7:30am – 8:30am Registration & Breakfast
8:00am – 8:50 am MACRA, Analytics and the Move from Volume to Value
Course: 1702J01 | CPE: 1.0 | Level: Intermediate | Prerequisite: None
Advances in technology have provided healthcare organizations with a myriad of disparate systems from which to get information. While the volume of data has grown exponentially in recent years, the availability and access to that data has dropped at the same alarming rate. Consolidation within the healthcare industry has only exacerbated the problem by creating organizations that have multiple clinical, financial and operational systems and as many reporting and analytic tools. Regulatory compliance requirements such as MACRA have contributed to make this a “Perfect Storm” for analytics in the healthcare industry.
Improving the US Health system requires simultaneous pursuit of three aims: improving the experience of care, improving the health of populations and reducing the per capita costs. Analytics are the key to enabling and achieving the Triple Aim.
During this session, a brief overview of the proposed rule, timing for the final rule, and implementation timelines will be discussed. A list of topics will be covered relating to Cost and Quality Analytics, Resource Use, Clinical Performance Improvement Activities, Advancing Care information and additional considerations.
After attending this webinar, attendees will be able to:
- Consider the steps involved in analyzing performance
- Ascertain MACRA and the Triple Aim components, provisions and timing relating to the proposed rule
- Understand key concepts and specifications for the MIPS composite
- Ascertain detailed considerations relating to the performance categories
William has over 28 years of experience in the healthcare industry and has specialized in enterprise applications and technology solutions since 1992. He provides specialist product expertise and develops and executes solution strategies for the Healthcare Finance market. Prior to joining Oracle, William was a former Chief Financial Officer of a 350 bed acute care hospital.
8:50am – 9:40 am Achieving Health Equity Through Diversity & Inclusion Strategies with Metrics and Incentives
Course: 1702J02 | CPE: 1.0 | Level: Intermediate | Prerequisite: None
In this course we will discuss strategies utilized in order to promote Equity of Care. The main areas discussed will be Diversity & Inclusion, Cultural Competent Care, Community Partnerships and Population Health. Combining these four strategies are a powerful offense strategy.
After attending this session, attendees will:
- Understand Health Disparities in our communities
- Discuss strategies to address barriers when caring for diverse communities
- Understand cultural competence strategies when shaping community programs
- Discuss metrics and incentives to measure impact and gain support
Marcos Pesquera is the System Vice-President for Health Equity, Diversity & Inclusion at CHRISTUS Health. CHRISTUS Health is an international Catholic, faith-based, not-for-profit health system comprised of almost 350 services and facilities, including more than 60 hospitals and long-term care facilities, 175 clinics and outpatient centers, and dozens of other health ministries and ventures; with the mission to extend the healing ministry of Jesus Christ. In this capacity he leads the integration of D&I strategies, cultural competence and community partnerships to impact population health and achieve health equity.
Prior to joining CHRISTUS Health, Marcos was the Executive Director of the Adventist HealthCare Center for Health Equity and Wellness. Adventist HealthCare, an integrated health care delivery organization based in Maryland. In this capacity, Mr. Pesquera created and implemented initiatives that eliminate barriers to enable health equity in health status, health care access, treatment, and outcomes within the health care system and the community.
9:40am – 9:55 am Refreshment Break
9:55am – 11:10 am How to prevent a Cyberattack from Crippling your Organization
Course: 1702J03 | CPE: 1.0 | Level: Intermediate | Prerequisite: None
Cyber threats are continuously evolving and healthcare organizations have been under siege by hackers due to the highest per-record value of any industry. Post-breach recovery costs are crippling profitability. This course will provide an overview of healthcare security risks and explain how finance executives can act as security champions by proactively investing in cybersecurity. As risk mitigation is a journey, Zecuris will provide best practices to keep up with emerging threats and achieve HIPAA compliance.
- Provide an overview of major security threats facing Healthcare industry
- Present unique security challenges and how to address the challenges
- Discuss how security risks and compliance issues are evolving as game changers in Mergers and Acquisitions
- Highlights from the Office for Civil Rights’ Cyber Security Wall of shame
Sathish is a cyber security consultant and cofounder of Zecuris. He cofounded Zecuris, to deliver cyber care solutions primarily for Healthcare providers. He led several initiatives to promote cyber security awareness in different Medical forums. He advises Healthcare providers on their risk profile and partners with them to act against cyber threats proactively. Prior to joining Zecuris, he developed partnerships within Managed Security Service Provider (MSSP) domain for Ericsson Inc. He architected a mobile security solution for Telecom operators in US. Sathish earned a M.B.A with Distinction, from University of Michigan – Stephen M. Ross School of Business. He also holds Bachelor’s degree in Electronics Engineering from Bharathiyar University, India.
Adam Laughton is a Senior Associate in the Corporate department of Seyfarth Shaw LLP’s Houston office. His practice focuses on providers and entrepreneurs in the healthcare industry.
Mr. Laughton has served many types of providers within the healthcare system, including facilities, physicians and other professionals, and ancillary service providers such as pharmacies and laboratories. He also works with start-up ventures, entrepreneurial individuals and groups, and provider joint ventures. He has been responsible for a wide variety of matters, including mergers and acquisitions among providers and facilities, False Claims Act litigation, regulatory and compliance counseling and reimbursement disputes and appeals.
11:10am – 12:00 pm Stop Waiting Days. Get Answers in Minutes
Course: 1702J04 | CPE: 1.0 | Level: Intermediate | Prerequisite: None
As value-based care and the patient experience moves to the forefront of medical care, processes associated with patient satisfaction, enhanced yield and various administrative functions need to be addressed in the most efficient manner possible. As a result, emphasis has moved toward an even more enhanced level of consumer-driven healthcare. As consumers become more engaged with their selection of healthcare services, it is important to encourage a culture that supports this movement within a healthcare system, which allows providers and payors to be at the forefront of providing innovative services to the patient segment of the healthcare market. These innovated services will enable healthcare providers and payors to offer even more enhanced services and related processes that will ensure patients have completely transparent knowledge of each of these environments.
This course will:
- Identify and understand the factors creating tremendous pressure on payors and providers.
- Gain a deeper understanding of “yield” and related factors, which impact yield.
- Seven strategies to enhance your revenue cycle.
Brad Cross is a Healthcare and Technology Leader consulting with Hospital Leadership teams for over 18+ years developing strategy and process design, improving hospitals performance and profitability through Revenue Cycle, HIM, and IT design and process flow. Brad joined Availity in 2014. He earned his BBA at University of West Georgia and Georgia Institute of Technology, also holds an Associate Degree in Emergency Medicine.
12:00pm – 12:45 pm Lunch & Networking
12:45 – 1:35 pm Initial Validation Audits – What are they and why should we care?
Course: 1702J05 | CPE: 1.0 | Level: Intermediate | Prerequisite: 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).
Paula is a graduate of Arkansas Tech University, Russellville, with a B.S. degree in health information management.
1:35pm – 2:25pm Accounting Update – It is What it is Except When it Changes
Course: 1702J06 | CPE: 1.0 | Level: Intermediate | Prerequisite: None
New revenue recognition standards, new lease accounting standards, M&A considerations for healthcare companies, and other related topics.
- Explain the new standards for revenue recognition and leases and compare to the prior standards
- Discuss applicable M&A topics and strategies as they apply to the healthcare industry
Brandy Arbuthnot has more than 16 years of tax compliance and consulting experience.
She focuses her practice on preparing and reviewing federal and state tax returns for corporations, partnerships and individuals, including consolidated corporations and S corporations. Brandy also has extensive experience preparing and reviewing deferred tax calculations for a variety of clients, including public companies. She also provides clients with Internal Revenue Service (IRS) examination support and settlement of tax controversy matters.
Kevin Olvera, Assurance Partner, BDO USA, LLP
Kevin Olvera has 13 years of audit and assurance experience in the healthcare industry. His clients include companies in ancillary services, imaging, pharmacy, and durable medical equipment, as well as surgical centers, physician groups, hospitalists, specialty hospitals, long-term acute care hospitals, home care and hospice centers, and other service providers. He also has specific healthcare experience assisting clients with initial public offerings and other public filing requirements.
Kevin has extensive experience with the financial and internal control audits of private equity–sponsored and public healthcare companies. He is also experienced in preparing financial statements and compliance reports in accordance with generally accepted accounting principles (GAAP), Securities and Exchange Commission (SEC), Public Company Accounting Oversight Board (PCAOB) and Sarbanes-Oxley requirements. Kevin works with clients to identify, recommend and implement accounting and internal control improvements for management based on analyses of company operations, policies and procedures.
Kevin also serves as an instructor and course developer for BDO’s national continuing professional education (CPE) conferences and has spoken at BDO’s CPE events on such topics as the Affordable Care Act, leadership and technical accounting issues. Kevin recently completed BDO’s leadership program.
2:25pm – 2:40pm Break
2:40 – 3:30 pm 340B Program Overview and Compliance Techniques
Course: 1702J07 | CPE: 1.0 | Level: Entry | Prerequisite: None
This presentation has been designed to discuss compliance needs and best practices for covered entities in the 340B Drug Pricing Program. We discuss the program at a high level, current Office of Pharmacy Affairs audits, and developing internal audit techniques.
After attending this course, attendees will understand:
- 340B Drug Pricing Program Overview
- Compliance Considerations
- Independent Audit Expectation
- HRSA Site Visits and 340B Audits
- Mega Guidance
- Success Stories
Working as a member of the BKD National Health Care Group, Catherine provides specialized consulting services to Community Health Centers (CHCs) receiving federal grant funding under Section 330 of the Public Health Service Act (PHS Act) and organizations participating in the 340B Drug Pricing Program.
Catherine frequently assists clients with the preparation of numerous types of federal reports and budget submissions as well as the review, analysis and audits of 340B programs and contractual relationships. In addition, she provides training to help organizations to aid in compliance with federal regulations, including the Uniform Guidance (2 CFR § 200) and Section 330 of the PHS Act.
3:30pm – 4:30 pm Reception
*Please note: Speaker and Topic information may change