring the business and policy issues that matter most to healthcare organizations. I’m your host, Kevin Chmura, CEO of Panacea Healthcare Solutions. In this follow-up episode, we’ll continue our conversation with Panacea’s policy expert, Brian Herdman, about Medicaid funding, a critical issue for hospitals and healthcare providers, and take a closer look at how the latest developments in Congress and the administration could impact your bottom line. We’ll also revisit some of the practical steps you should be thinking about today to strengthen your organization’s financial position now that we’ve seen how these policy issues have unfolded. So Brian, welcome back to the podcast. Brian Herdman Great to be here. Kevin Chmura Great to have you back. So, Brian, the One Big Beautiful Bill Act, the OBBBA has now been signed into law and we did a podcast on this topic in March, at which point we were really looking at the versions of the bill that were being kicked around. We were really probably going more off of what we were seeing in the press, in the media, and less what we really knew. Now we’re getting a real look at it. You’ve had an opportunity to spend some time with the text and do your analysis. You are by far our best regulatory expert here at Panacea, so interested in in what you’re saying now, we can spend a lot of time going through the individual provisions as they relate to Medicaid and those things that will be deeply impactful. If we went through all of them, this would be a three hour podcast and I think we lose a lot of the audience. I thought maybe what would be better for everybody, given your expertise in this area? Probably crafting it a little to our target audience, which is probably mostly hospitals and health systems, wondering if you might just spend some time talking about those provisions and those elements that you’re paying the most attention to, the things that you think will be most impactful. And maybe we just take the conversation from there. Brian Herdman Sure. Sure, Kevin. So, you know, after all that back and forth and all those, you know, 4th of July deadline to get the bill passed and whatnot, there is a lot of, you know, what’s going to stay in, what’s not going to stay in between the House and Senate reconciliation process. And now that that has shook out, you know, as I’m looking at the Medicaid specific provisions, because I think that’s where the big change is going to be for our clients, on that Medicaid provisions, you know, there’s kind of two kind of two way, two sets of issues our clients are going to have to look at, you know, the things are going to affect which specific claims are going to be eligible for Medicaid and at what amount. And just generally speaking, the environment that the state, that the provider operates in the state with the state’s Medicaid program, what’s happening with FMAP, what’s happening with state directed payments and how is that going to all unfold? So as I’m looking at those two kind of main themes, you know, what’s happening like, you know, soon what’s happening soon-ish and then, you know, what’s kind of pushed out far ahead. And when I look at the things that are coming up soon, it’s not anything that’s like, you know, hair on fire, oh, my gosh, we have to do a lot of things differently. There was that immediate elimination of some moratorium on some things that would get you streamline applications into Medicaid. That’s going away. And, you know, there is that reduction in FMAP percentage to states when they have done that expansion. But, you know, on the margins, none of those things are going to be a dramatic change to how our clients, you know, get how many of those claims go through and how much they really get paid by the state. When you really start to see that happen is around January 2027. That’s when we’ll start to see a lot of ...
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    15 mins
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