8:00 am – 8:50 am
Driving Success with Transparent KPI Targets
Course 180413 | CPE: 1.0 | Level: Intermediate | Prerequisites: None
This session 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
Connor is a 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
Course: 180416| 1.5 CPE | Level: TBD | Prerequisites: None
This panel will discuss and analyze the current and future status of health insurance marketplace enrollment, carrier participation and outlook for 2018-2019.
We will also discuss medical group plan insurance trends, pharmaceutical costs and reimbursement by insurance plans. We will examine the higher deductible plans and the impact on provider bad debt expense currently and in the future.
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.
Jeffrey Cook, CEO, Texas Health – Aetna
Jeff Cook serves as CEO of the Texas Health Aetna joint venture. He reports directly to the Texas Health Aetna joint venture board of directors and is integral to the overall success of the new health plan company.
Most recently, Cook served as national vice president of insurance and value-based strategy and reimbursement for Ascension Health. While at Ascension, Cook managed the insurance and value-based strategy for seven health plans, 20 Accountable Care Organizations, 145 hospitals and 6,000 employed physicians across the U.S.
Concurrently, Cook served as president and chief executive officer for Seton Insurance Services, Seton Health Alliance and Seton Health Plan. In that role, he was responsible for Seton’s managed care, accountable care organization, health plan, community insurance, charge master pricing and hospital case management.
Prior to these positions, Cook served as vice president, managed care and pricing strategies, for Seton Healthcare Family, and as chief executive officer of United Healthcare in Central Texas.
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.
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 – 11:10am
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.
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
11:10am – 12:00 pm
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