2018 TEXAS STATE CONFERENCE AGENDA

This program contains a total of 19.5 CPE credits if all possible sessions are attended.

Learning Objectives: At this Conference, participants will be able to obtain healthcare specific education. The Instruction Method for all conference sessions is Group Live.

Sunday, April 22

Conference Registration

Sunday, April 22 @12:00 pm – 6:30 pm

1:00 pm – 1:50 pm Concurrent Session

A & A Update

Course 180400 | CPE: 1.0 | Level: Intermediate | Prereq.: None

More details on this session to come.

1:00pm – 2:40pm Concurrent Session

Reforming the Authorization Process

Course:180401 | CPE: 2.0 | Level: Intermediate  | No Prerequisites

While the current process for prior authorization (PA) has resulted in a reduction of unnecessary services, it has created an administrative burden to all parties with limited effectiveness. According to a recent survey conducted by the American Medical Association (AMA) in December of 2016, 80% of PA’s are approved real time and only 20% of PA’s require additional documentation and review. However, the current process is not built to weed out the 80% and has created a manual, labor intensive process that requires substantial resources to support by both providers and payers. Unfortunately, there is a lack of engagement from key stakeholders in truly building consensus to resolve the administrative burden
Issues with the current PA process include: Correct documentation; Various communication options; Ability to monitor delivery of care against authorization; Unexpected changes with patient services; Obtaining approval; Patient frustration with the process.

There is an overall industry agreement that the PA is primarily a clinical requirement but because there is a financial impact it has erroneously become the responsibility of the revenue cycle to obtain, leaving significant gaps in the process. Most healthcare organizations utilize revenue cycle staff to obtain the PA information even though clinical input is required. Any change that occurs needs to encourage a cultural transition where the completion of the PA is the primary responsibility of clinical staff.

Key reform principles that must be discussed as a first step to engaging other stakeholders in deeper conversations include the following: Clinical validity; Continuity of care; Transparency and fairness; Timely access and administrative efficiency; Alternatives and exemptions

Sunday, April 22 @1:50 pm – 2:40 pm Concurrent Session

A & A Update

Course 180402 | 1.0 CPE | Level – Basic | No Prerequisites

More Information on this session to come.

Suzanne K. Lestina, FHFMA, CPC, Vice President, Revenue Cycle Innovation, AvadyneHealth

In this role, Suzanne works on executing strategies that will lead the industry in next-generation revenue cycle concepts.  In addition, leveraging innovative tools and technology Suzanne will help customers implement change that will transform their revenue cycles and help them achieve positive outcomes.

Prior to joining AvadyneHealth, Suzanne was HFMA’s director of revenue cycle MAP where she served as the technical expert and consultant for HFMA’s MAP product line(s) and served in an advisory capacity regarding the technical aspects of revenue cycle performance improvement.  Suzanne has extensive revenue cycle experience, including revenue cycle consulting and hospital revenue cycle leadership roles in the Chicago area

Sunday, April 22 @2:40 pm – 3:30 pm Concurrent Sessions

A & A Update

Course 180404 | 1.0 CPE | Level: Basic | Prereq.:None

 

More details on this session to come.

Charge Capture Revived: Driving Results Through Managing Change and Innovation

Course 180405 | 1.0 CPE | Level – Intermediate | No Prerequisites

This presentation will walk the audience through the journey of our Charge Capture program, tips for driving success and how we re-structured our processes to reduce Late Charge quantities, gross dollars and average days for charge corrections. A large focus on Operational and Clinical communication, robust financial reporting and building outside vendor relationships will also be discussed.

Lena C. Tisten, Director-Revenue Integrity & Compliance – Revenue Cycle Business Services, CHRISTUS Health

Lena Tisten is the Director of Revenue Integrity and Compliance at CHRISTUS Health, providing support with ChargeMaster and Charge Capture programs. Her passion for improving charge capture has resulted in a range of success through financial reporting, leadership support and enhanced vendor relationships.

Lena received a Bachelor’s of Science degree from Indiana University with a focus in Healthcare Administration and Economics. Throughout her 15 year career in the Healthcare industry, Lena has worked in various aspects of the Revenue Cycle including Patient Access, Patient Financial Services and HIM. She also serves on the Leadership Development Team to help develop other healthcare leaders.

3:45 pm – 5:00 pm

Sunday

Overcoming Self Handicapping Leadership

Keynote

Course 180406 | 1.5 CPE | Level: Intermediate | No Prerequisites

Self-handicapping is the process where people make excuses, withdraw effort, and create obstacles in order to maintain a public or self-image. The need to appear competent drives people to self-handicap. In this session, we will explore how people use self-handicapping in business and leadership as a means of impression management and how it eventually leads down to poor leadership. At the conclusion, our participants will leave with a deeper understanding of self-handicapping and how to overcome it (personally and organizationally).

Dr. Jordan Mitchell, Assistant Professor of Healthcare Administration, University of Houston-Clear Lake.

Jordan Mitchell is an Assistant Professor of Healthcare Administration at the University of Houston-Clear Lake. He received his Ph.D. in Health Services Policy and Management from the University of South Carolina. His research has been published in the Journal of Rural Health, the International Journal of Health Information Systems and Infomatics, the Journal of Healthcare Quality, and other peer-reviewed journals.

5:00 pm – 6:30 pm 

Welcome Reception

Monday, April 23

7:30 am – 8:30 am  

Breakfast & Registration

8:00am – 9:15am

Monday

Seeding Innovation with Physicians

General Session

Course 180408 | 1.5 CPE | Level – Intermediate | No Prerequisites

Healthcare finance leaders are challenged each day to reimagine and transform what they know Healthcare finance leaders are challenged each day to reimagine and transform what they know into what their patients and communities need and deserve. Today, that means navigating innovation and experimentation to meet the challenge to provide the right care, at the right time, and at the right cost. It also requires collaboration with physician colleagues to redesign and transform the delivery and organization of care. Such collaborative relationships are the cornerstone of innovation, and this presentation will explore how to build partnerships of trust that have the power to advance health.

Carol A. Friesen, Vice President, Health System Services, Bryan Health; 2017-2018 HFMA National Chair

Carol A. Friesen, FHFMA is VP of Health System Services, Bryan Health, Lincoln, Nebraska and serves as Chair of HFMA for the 2017-18 term. A member of HFMA since 1999, Ms. Friesen’s involvement with the National Association includes serving as Director for the Board of Directors, the National Advisory Council, Early Careerist Task Force and Region 8 Regional Executive. Ms. Friesen has also served the Nebraska Chapter as Director, Treasurer, Secretary, Vice President, and President. She has received the Follmer Bronze, Reeves Silver, and Muncie Gold merit awards, as well as the HFMA Medal of Honor.

Ms. Friesen, a Fellow of HFMA and Certified Healthcare Financial Professional, holds a Bachelor of Science in business management and a Master of Public Health in healthcare administration.

9:15 am – 10:30 am

Monday

Using Analytics to Reduce Revenue Cycle Cost to Collect

General Session

Course: 180409 | 1.5 CPE | Level: Intermediate | Prerequisites: None

In this presentation we will be discussing how analytics can be used to maximize efficiencies in operations, vendor management, payer scorecards, etc. and how to infuse the data into daily performance at a lower cost to collect. What are your blind spots that create waste or redundancy? How do your KPIs link to employee daily engagement? Are your vendors costing you more than they should? Are you using payer performance in contract negotiations? Where are your cost blind spots? Typically Revenue Cycle and Billing Office leaders have strong metrics, measurements and reports to drive their departments in achieving desired goals. This session will provide insight how to use the data available to focus in on achieving higher performance while reducing the cost to collect.

Course Objectives:

Understanding your KPI and how to link standard work and employee engagement to achieve operational efficiency. Measuring your vendor partners and optimizing the return. The value of payer scorecards. The importance of understanding your data to drive decisions that reduce operational cost.

Michael Taylor, Central Business Office Leader, Sutter Health – Sutter Shared Service

Michael Taylor presently works for Sutter Health’s Shared Services organization as the Leader of the Central Business Office (CBO) providing billing and collection services for twenty eight (28) acute care facilities in the Sutter Health system. Prior to leadership of the CBO he designed, implemented and led the Patient Access Center which provides centralized patient access and financial clearance support for all acute care facilities in the Sutter Health System. Mr. Taylor has 27 years of management experience in acute care hospital billing and registration with extensive knowledge in all aspects of the patient revenue cycle. He is Lean Certified through Sutter Health’s Lean program and has previously been an HFMA speaker on the topics of Quality Metrics, Pricing Transparency, Charity, Charge Capture, Process Transformation and Lean Concepts.

 

10:45 am – 12:00 pm

Monday

Hackers Love Healthcare

Why the Healthcare Industry is a favorite Target for hackers – and How to Prevent It

General Session

Course: 180410| CPE: 1.5 | Level: Intermediate |Prerequisites: None

 

In the digital age, security breaches are inevitable and cyberattacks against businesses are becoming more frequent and severe.  In fact, business email scams alone have increased 2,370% from January 2015 to December 2016, now totaling $5 billion worldwide.  Whether ransomware, wire transfer and email scams, or data theft, cyberattacks are ranked the No.1 risk facing non-bank US businesses.

This presentation will make sense of the bewildering landscape of top cyber threats facing the healthcare industry.  We will explain the motivations and tactics of cyber threat actor (hackers), how their methods have evolved over time, and how they successfully prey on human behavior, complexity, and social tendencies.  Backed by this understanding, you will learn best practices, tips and tricks on how to become more secure through a smart blend of controls, technologies, and cultural changes.

Jan S. Hertzberg, CIPT, CISA, Director – IT Risk Services, BKD
Jan has more than 30 years of experience providing IT audit, risk, cyber security
and privacy compliance services. This includes extensive experience in
identifying and managing IT internal control risks and recommending solutions
that apply cybersecurity and privacy frameworks (including COBIT, NIST,
GAPP, ISO and AICPA Trust Principles) to implement leading practices and help
clients meet compliance requirements.

Jan has led IT audit co-sourcing engagements for healthcare providers. Audits
included reviews of a number of Electronic Health Record (EHR) systems,
including EPIC, Cerner and Meditech. Also, he has performed a variety of
cybersecurity engagements (e.g. HIPAA Security Risk Assessments, Payment
Card Industry Data Security Standard (PCI DSS) Readiness Assessments) for
healthcare providers, payers and business associates.

Lanny Morrow, Senior Data Scientist and Technical Lead – Forensics & Valuation Services, BKD 
With 21 years of experience at BKD, Lanny is the senior data scientist and technical lead in advanced data mining and digital forensics for BKD’s Forensics & Valuation Services division. Lanny is an EnCase® Certified Examiner (EnCE) and Cyber Threat Forensic Investigator (CTFI), and is a frequent speaker and writer on data mining and digital forensics, including contributions to university textbooks and the Association of Certified Fraud Examiners’ Fraud Magazine.  He also is an adjunct professor in the Master’s in Data Science Program at Rockhurst University, Kansas City, Missouri. Lanny is also the developer of several proprietary artificial intelligence technologies used by BKD to investigate fraud, and identify risk in organizations.

1:00 pm – 1:50 pm

Monday

The View from Washington: AHA Political & Legislative Update

Course: 180411| CPE: 1.0| Level: Entry| Prerequisites: None

This presentation will provide an overview of federal level activity that impact the hospital field, including the political environment, key bills, and AHA advocacy and outreach efforts. Attendees should include those who are employed by or work with the hospital field. They will benefit from a timely update of politics and policies that could impact their workplace.

ay a role in the revenue cycle from Billing Representative to Chief Financial Officer, and will provide an appreciation of why black holes are so common today and some recommendations on how to prevent this revenue leakage.

Megan Cundari, Senior Associate Director – Federal Relations, American Hospital Association
Megan has been a member of the Federal Relations department at the AHA since 2001 and has been lobbying Congress for the last fourteen years.  In addition to advocating the full range of AHA’s legislative and regulatory agenda, her specific issue areas include Medicaid and the Children’s Health Insurance Program (CHIP).  Prior to her work at the AHA, she spent five years in campaign politics, working for a Chicago-based political consulting firm.  She graduated from the University of Illinois, Urbana-Champaign, where she majored in political science and economics.

John Hawkins, Senior Vice President – Advocacy & Public Policy, Texas Hospital Association

John M. Hawkins is the senior vice president of government relations for the Texas Hospital Association.  He is responsible for managing all aspects of THA’s state and federal advocacy efforts before the Legislature and regulatory agencies.

Before joining THA, Hawkins served as a senior policy analyst for the Texas Sunset Commission, where he managed the performance reviews of state agencies.  Hawkins also served as a legislative aide in the House of Representatives for two legislative sessions and worked as legislative liaison for the Texas Department of Information Resources for three sessions.

1:50 pm – 3:05 pm

Monday

What Were They Thinking? An Update on the Current State of Healthcare Fraud and Abuse Enforcement   

Course# 180412 | CPE:1.5 | Level: Intermediate | Prerequisites: None

Fraud and abuse continue to plague the U. S. healthcare system and the dollar amounts often are significant. Government enforcement efforts are increasing and enforcement continues to be a national priority of the Department of Justice, especially in Texas. The U. S. Attorney’s offices in both Dallas and Houston have federal strike forces dedicated to health care fraud.

The presentation will focus on a discussion of recent cases and actions, positions taken by the Department of Justice, hot button issues, types of providers at risk, and questions to ask yourself when contemplating new ventures.

 

Barrett Richards, Member, Frost Brown Todd LLC

Barrett Richards has more than 30 years of experience representing providers in the business, financial, and regulatory aspects of the delivery of health care. His clients range from sole practitioners to multi-hospital organizations, and include direct providers as well as indirect, such as pharmacies, durable medical equipment manufacturers and suppliers, and health care staffing and employee leasing companies. He advises clients regarding taxation and exemptions; hospital physician joint ventures; contracting; and health care real estate transactions.

Mr. Richards is the only lawyer in Texas who is board certified in both Health and Tax Law by the Texas Board of Legal Specialization.

3:20 pm – 4:10 pm

Monday

Behavioral Health   

Course 180413| CPE: 1.0 | Level: TBD | Prerequisites: None

More information coming soon

4:10 pm – 5:25 pm

Monday

Keynote Session: Building High-Value Care Bridges

Course: 180414 | CPE: 1.5 | Level: Intermediate| Prerequisites: None

In this presentation, Dr. Chris Moriates, Assistant Dean for Healthcare Value – a first of its kind position at a medical school – will describe emerging work at Dell Medical School at The University of Texas at Austin and around the country to teach and engage clinicians in healthcare value. Dr. Moriates will introduce the brand new interactive and adaptive Dell Med Value-Based Health Care (VBHC) modules, which are freely available online for learners of all levels. He will also describe tools developed at other institutions to integrate VBHC into training environments and to engage trainees in value improvement activities. He will highlight the importance of bridging educational and clinical environments and creating a high-value care culture.

Dr. Chris Moriates, Assistant Dean for Healthcare Value and an Associate Professor –  Department of Medicine at Dell Medical School, UT Austin.

Dr. Moriates co-authored the book Understanding Value-Based Healthcare (McGraw-Hill, 2015). He led the creation of the University of California at San Francisco (UCSF) Cost Awareness curriculum for internal medicine residents. He is a founding editor for the “Teachable Moments” series in JAMA Internal Medicine. He is also the Director of Implementation Initiatives at Costs of Care, a global non-profit organization curating clinician insights that drive better care at lower cost. He speaks internationally on topics related to educating clinicians about healthcare value and how to implement high-value care programs.

6:00 pm – 9:00 pm

Monday

Maggie Mae’s Reception

Monday, April 23 @6:00pm – 9:00pm

Tuesday, April 24, 2018

8:00 am – 8:50 am

Tuesday

Driving Success with Transparent KPI Targets

Course 180413 | CPE: 1.0 | Level: Intermediate | Prerequisites: None

I will cover the transparent approach used to reduce backlogs that resulted all in all-time record low metrics with DNFB, CFB, Open Denials, Claim Edit days, and Coding Days that resulted in record cash months.

Connor Burdine, Executive Director – Revenue Cycle Analytics, MD Anderson Cancer Center
Leader who is passionate about improving inefficiencies in healthcare through demonstrating where “waste” exists and educating constituencies about the return on investment of changes across clinical, revenue cycle, and research disciplines.  18 years healthcare experience covering patient advocacy, clinical, and access and revenue cycle responsibilities.   14 year’s experience at MD Anderson Cancer Center serving in clinical operations and finance divisions.

8:50 am – 10:05 am

Tuesday

Payor Panel

Course: 180416| 1.5 CPE | Level: TBD | Prerequisites: None

More details on this session to come.

Moderator:

W. Stephen Love, President & Chief Executive Officer, Dallas-Fort Worth Hospital Council
Mr. Love is currently President and Chief Executive Officer of the Dallas-Fort Worth Hospital Council which promotes collaboration, cooperation and advocacy on behalf of its 90 member hospitals.  The Hospital Council also has approximately 100 Associate Members (business and industry), including prominent accounting, legal and consulting firms.  The primary mission is to promote patient safety, quality healthcare and coordination in the delivery of healthcare within the North Texas market.  He served as 2015 Chair for the Conference of Metropolitan and Regional Hospitals Association in the United States.

Panelist:

Jeffrey Cook, Texas Health – Aetna

Panelist:

Shara McClure, Divisional Senior Vice President, Texas Health Care Delivery, Blue Cross and Blue Shield of Texas

Shara McClure is divisional senior vice president (DSVP) of Texas Health Care Delivery at Blue Cross and Blue Shield of Texas (BCBSTX). She is responsible for Provider Network Management and Operations for BCBSTX’s group, government, and retail products. Based in Richardson, Shara leads the efforts across all product segments to develop and implement provider contracting and service strategies to ensure competitiveness, contain unit cost, improve member access, and add value through alternative payment systems.

Panelist:

LaMonte Thomas, President, North Texas and Oklahoma, Cigna

LaMonte Thomas became Cigna’s president and general manager for North Texas and Oklahoma in January 2012. In this role, he serves as the senior leader for Cigna’s operations, competitiveness and market growth in the region, and he helps to provide access to quality care for Cigna customers. His responsibilities include enhancing customer satisfaction through personalized service; helping to improve quality of care by working in collaboration with area heath care professionals; assisting clients to improve the health and productivity of their workforces; and leading Cigna’s community service efforts. Thomas has over two decades of experience in the health care industry. At Cigna, he has held roles in human resources, sales operations and sales management. Most recently, prior to returning to the Dallas/Fort Worth area, he served as Cigna’s sales manager in Richmond, Virginia. Prior to joining Cigna, he held roles in finance, audit and operations.
In the workplace, Thomas has created a culture that values the ideas, contributions and energy of each Cigna employee. He encourages employees to be active in the Dallas/Fort Worth community where they work and live, which is reflected in the company’s strong participation in community events such as the March of Dimes walks for healthy babies

10:20 am – 11:10 am

Tuesday

Population Health: As a Consumer Driven Business Model

Course: 180417| CPE: 1.0 | Level: Intermediate | Prerequisites: None

As Hospital based IDN’s continue to struggle to make the traditional business model succeed, making the pivot to population health management as a business model, and operationalizing the required infrastructure, is imperative. This course describes the rationale and building blocks required to fully leverage the primary care physician and post acute networks to respond to the rapidly changing payer, employer and consumer driven environment.

Course Objectives:
Understand the Post Macra Business Drivers, Understand Advanced Alternative Payment Models, Understand Population Health Management as a Business Model, Understand Consumer Drivers in the Business of Population Health.

A. David B. James, MD, JD, CPA, SVP & CEO, Memorial Hermann Medical Group & Post Acute Services

 

11:10 am – 12:00 pm

Tuesday

General Session: TBA

Course :180418 | CPE: 1.0 | Level: TBD | Prerequisites: None

More details on this session to come.

Dr. Ed Niewiadomski, MD, President, PAOC

An accomplished physician with over three decades of experience in direct patient care and healthcare administration, Dr. Niewiadomski brings a wealth of knowledge to Physician Advisor On-Call, LLC.
Dr. Niewiadomski is Founder and President of Physician Advisor On-Call, LLC, a healthcare consulting company that provides state-of-the-art seamless, remote Physician Advisor services to Hospital/Healthcare Systems. Combining the clinical expertise of experienced Physician Advisors with an advanced Information Technology platform, PAOC delivers a full array of Physician Advisor services to complement current PA staffing models. Dr. Niewiadomski has twenty years in Hospital Leadership in the capacity of Senior Vice President and Chief Medical Officer.  After a distinguished career in Internal Medicine, in 1994 he was appointed Corporate Vice President for Medical Affairs/CMO and served as interim Vice President for Operations at Robert Wood Johnson University Hospital at Hamilton. In 1996, he took on the additional role of President and CEO at Robert Wood Johnson Medical Associates at Hamilton, P.A., and followed that with an opportunity to serve as Vice President of Medical Affairs and Chief Medical Officer at Cape Regional Medical Center and President of Cape Shore Medical Associates, P.A. in Cape May Court House. Dr. Niewiadomski has recently completed a five-year association with Southern Ocean Medical Center as SVP, Chief Medical Officer.
In addition to his healthcare administrative responsibilities, Dr. Niewiadomski has been a champion for access to healthcare for the undeserved population. He was appointed by Governor Corzine to serve on the “New Jersey Healthcare Access Study Commission”.  Dr. Niewiadomski has been voted NJ Monthly Magazine’s Award “Top Doctor 2011.”

12:00 pm – 12:15 pm

Wrap up and Giveaways