7:30 am Breakfast & Registration
8:10 am The Credits and Debits of Conflict Management in Healthcare
Course: 1702J01 | CPE: 1.0 | Level: Entry | Prerequisites: None
In this session, participants will be equipped to engage others in moments of conflict with skills and understanding that will produce agreement and, most often, mutual benefit. This topic is essential to any organizational leader in their daily interactions with administrators, peers, employees, outside vendors, patients, and patients’ families.
Conflict is present in every part of our lives. Even though financial matters may seem far from the trauma center, surgical suite, and hospital room, the healthcare financial professional is faced daily with challenges that are intensified by the healthcare environment. This session will include the following elements:
- Conflict’s components and why it dominates our attention
- Ways to separate your personal feelings and emotions by developing empathic approaches to confrontation
- Practical methods for opening conversation and moving to closure.
- Evidence of the value of collaborative conflict management, along with the costs
Joe L. “Joey” Cope is Executive Director for Duncum Center Solutions (a THA Endorsed Company) and an Associate Professor in Conflict Resolution at Abilene Christian University. He has served as adjunct professor at the Pepperdine University School of Law in Malibu, California, the Bowen School of Law in Little Rock, Arkansas, and the Center for Dispute Resolution and Conflict Management at Southern Methodist University.
Cope is past chair of the State Bar of Texas Alternative Dispute Resolution Section. He serves on the board of the Texas Mediator Credentialing Association and is coauthor of West Publishing’s “Texas Practice Guide: Alternative Dispute Resolution.”
9:00 am Obtaining Physician Engagement
Course: 1702J02 | CPE: 1.0 | Level: Intermediate | Prerequisites: None
Many experts in healthcare are encouraging greater collaboration between physicians and various organizations – a seamless approach. But, engaging phsicians in organizational goals remains elusive.
This course will breakdown the meaning of physician engagement, discuss current obstacles and the various methods that can be used to increase engagement.
Brent D. Magers has more than 35 years of experience in the health care industry. In his current role, he is responsible for all aspects of Texas Tech Physicians, a multi-specialty academic practice plan comprised of more than 250 physicians and 250 residents associated with the Texas Tech University Health Sciences Center (TTUHSC) School of Medicine. In addition to working with the chairs of 13 clinical departments on care delivery, with whom he shares a supervisory matrix relationship for each of the individual department administrators, Brent also supervises all central service departments, such as the Business Office, GE Centricity (IDX) System, Cerner Electronic Health Record, Patient Satisfaction, Managed Care Contracting, Nursing Services, Infection Control, Accreditation, Performance Improvement, and Volunteers. He also serves as the Executive Director of Texas Tech Physicians Associates – an organization that conducts business on behalf of the regional campuses of the TTUHSC Medical School and the TTUHSC Paul L. Foster Medical School in El Paso. During his time with Texas Tech Physicians, it has consistently increased its collections and is in the top-tier for revenue growth as ranked by the Association of American Medical Colleges, improved its patient satisfaction, as measured by the Press-Ganey organization, from the lower quartile to the upper quartile, and started participation in several quality improvement initiatives, including the Centers for Medicare and Medicaid Services’ Physician Quality Reporting System.
9:50 am Break
10:00 am Healthcare Compliance; Protecting and Preparing for Success
Course: 1702J03 | CPE: 1.0 | Level: Intermediate | Prerequisites: None
This session will provide a brief overview of healthcare trends, a review of recent government enforcement efforts and a discussion of lessons on how to prepare for a government inquiry
- Understand the evolving nature of healthcare
- develop an awareness of the level of government enforcement efforts and recoveries
- learn practical lessons on how to respond to a government inquiry
Hospitals, health systems, physician practices and other healthcare providers throughout Texas rely on Fletcher Brown for assistance with operational and regulatory issues ranging from contract negotiations to Stark and anti-kickback compliance. Fletcher is Martindale-Hubbell AV Preminent rated and recognized by Chamber USA as a leader in Texas health law, and widely respected for his precendent setting work with the Texas Medicaid 115 Waiver which helped more than 45 healthcare providers receive additional funding to expand risk based managed care statewide.
10:50 am Initial Validation Audits – What Are They and Why Should We Care?
Course: 1702J04 | CPE: 1.0 | Level: Intermediate | Prerequisites: None
The Affordable Care Act (ACA) requires qualified commercial health plans to retain an independent Initial Validation Auditor (IVA) to validate member risk adjustment data in accordance with the Department of Health and Human Services (HHS) Risk Adjustment Data Validation audit program. This includes non-grandfathered individual and small group market plans, inside and outside the Exchange.
The presentation will be an overview of the IVA process including provider documentation requests and requirements for an IVA to audit provider coding and enrollee demographics The presentation will highlight and focus on the following:
- Definition of an IVA entity
- The requirements of an IVA
- Definition of Hierarchical Condition Categories (HCCs)
- The importance of enrollee and demographic information submitted on claims
- The importance of accurate coding and documentation
- Definition of face-to-face encounters
- The differences between initial validation audits and regular Medicare or CERT audits
The presentation will also focus on the completion of the pilot year of HHS’ initial validation audits and lessons learned from an IVA perspective.
Previously a System Director of Utilization Review and Revenue Integrity, Paula has 20 years of experience in documentation, charge capture, coding and billing for both hospital and physician services. She assists hospital and physician practice clients in increasing their net revenues through improved documentation, revenue cycle operations, and revenue integrity practices. Paula assists clients with denial prevention efforts by assessing physician documentation and utilization review processes.
Paula provides ICD-10-CM and CPT-4 coding and documentation compliance reviews and training on Medicare’s Inpatient Prospective Payment System (IPPS) and Outpatient Prospective Payment System (OPPS).
She provides education to both clinical and physician staff on current and changing regulatory guidance and revenue cycle topics. Paula is a member and presenter for regional meetings of the Healthcare Financial Management Association (HFMA) and American Health Information Management Association (AHIMA). Paula is on the education committee of the Texas Association for Healthcare Financial Administration (TAHFA). She previously served as a director on the board of the Arkansas Chapter of HFMA. Paula is a Registered Health Information Administrator (RHIA).
11:40 am Lunch & Networking
12:30 pm Management Liability Policies: How Do They Provide Protection for Healthcare Executives and Healthcare Systems
Course: 1702J05 | CPE: 1.0 | Level: Entry | Prerequisites: None
This course will provide a description of Cyber Liability, Crime Coverage, Kidnap & Ransom, Directors & Officers Liability, and Employment Practices Liability Insurance Coverages and provide multiple claims examples for each coverage.
- Educate hospital professionals on the topic of management liability insurance
- Show the benefits provided by management liability insurance to the financial health of the hospital.
Lori began her career in insurance in 1990. She has spent the past 26 years specializing in Directors & Officers Liability (nonprofit, private and public), Employment Practices Liability, Fiduciary Liability, Crime Coverage, Kidnap & Ransom, Cyber Liability and Errors & Omissions Liability coverages. She has worked as a senior level broker for Johnson & Higgins and Jardine Lloyd Thompson (USA) and as a regional underwriting manager for AIG, Kemper, and Ace. In October 2011, Lori joined the Wortham Insurance Professional Indemnity practice where she handles accounts across multiple industry groups. Lori is also frequent guest lecturer for the Risk Management department at the University of Houston Bauer College of Business. She is a graduate of Baylor University and received her BBA in Management and Administrative Information Systems.
1:20 pm Eligibility and Point of Service Collection Practices That Work
Course: 1702J06 | CPE: 1.0 | Level: Intermediate | Prerequisites: None
This Course provides an analysis of the need for and benefits of an Eligibility and Point of Service Collections Program, as well as a discussion of the practices that work to achieve those benefits.
Douglas Turek has worked in healthcare Revenue Cycle Management since 2001 and is currently the Senior VP of Regulatory and Governmental Affairs for MedData. MedData provides a broad range of revenue cycle services to hospitals and physicians including coding, billing, eligibility, reimbursement and first party collection efforts. Doug is an attorney that has been licensed in Texas for 22 years and is also licensed in 9 other states. His law firm, The Turek Law Firm, PC, handles a broad range of healthcare consulting and litigation matters including third party liability, denials and other types of reimbursement litigation for healthcare clients across the country.
2:10 pm Break
2:20 pm Voyage or Destination – The Direction of Healthcare Finance and Reimbursement?
Course: 1702J07 | CPE: 1.0 | Level: Intermediate | Prerequisites: None
An overall update to the Healthcare Financial and Reimbursement Matters currently impacting Hospitals. We will focus on new guidance and legislation in relation to the Medicare / Medicaid Cost Report, UC and DSH reporting, and “Provider Based” matters, as well an update on the 1115 Waiver and Medicaid supplemental payments.
Target Audience: Hospital CEO, CFO, Business Office and Accounting Staff representatives.
- Provide an update to the Reimbursement and Medicare/Medicaid Certification Matters impacting hospitals
- Provide an update to the 1115 Waive and future of State Supplemental Payment Programs.
Brent has in excess of 25 years of experience in Medicare / Medicaid reimbursement for acute care hospitals, cancer hospitals, academic medical centers, and many other specialty health care providers. Prior to his current position, Brent was the Regional Director of Field Audit Offices for Trailblazer Health Enterprises, the former Medicare Administrative Contractor for the South Central US. His area of responsibility included Medicare cost report and audit services for the Trailblazer offices located in Texas, New Mexico, and Colorado. While with Trailblazer, Brent was also periodically assigned to the Office of Inspector General (OIG), for various health care investigative audits. Brent led many audits dealing with the highly complex and technical issues, including issues of graduate medical education, organ transplants, and disproportionate share; but also worked with more traditional cost based reimbursement theory, as critical access hospital reimbursement and other rural hospital concepts. Brent now has more than 10 years on the consulting side working with hospitals and healthcare facilities, managing Durbin and Co. / DHCG’s reimbursement reporting and various reimbursement analyses, ranging from hospital cost report completion and strategic models, reopenings and appeals, to special reimbursement analysis and projects for both Medicare and Medicaid funding opportunities. Brent has also participated in speaking engagements for several healthcare advocacy groups. Brent is a CPA and a partner in the firm.
Mark is a Partner in Discovery Healthcare Consulting Group and has been with the Group for 9 years. Mark has over 30 years of healthcare experience. Mark’s experience consists of hospital financial and operational management as well as physician employment. He has over 9 years of experience in not-for-profit settings and over 13 years working in the for-profit arena. He has held various CFO positions ranging from surgical hospitals, rehab hospitals, acute hospitals to holding a regional CFO position managing 14 rural hospitals for a not-for-profit system. Mark provides various consulting and interim assistance to hospitals, working to strengthen their internal reporting and system development. Mark operates Discovery Medical Network, a physician employment organization that provides employment options for physicians in rural areas employing around 150 providers.
3:10 pm Revenue Portfolio Design and Care Transformation or How I Learned to Love Bundles
Course: 1702J06 | CPE: 1.0 | Level: Intermediate/Advanced | Prerequisites: None
In this course, we will introduce the concept of Revenue Portfolio Design and it’s use in Transformational strategy development. We’ll discuss the impact of Episodic Payment Models and present lessons learned from over 100 clients currently managing episodic payments.
- Introduce the concept of Revenue Portfolio Design and it’s important as a strategic initiative
- present a case study from a client that has implemented the Revenue Portfolio Design methodology
- present findings and data from clients that are currently managing episodic payments.
As a principal with DHG Healthcare, Bill currently acts as the firm’s practice leader for the Healthcare Alternative Payment Model Practice. He also serves as the Partner in Charge for the Healthcare practice in the Southwest.
His professional career spans over 30 years in the healthcare industry, and he is a member of DHG’s Healthcare Steering Committee. At DHG Healthcare, he led the development of the Revenue Cycle and Compliance practice and was instrumental in developing the firm’s thought leadership and approach related to Risk Capability and revenue transformation. Bill regularly assists his clients in navigating the challenging and difficult transition to alternative payment models and is a highly regarded and sought-after speaker on topics such as: “Revenue Portfolio Design for Healthcare Providers”; “Transparency in Healthcare Pricing”; as well as other topics related to the ongoing transformation in the industry. Through his expertise and industry experience, Bill continues to be actively engaged in leadership initiatives at DHG Healthcare.
4:00 pm Closing
5:30 pm – 7:30pm Early Bird Networking & Happy Hour with Cash Bar
Overton Hotel & Convention Center
2322 Mac Davis Lane
Lubbock, TX 79401