First Illinois HFMA Fall Summit 2019

Agenda

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  • Tuesday, October 22, 2019
  •  

    Registration

    7:00 AM  -  8:00 AM
    Registration, Networking, and Continental Breakfast
     Optional 
     

    Breakout Session

    8:00 AM  -  9:00 AM
    Consumerism: How Can Improving The Consumer/Caregiver Experience Improve Your Bottom Line?

    Key market shifts continue to necessitate a change in how providers approach consumer experience strategies. Healthcare is requiring the same approach to consumer experience that you find at Four Seasons, Disney and Apple. In this session, you'll hear how Banner Health began applying these best practices to transform their patient and caregiver experience, increasing their Net Promoter Score (NPS) and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and its direct correlation to operational and financial outcomes.


    Learning Objectives

    • Understand why surveys are not enough to make a meaningful, long term impact.
    • Learn how to gather and act on "signals,” not just direct feedback
    • Use consumer and caregiver feedback and signals to fuel the next innovation (operationally, clinically, and in the care delivery process) and to remain competitive.



     Optional 
    8:00 AM  -  9:00 AM
    Data Analytics
    Session information coming soon
     Optional 
    8:00 AM  -  9:00 AM
    Revenue Cycle: Registration and Billing - Automation and Streamlining

    Learning Objectives

    • Learn how Northwestern Medicine has begun the process of automating many payor plan mapping issues from both an Electronic Data Interchange (EDI) and plan registration perspective.Philosophy of not touching every account and where can automation make sense in claims submission?
    • Understand clearinghouse objectives in clean claim submission.
    • Learn ways that automated payor mapping can help reduce denials.
    • Understand the collaborative approaches between revenue cycle, patient access, and clearinghouse

     

    Tools & Takeaways

    Northwestern Medicine has a very unique EDI process for generic or commercial payors.  Session participants will learn about  potential takeaways when dealing with Third-Party Administrator (TPA) denials and dealing with situations where the payor is just adjudicating.

     Optional 
     

    General Session

    9:00 AM  -  9:10 AM
    Welcome and Opening Remarks

    Welcome & Opening Remarks - Lana Dubinsky, 2019-2020 First Illinois HFMA Chapter President 

     

    Speakers:
    9:10 AM  -  10:10 AM
    A New Frontier—Healthcare Price Transparency in 2020 and Beyond

    Consumer expectations and government regulations are demanding greater price transparency in healthcare. HFMA has formed a Chargemaster Alternative for Medicare Payment (CHAMP) committee to explore the feasibility of a system devoid of charges. Implications and requirements will be reviewed. Attendees will also learn how to implement and maintain an innovative, transparent, rational and defensible pricing strategy.


    Learning Objectives

    • Understand current environment and significant government pricing transparency policy changes.
    • Review the HFMA Price Transparency recommendations and the CHAMP committee, including implications for a future state
    • Learn how to implement and maintain an innovative, transparent, rational and defensible pricing strategy.
     

    Break

    10:05 AM  -  10:30 AM
    Networking and Refreshment Break
     

    General Session

    10:30 AM  -  11:20 AM
    The Evolution of Health Care—Where We Are and Where We Are Going

    Dr. Clarke will discuss insights he has gained from over 45 years working in healthcare finance, including serving as a Chief Financial Officer, President and CEO of the Healthcare Financial Management Association (HFMA), and Board Chair of a large, international Catholic Health System.  He will discuss his observations on the factors that will influence where healthcare will be going during the next five to ten years.

     

    Learning Objectives

    • Understand a context for the forces driving healthcare today and in the future
    • Assess the importance of these changes to the strategic direction of healthcare systems
    • Synthesize the necessary actions for financial executives to thrive in an changing environment
     

    Lunch

    11:20 AM  -  12:20 PM
    All Attendee Lunch – Special Guests – First Illinois Chapter Past Presidents
     

    General Session

    12:20 PM  -  1:20 PM
    Leading with Innovation How to Future-Proof Yourself, Fearlessly Innovate, & Succeed

    How to Future-Proof Yourself, Fearlessly Innovate, and Succeed in the New Normal


    Scott Steinberg, award-winning strategic consultant, trends expert, and professional speaker. 


    Even the most successful organizations must continually reinvent their products, processes and enterprises to remain market leaders in an age of growing change, connectivity and globalization. In this eye-opening presentation, audiences will learn how to thrive in the new operating reality, create competitive advantage, and successfully leverage new leadership strategies to adapt to changing times. From more powerful ways to unleash innovation to solutions for better capitalizing on cutting-edge advancements, discover how you and your organization can flourish in tomorrow's world – and effectively apply its most crucial success strategies and skills in context.

    Speakers:
     

    Breakout Session

    1:20 PM  -  2:10 PM
    Consumerism: Telehealth: Key Adoption Factors, Barriers & Opportunities

    Telehealth, including modalities such as virtual encounters through live video, mobile health, remote patient monitoring (RPM), and store-and-forward technology, offers great promise to provide expanded access to better coordinated, more efficient and more effective healthcare. Expanded uses of telehealth, however, also face substantial challenges, including reimbursement restrictions and other barriers. Our panel will provide an overview of telehealth modalities, uses, trends, projections and drivers, as well as reimbursement restrictions that provide barriers to telehealth and recent reimbursement policy changes making telehealth more attractive. Our speakers will discuss how health systems are using telehealth to provide services such as RPM, teleICU, telebehavioral health, teleneurology, telestroke, chronic care management, transitional care management, as well as return on investment (ROI) considerations.


     Learning Objectives

    • Recognize telehealth modalities, trends, emerging technologies, projections and drivers
    • Recognize telehealth reimbursement restrictions that provide barriers to telehealth as well as recent reimbursement changes that make telehealth more attractive
    • Identify various uses of telehealth to provide more efficient and effective care
    • Identify ROI and related financial implications of recent telehealth arrangements

     

     

     Optional 
    1:20 PM  -  2:10 PM
    Data Analytics: Drug Waste & Optimization: A Deep Dive into JW Modifier

    This session will provide a case study that utilized data analytics to drive meaningful reviews of drug waste charges to identify instances of non-compliance, overbilling, and/or missed revenue opportunity.


     Learning Objectives

    • Describe the elements of compliance associated with billing drug waste with the JW modifier, including commonly misunderstood requirements.
    • Analyze and discuss system configurations to assist with calculating waste and documenting support, as well as common missteps in charging for drug waste.
    • Explain required data points and utilize JW Modifier analysis tool to identify instances of non-compliance and opportunities for missed revenue.

      

    Tools & Takeaways

    Attendees will gain confidence in efficiently monitoring their drug waste charges or how to perform a business case to start charging for drug waste with the JW modifier if not currently doing so.

     

     Optional 
    1:20 PM  -  2:10 PM
    Revenue Cycle: Reforming the Authorization Process

    The healthcare industry relies heavily on labor-intensive manual methods to adjudicate PA with only 12% of the industry using automation to support the PA process according to the 2018 Council for Affordable Quality Healthcare (CAQH) Index report. In addition, according to the 2018 American Medical Association (AMA) survey, broadly applied prior authorization programs impose significant administrative burdens as 86% of providers surveyed indicated their PA burden had increased significantly over the past five years. Finally, even with extensive manual processes in place, providers still experience an impact to revenue as 43% of post service denials are related to inappropriateness of care/services according to a recent analysis by Change HealthCare.

    This industry update will highlight the current initiatives underway to promote standardization, uniformity, and simplified communication between providers and health plan and other industry stakeholders. In addition, we will clarify Centers for Medicare and Medicaid’s (CMS’s) Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging Services status.


     Learning Objectives

    • Review and discuss data from the American Medical Association‘s (AMA’s) Physician Survey on Prior Authorizations, and CAQH CORE’s research on adoption of automation.
    • Explore the industry-wide effort to address prior authorization challenges through current initiatives to promote standardization, uniformity, and simplified communications.
    • Review current status of AUC.

     

     Optional 
     

    Break

    2:10 PM  -  2:25 PM
    Networking and Refreshment Break
     

    Breakout Session

    2:25 PM  -  3:25 PM
    Consumerism
    Session information coming soon
     Optional 
    2:25 PM  -  3:25 PM
    Data Analytics: Advanced Analytics to Model Performance and Manage Outcomes

    With the expansion to risk-based based payment and delivery models, hospitals and health systems are leaning on advanced analytics to model performance and manage outcomes. Financial leaders should be carefully monitoring payer contracts based on quality incentives, annual benchmarks [such as Accountable Care Organizations (ACOs)], bundles or global capitation which challenge the status quo of fee-for-service medicine. Join BKD as we present case studies and best practices for applying advanced analytics under risk-based models. We will discuss how data can be used to forecast performance using historical evidence, engage clinicians and even develop strategies for revenue and enhancement and cost reduction. BKD’s Big Data team will share strategies for developing predictive and prescriptive analytics as well as practical applications for robotic process automation.


     Learning Objectives

    • Define the key metrics under risk-based models
    • Learn how advanced data can be used to forecast performance using historical evidence
    • Understand how data can be used to develop strategies for revenue and enhancement and cost reduction
    • Discuss strategies for developing predictive and prescriptive analytics as well as practical applications for robotic process automation
     Optional 
    2:25 PM  -  3:25 PM
    Revenue Cycle: Optimizing Hospital System Reimbursement Through Home Office Cost Reporting

    This session will provide a case study outlining focus areas for hospital health systems to review and optimize their reimbursement structure. We will discuss areas of a hospital health system that could be influenced by home office cost reporting. Additionally, we will review reimbursement areas that should be considered when reviewing the cost structure of the organization.


     Learning Objectives

    • Discuss the overall structure and flow of the Home Office cost report
    • Identify areas of an organization impacted by home office cost reporting
    • Outline impactful strategies to optimize the overall reimbursement structure of the organization


     Tools & Takeaways

    • Provide a comprehensive view of the major areas impacted by home office allocations
    • Explore meaningful ways that systems can review their home office allocations to optimize reimbursement across their system.



     Optional 
     

    General Session

    3:25 PM  -  4:30 PM
    CFO Panel The Opportunities and Challenges of Stand-Alone Hospitals
    Moderator:
     

    Networking

    4:30 PM  -  5:30 PM
    Connect. Network. Engage
    Connect. Network. Engage. Join us for a networking evening of food, cocktails and fun. You’ll be able to meet with your friends and colleagues as well as our conference partners while trying your luck at our Casino games to win great prizes.
     Optional 
  • Wednesday, October 23, 2019
  •  

    Registration

    7:00 AM  -  8:00 AM
    Registration, Networking, and Continental Breakfast
     

    Breakout Session

    8:00 AM  -  9:00 AM
    Compliance and Risk: Evolving an (ERM) and Using a Unique Control in Risk Mitigation

    An organization’s ability to recognize and mitigate risks early directly correlates to improved resource efficiency and fiscal outcomes.  In this presentation, Northwestern Medicinewill share how it identifies complex risks and a unique addition to senior management’s toolbox to help monitor and validate risks and mitigation efforts. 


     Learning Objectives

    • Understand what ERM means and the related attributes
    • Understand how your organization can evaluate risks and categorize them
    • Learn potential gaps that exist in mitigation
    • Learn about how Northwestern Medicine uses traditional and newly created resources to reduce risk

     Optional 
    8:00 AM  -  9:00 AM
    New Revenue Streams: Population Health Through Value-Guided Care

    Population Health Management (PHM) programs are a strategic component of future state of health care organizations. The goal of PHM programs is to keep a patient population as healthy as possible and minimize the need for expensive hospital services such as emergency department visits, imaging tests, and other preventable procedures. The success of these programs is directly correlated to the successful transition from fee-for-service (by volume) models to fee-for-value (high quality + low resource use cost) models. To accomplish this, savvy health care systems will implement strong data analytics and population health management tools that will report both descriptive data (what was) and predictive data (a range of what is expected) to help optimize future information capture and clinical practices. Health care systems need to evolve to take advantage of the rapidly accelerating use of data analytics and develop improved health care quality practices at a greater value for their patients.


     Learning Objectives

    • Articulate the objectives of Population Health Management (PHM) programs
    • Understand the evolving role of the HIM (Health Information Management) professional in PHM and the power of the data
    • Recognize the skills needed to excel in PHM
    • Articulate the difference between descriptive and predictive analytics as it pertains to the transition from fee-for-service reimbursement models to fee-for-value
     Optional 
    8:00 AM  -  9:00 AM
    Treasury/Finance: Trends in Investment Strategies for Hospitals/Health Systems

    We will explore a relatively new asset class:  Opportunistic Credit (also known as Private Credit).  We will review the typical structure of these funds—a hybrid between hedge funds and private equity funds.  Liquidity, expected return, risk profile and typical holdings will be discussed.  Is there a role for this asset class in your portfolio ?


    Learning Objectives

    • Understand the basics of Opportunistic Credit investing – Fund structure and return expectations
    • Different subclasses under this heading
    • How the asset class can help health care organizations


     Tools/Takeaways

    • What to look for (and look out for) in this asset class
    • Whether this might be appropriate for your institution

    Speakers:
     Optional 
     

    General Session

    9:00 AM  -  9:50 AM
    State of Illinois: Update on Healthcare Legislative and Policy Matters in the Land of Lincoln

    This session is a presentation on the major healthcare legislative and policy issues affecting the health care industry in Illinois and nationally.  The presentation will cover topics such as the role of Medicaid managed care organizations, rural healthcare challenges, workforce, hospital transformation and population health.

     

    Learning Objectives

    • To learn about the national healthcare trends and how they are impacting Illinois hospitals.
    • To learn how the key Illinois legislative issues will affect health care delivery in Illinois.

     

    Tools/Takeaways  

    To have a better understanding of how health policy and state legislation can improve or harm health care delivery and access to care and the role of advocacy organizations in the legislative process.

    Speakers:
     

    Break

    9:50 AM  -  10:20 AM
    Networking and Refreshment Break
     

    Breakout Session

    10:20 AM  -  11:20 AM
    Compliance and Risk: Hot Topics in an Effective Risk Management Assessment

    During this session, participants will learn how to build an effective risk assessment process that will focus their organization on their key risks and processes by leveraging innovative and enabling technologies.

     

    Learning Objectives

    • Identify hot topics and key risks from multiple sources to make sure you are assessing the correct compliance, revenue cycle, financial, information technology, and operational information for your organization.
    • Demonstrate key steps your organization can take to build and perform an effective Joint Compliance and Internal Audit Risk Assessment.
    • Analyze and interpret quantitative and qualitative feedback to build the proper Compliance Work Plan and Internal Audit Plan for your organization.
    • Ensure Next-Gen innovative concepts are integrated into designing, conducting, and reporting aspects of your audits.

     

    Tools/Takeaways

    Attendees will gain deeper understanding of how to comprehensively gather risk information and how to leverage innovative and enabling technologies to assist your organization when perform a risk assessment performing audits.

     Optional 
    10:20 AM  -  11:20 AM
    New Revenue Streams: OrthoSync-Management of Orthopedic Bundles

    Illinois Bone and Joint Institute (IBJI), a large Chicagoland orthopedic practice, will discuss their successes and challenges under Medicare's Bundled Payment for Care Improvement Program.

     

    Learning Objectives

    • Understand how historical information was analyzed to determine opportunities under the program.
    • Understand the approach IBJI took to manage the program. Rehab is key.
    • Understand how to establish and manage a post-acute network.
    • Learn about IBJI's technology platform and case management.

     

    Tools/Takeaways

    Attending this session will allow participants to learn the successful implementation process for a large orthopedic practice in the BPCI classic program, and will understand local challenges and best practices to continued success within the BPCI-Advanced program.

     Optional 
    10:20 AM  -  11:20 AM
    Treasury/Finance: How Hospitals Can Best Manage Relationships with Rating Agencies

    This session features a panel from each of the major rating agencies – Fitch, Moody’s and S&P – a group to whom we all want to show our organizations in the best possible light. Panelists will demystify the rating process and share their perceptions of various information and communications. How much is too much? Too little? Come learn what the rating agencies consider to be a good hospital partner!


    Learning Objectives

    • Describe the process the rating agencies undertake when evaluating hospitals and health systems
    • Explain best practices for communicating with rating agencies, from the agencies’ perspectives
    • Improve your organization’s relationship with rating agencies

     

    Moderator:
     Optional 
     

    General Session

    11:20 AM  -  12:10 PM
    Innovative Solutions

    Session information coming soon

     

    Lunch

    12:10 PM  -  1:10 PM
    All Attendee Networking Lunch
     

    Breakout Session

    1:10 PM  -  2:00 PM
    Compliance and Risk: The Future of Compliance: A Chief Compliance Officer Panel's Perspective

    Moderator

    Leyla Erkan, Global Compliance Healthcare Lead & Midwest Healthcare Lead, Protiviti

     

    Panel Members

    • Anne Daly, RN JD CCEP CHC CHPC CHRC, Chief Compliance & Integrity Officer, Ann & Robert H. Lurie Children's Hospital of Chicago

    • Melissa Mitchell, JD, CHC, CPC, Chief Compliance and Privacy Officer at Shirley Ryan AbilityLab

    • Donna D. Morris, MU, CHC, Associate Vice President Corporate Compliance at Rush University Medical Center

    Moderator:
     Optional 
    1:10 PM  -  2:00 PM
    New Revenue Streams: Urgent Care for the Health System Senior Financial Executive

    Merchant Medicine and Southern Illinois Health Care will present an overview of the urgent care sector in the US, and share a case study on their project to bring high performance urgent care and employer services to the southern Illinois market.


     Learning Objectives

    • Provide background on the national market and large players
    • Share Best practices for how to invest in, joint venture, or acquire urgent care center
    • Identify Service line financial and operational key benchmarks
    • Understand how these fit in the ambulatory portfolio and build revenue diversity, including same-center versus new center growth
    • Identify Target performance levels for profitability and referral management in health systems
    • Create top 3 questions to ask at your next urgent care service line operating review

     

    Tools/Takeaways

    • An understanding of urgent care in terms a board and finance team can understand as an in-depth look at the largest private-equity and hospital-affiliated operators, and why having these assets are critical to your organization's future success.
     Optional 
    1:10 PM  -  2:00 PM
    Treasury/Finance: The Path to Greater Efficiency and Improved Working Capital

    Advocate Aurora Health, a large, multi-hospital health system, will share its strategy and solution to achieving greater operational efficiency and greater working capital

     

    Learning Objectives 

    • Understand the revenue cycle challenges of a multi- hospital health system
    • Understand the process of how greater efficiencies are achieved in the revenue cycle
    • Learn how one health system essentially eliminated the need for manual posting of paper Explanation of Benefits (EOBs)
    • Achieve a substantial improvement in working capital
     Optional 
     

    Break

    2:00 PM  -  2:10 PM
    Networking and Refreshment Break
     

    General Session

    2:10 PM  -  3:10 PM
    Artificial Intelligence & Digital Workforce: A Shift Toward the Future of Work

    As technologies have rapidly improved and advanced in their cognitive abilities, humans have willingly deduced themselves to manual routers of information. But wait… weren’t computers supposed to do that? Join Braden Lambros as he discusses how healthcare organizations are transforming their businesses and delivering higher quality care with the help of artificial intelligence and a digital workforce.

    He’ll discuss how Artificial Intelligence (AI) can be used to scale human capacity rather than replace human necessity, and how it can work side-by-side with employees of all levels and specializations.

     

    Learning Objectives

    • Define artificial intelligence and the technologies that support it
    • Present the impact a digital workforce will have and the concept of Shift Work
    • Review examples demo videos of operational use cases
    • Provide tips to getting started, lessons learned, and key items to address

     

    Tools/Takeaways

    • Understand how to identify high impact opportunities to get started with
    • Considerations for what the future of work will look like, and how to embrace it
    Speakers:
    3:10 PM  -  4:10 PM
    CFO Panel: The Future Healthcare Leader—What Will Be Required?

    Opening Remarks

    Brian Pavona, CPA, First Illinois Chapter Program Chair and Managing Director, BKD CPAs and Advisors

     

    Moderator

    K. Michael Nichols, Associate Vice President Reimbursement Rush University Medical Center

     

    Panel Members

    • Ron Blaustein, Chief Financial Officer, Ann & Robert H. Lurie Children's Hospital of Chicago

    • John Mordach, Senior Vice President, Chief Financial Officer, Rush University Medical Center

    • Jonathan Tingstad, CPA, Senior Vice President, Chief Financial Officer, Shirley Ryan AbilityLab

    • Doug Welday, CFO, Northshore University Health System

    Moderator:
    4:10 PM  -  4:30 PM
    Closing remarks - Prize Drawings
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