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WI HFMA Future Planning Meeting/ LTC

4/24/2016

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​As the presidential year of Kevin Boren comes to an end, the realization sets in of what large shoes I have to fill next year as I assume the office of President for the Wisconsin Chapter of HFMA. Kevin was like Donald Trump or Bernie Sanders in few ways. Not so much the hair of Donald or age of Bernie but because he had some crazy big ambitions and plans for 2015/2016, but what sets Kevin apart from those two is that Kevin has accomplished almost everything he set out to do in 2015/2016. Below are seven of the eighteen strategies that Kevin and the rest of the board of directors and volunteers have made were:
  1. H20 (Healthcare TED-like talks) – Fall conference’s introduction of H20 talks became the highest rates session. Even beating the likes of Barry Alvarez (Wisconsin’s past football coach and current AD).
  2. Website – HFMA introduced our long desired new website that makes it not only easier to find information but also to update information.
  3. Certification YouTube Training Videos – Leslie Claas and Alan Mendenhall (with the help of a few other HFMA chapters) released E-learning opportunities to study to become CHFP certified.
  4. Early Careerist – HFMA Wisconsin formed an early careerist task force and began exploring how we can relate to the next generation of HFMA members.
  5. Build partnership with HFMA Minnesota - HFMA Wisconsin will host a joint event in Duluth, MN on May 5th, 2016. We also discussed evaluating if we can get MN chapter included in Mega event for future years.
  6. Evaluate the potential use of a Membership Directory App -  Evaluate the possible use of a web app for the chapter. Would be helpful if it could eliminate the need for a directory, help members access website content more easily, connect members socially (though with appropriate limits), and help leaders know about events and happenings.
  7. Year 2016 HFMA Region 7 Event - This event will be held on July 17-19th, 2016 in Lake Geneva, WI.
These strategies will allow HFMA Wisconsin to continue to be the indispensable resource for healthcare financial professional for years to come as stated in our mission. Thank you, Kevin, for your leadership.
 
The last few days (week of April 20th) myself and several of our officers have had the pleasure of traveling to Fort Lauderdale for HFMA national’s Leadership Training Conference to continue our strategic planning that occurred in March with all incoming and departing board members. In 2016/2017, we have decided to slow down our crazy ambitious strategies and monitor those that we put in place. In 2016/2017 we have decided on three keep strategies with a few sub-strategies:
  1. It’s about the Members- Three strategies have come to make it about the Members.
    1. Mentorship Program – HFMA Wisconsin wants to help our early careerist or those new to healthcare to have a support system to help individuals grow in healthcare. HFMA Wisconsin will begin to offer mentorship programs that should be rolled out by September of 2016. This will include a bonus to our new mentors of a free conference if your Mentee attends the conference with you. So we need HFMA Wisconsin’s help – We need mentors to step up and help the next generation of financial leadership of healthcare. A volunteer signup will soon be online at www.hfmawisconsin.com. Please consider volunteering to help our future.  
    2. Intentional Networking – HFMA Wisconsin is going to roll out "intentional" networking events to help those that are new to HFMA events to meet additional peers to use as resources in the future.
    3. Volunteer Experience: HFMA Wisconsin is a volunteer organization that could always use an extra hand. We have several open options for those that want to volunteer including a data analyst volunteer to help us monitor our changes, membership app volunteer, and E-Communications Coordinator. Please email me at shawn@americollect.com if you are interested in volunteering for one of these positions.
  2. Communications – HFMA Wisconsin has to coordinate our communications to control the quantity of communications that are distributed to each member and make them more meaningful when we communicate to members. We will be working on a bi-weekly email to combine multiple communications from events@hfmawisconsin.com. We will also start tracking and measuring our success of our communications and drive content by those that the membership would prefer.
  3. Healthcare Finance 101 - HFMA Wisconsin members have been asking for 101 educational opportunities that are easy to access and convenient. HFMA Wisconsin will be testing education direct to providers at their facilities that will focus on Language of Healthcare, Healthcare Financial Puzzle, Need to Know Compliance, and Hot Topics in Healthcare.
 
We are excited to see how these strategies help HFMA Wisconsin members in 2016/2017. We are also excited to monitor previous year's strategies as well. HFMA Wisconsin board always appreciates hearing from our members on how we can improve the membership experience. Please consider volunteering to help us initiate these strategy changes. Just email events@hfmawisconsin.com for more information. Please join us at the Wisconsin Annual Conference, May 26th & 27th, 2016 at Elkhart Lake, WI. 

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National HFMA LTC was held in Ft. Lauderdale, FL. From left to right: Matt Streeter, Dave Cartier, Pam Ott, Shawn Gretz, Steve Backus and Rebecca Havlicek.
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WI HFMA Sponsors

4/24/2016

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Our Platinum Sponsors:

MMIC

A Minnesota-based company, MMIC provides physicians, clinics, hospitals and care facilities with medical professional liability insurance, exceptional risk management, claim management and health IT services. We empower caregivers to provide the best medical care possible while promoting safety and minimizing risk. Our full-service organization has been partnering with medical professionals for more than 30 years with the goal of protecting and promoting the practice of good medicine.


ProAssurance

Thank you to our Gold Sponsors:

BMO Harris Bank

Craneware

Hall Render Killian Heath & Lyman

ProSource/ JCC/ Care Call, Inc.

Rycan

WHEFA
Wisconsin Health and Educational Facilities Authority

Bank of America/ Merrill Lynch

HELP Financial

RC Healthcare Management


Godfrey & Kahn, S.C.


Thank you to our Silver Sponsors:
    • Americollect, Inc.
    • Associated Bank, N.A.
    • Cirius Group
    • Cleary Gull Advisors, Inc.
    • Clifton Larson Allen LLP
    • Eide Bailly LLP
    • KaufmanHall
    • Medical Recovery Specialist
    • OS Inc.
    • Precyse, Inc.
    • R&R Insurance Services, Inc.
    • Von Briesen & Roper, s.c. 
    • Wipfli CPA’s and Consultants
Thank you to our Bronze Sponsors:
    • Alliance Collection Agencies, Inc. a division of RevCycle, Inc.
    • Avadyne Health
    • Availity
    • Baird
    • Cardon Outreach
    • Coversys
    • EnableComp
    • Halley Consulting Group
    • HC Healthcare Consulting, LLC
    • Helvey and Associates, Inc.
    • Medical Business Bureau
    • Medical Reimbursements of America
    • NAVEOS
    • State Collection Service, Inc.
    • Transworld Systems
    • Tri-State Adjustments, Inc.
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Welcome New WI HFMA Members

4/24/2016

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Kathy  Abt-Glynn  
Patient Financial Counselor  
Orthopaedic Associates of Wausau S.C.  
Wausau  WI 

Paul  Andres  
New Business Development  
The Billing Pros - Powered by Cvikota  
La Crosse  WI 

Dennis  Bangart  
Accountant
Beaver Dam Community Hospital  
Fond Du Lac  WI 

Aaron  Bridgeland  
Director of Finance  
Wheaton Franciscan Healthcare  
Glendale  WI 

Beth  Griffin  
Chief Product & Marketing Officer  
Health Payment System  
Milwaukee  WI 

Matt  Huff  
Chief Finance Officer  
Bay Area Medical Center, Inc.  
Marinette  WI 

Nicole  Kopacz  
Administrative Assistant 
Waukesha  WI 

Dave  Krueger, MD  
Executive Director  
Bellin Thedacare Healthcare Partners  
Green Bay  WI 

​Gina  LaFaunge  
Revenue Cycle Director  
Black River Memorial Hospital  
Black River Falls  WI 

Amanda  Larson  
Accountant  
Bellin Health  
Green Bay  WI 

Moira  Lechtenberg  
Director of Client Services  
Healthfuse  
Grafton  WI 

Andrew  Marsh 
Client Relationship Representative  
Kforce  
Milwaukee  WI 
 
Matt  Mueller  
Senior Accountant 
Wipfli LLP  
Milwaukee  WI 
 
Jacqueline Marie  Nowak  
System Director of Patient Scheduling  
Aspirus, Inc.  
Wausau  WI 

Kathleen  Olszewski  
Manager, Business Operations  
Saint Michael’s Hospital  
Steven’s Point  WI 

Wendy  Ostrander  
Director Hlth  
Beaver Dam Community Hospital  
Beaver Dam  WI 

Marcie  Peirick  
Market Mgr, Primary & Specialty Clinics  
Watertown Regional Medical Center  
Watertown  WI 
 
Terri  Rexrode  
Tax Senior Manager  
Wipfli LLP  
Green Bay  WI 

Heather  Sorenson  
Manager  
Sacred Heart Hospital  
Eau Claire  WI 

Rebecca  Swanson  
Revenue Charge Capture  
Froedtert Health  
Menomonee Falls  WI 

Marcel  Tetzlaff  
Director of Program Implementation  
Integrated Health Network of Wisconsin  
Brookfield  WI 
 
Leo  Zalaznik  
Account Business Manager  
Baxalta  
Green Bay  WI 
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Future Healthcare Executives Meeting at UWM

4/24/2016

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For the second year in a row, the Future Healthcare Executives (FHE) student organization at the University of Wisconsin-Milwaukee hosted a professional LinkedIn event featuring best selling author and consultant Wayne Breitbarth, CPA. 

Students learned 
The Power Formula for LinkedIn Success from Wayne's 2016 edition of his well known book by that title, and experienced a full 2-hour workshop training in addition to having professional photos taken for their LinkedIn profiles. 

Students thanked HFMA for serving as an event sponsor and making this such a success.

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WI HFMA Sponsorship Opportunity

4/19/2016

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​​Sponsor Now!


The 2016 - 2017 HFMA WI Chapter Sponsorship information is now available on our  HFMA WI Chapter website.  

1. All Sponsors get to Exhibit at our January Conference in Wisconsin Dells! 
2. Platinum Sponsors three program certificates & the opportunity to sponsor three new chapter members. 
3. Pay & Register with Credit Card Online! 

If you have any questions or need any additional information please feel free to contact either Art Mertig  or Jim Nelson thought the contact information provided. You can access the Sponsorship Program information by using the link provided below.

Thanks, Art & Jim

Art Mertig 715-685-5550  amertig@ashlandmmc.com
or
Jim Nelson (920) 568-5490 James.Nelson@forthc.com for more information. 

Get more information
Sponsor Now!

I can't make it

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Planning for the Unknown: Triple Aim

4/19/2016

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 “In preparing for battle I have always found that plans are useless, but planning is indispensable.” This quote attributed to Dwight Eisenhower is good advice for strategizing in an environment where one knows that the conditions will change. Such is the case with the future of revenue for health care providers in America.

U.S. health care is a $2.9 trillion complex and adaptive system of entities including insurance companies, hospitals, pharmaceutical companies, medical equipment manufacturers, technology companies and increasingly more stakeholders. Until recent years, the federal government had largely been a reactive participant since the advent of Medicare. For many Americans, the system has worked relatively well, with the average consumer enjoying access to quality care, state-of-the-art technology and a fair amount of options. However, the Medicare system has some glaring flaws that make it unsustainable as the population ages. The primary flaws include the unacceptably large percentage of the population without insurance and costs growing much faster than the rate of overall inflation, which led to the adoption of the Patient Protection and Affordable Care Act (ACA).

While the ACA aimed to accomplish several things, perhaps the single biggest long-term change was the creation of the Center for Medicare and Medicaid Innovation (CMMI). CMMI is intended to drive changes through new payment models and performance metrics. Currently, CMMI is testing innovative payment and delivery system models that show important promise for maintaining or improving the quality of care in Medicare, Medicaid and the Children's Health Insurance Program (CHIP), while slowing the rate of growth in program costs.1 In order to prepare for the impending changes, a hospital’s management and board should carefully reconsider its organization’s mission and role in the community.

The New Health Care Paradigm – Incentives Matter

Historically, hospitals in the United States were paid on a fee-for-service (FFS) model. While this method has some merit, it can create perverse incentives. The new paradigm, called “triple aim,” seeks to better align incentives through improving the patient experience of care (including quality and satisfaction), improving the health of populations and reducing the per capita cost of health care.

None of these goals are controversial, but there exists a major challenge in getting the various stakeholders to coordinate in achieving these goals. At best, many of the key players have worked independently to form a high-quality and cost-effective system. Often, entities have battled over revenue arrangement such that health of populations’ vis-à-vis access is compromised.

Recognizing the incentive problems with FFS, CMMI is pushing a number of models that will challenge all participants in the American health care system. The biggest change is a shift to value-based reimbursement, which is a search for better health outcomes at a lower cost. According to Standard and Poor’s (S&P) Rating Service, “it's probably the single most significant factor now fueling health care reform.”  In a fee-for-value system, the emphasis changes to paying providers for stronger preventive care and early detection, instead of paying them to treat an illness through episodic care, as they would under FFS models.2 This shift is still in its infancy, as the majority of reimbursement remains in a FFS model. Consequently, creditors and financial analysts have to look beyond historical financial statements to determine if a particular organization is set-up to handle the future.

Medicaid Expansion and the Power of Technology

The most widely reported aspect of the ACA is the expansion of insurance to millions of Americans. Partly through insurance exchanges, over 11 million more people now have insurance. While this is an unalloyed positive development in achievement of the “triple aim”, the expansion brings new challenges. Medicaid is the primary source of reimbursement for the newly insured and it is generally considered to be an inferior payor source. Many physician groups do not accept Medicaid; thus, patients wind up visiting the local emergency room (ER) for care. ERs in many communities were already stressed, and the influx of new patients has further stretched the resources at many facilities.

Creditors and financial analysts recognize the potential benefits of more efficient facilities, including the potential for additional admissions or procedures at the hospital. However, the temptation to expand must be tempered by the risk incurred by overleveraging a hospital’s balance sheet. Carrying too much debt can make a hospital’s credit profile too fragile in an uncertain environment.

Perhaps the biggest opportunity and greatest challenge facing health care providers is the use of technology. Technological improvements are nothing new, of course, but a government mandate for Electronic Health Records (EHR), along with market demands to improve efficiency and accuracy, make this area a paramount strategic and operational focus for every organization. The promise of a well-executed IT strategy is better population health, with more accurate and complete data, more efficient billing and reduced cost. The difficulty is often in the implementation, as a lack of resources and poor training can lead to delayed projects and an unwillingness to embrace the full power of innovation. From an analytical point of view, some important questions are: does a hospital have a reasonable plan for integrating technological systems? And what has been its recent experience with major projects? Often, the answers are disappointing, which ties into another major consideration for all health care providers—affiliation.

M&A – Strength in Numbers

Mergers and acquisitions (M&A) and affiliation agreements are a dominant theme for financial analysts. It is generally understood that the health care delivery system has to be more efficient. The improved use of technology is one aspect of the operational efficiency that ties in with value or risk-based health plans. Through the use of “big data,” insurers and government payors have a much better means to track population health and pinpoint costs. In addition, affiliations or business combinations offer an opportunity to, “bolster scale, scope and diversify; boost profitability; enter new markets; and enhance their competitiveness.”3

From an analytical and creditor’s perspective, it is crucial that organizations clearly articulate the current and future states of their affiliation strategy. For some providers, the only viable option may be a merger. Many health care systems have expanded through horizontal integration by the acquisition of other health care operations, in addition to combinations with strategically targeted hospitals. Generally, from an analyst or creditor’s point of view, the fewer providers in a market the better. Fewer providers leads to better buyer power when negotiating with payors and vendors. For now, independent hospitals can survive, but it will be increasingly difficult to manage the health of a population without being part of an integrated network of providers.

Putting it All Together

Improving the overall wellness of the population is the main goal of stakeholders in the health care system. Physicians and hospitals are on the front line in the effort to improve access, while at the same time reducing cost and improving the patient experience. A welcome change in recent years is the push for community programs designed to better educate the population regarding health issues. It is important for providers to identify and describe initiatives to improve the wellness in their community. While risk-based payment programs represent a very small proportion of the payment plans now (less than 5%), it is undeniable that payments tied to health of a population are a growing force.

The challenges mentioned in this article and the context where market driven reforms dovetail (or sometimes collide) with regulatory changes can be daunting. Until recently, it was generally accepted for hospital management to respond with a blithe dismissal when asked about the impact of reform. No longer can a hospital board or management get by with vague assurances to questions about planning for a vastly different payment structure.

For now, rating agencies and financial analysts continue to examine the historical operating performance of a health care organization. Debt service coverage, cash to debt and operating margins are still important. However, the examination goes deeper with an increased focus on underlying metrics (ie: FTEs per occupied bed) that provide signals of operating efficiency. The market-driven and government mandated reforms will place increasing pressure on operating costs.

While operating efficiency is the most important piece of the puzzle, creditors and analysts are placing a greater emphasis on the strength of hospital boards and management. Importantly, hospitals need to understand that a complex adaptive system cannot be predicted, so risk management is difficult. Organizations that can adapt by implementing robust processes and systems will have the best chance to survive and thrive.

Hearkening back to the Eisenhower quote, creditors and analysts are more interested in seeing that an organization is planning than knowing the details of the plan. Key questions are: how is the organization set up for value and risk based reimbursement? What is the organization’s affiliation plan? What is the organization’s track record and plan for implementing new technology? And what is the organization doing to connect to its community? Organizations that can demonstrate a thorough and consistent examination of these questions will be well-prepared for the future.

1. Guterman S, Davis K, Stremikis K, Drake H (June 2010). "Innovation in Medicare and Medicaid will be central to health reform's success". 
2. Standard & Poor’s Rating Services, (July 20, 2015) “As The ACA Takes Hold, Health Industry Outlooks Are Mostly Stable,  But Not The Health Care Landscape”. 
3. Ibid.

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  • By Ritchie Dickey, CFA

  • By Jason Beakas




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A Shift in Care: Protecting Access to Medicare Act

4/19/2016

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The Protecting Access to Medicare Act (PAMA), like a lot of legislation, is based on a noble intention and is full of trade-offs, benefits and drawbacks. Overall, the Act aims to move the health care industry toward one that pays for results as opposed to services. Getting there, of course, is the tricky part.

Since the PAMA was signed into law on April 1, 2014, it has been a source of conversation among health care providers, lenders and beneficiaries. While there are many important components to this multifaceted legislation, this article will focus on the key components pertinent to senior living and health care providers. Perhaps most noteworthy for providers is the introduction of a value-based payment system for skilled nursing facilities (SNFs) that is based on individual SNF performance on a hospital readmission measure.

In the spirit of transparency and clarity, the goal of PAMA is to further define the terms, expectations and limitations of the Medicare Act pertaining to Medicare providers, beneficiaries and legislative branches. When it was signed into law in 2014, one of the key provisions was a delay in any cuts in the Medicare reimbursement rate until 2015. These cuts were originally scheduled to go into effect April 1, 2014, and have traditionally been delayed each year for more than a decade. This time, the cuts went into effect with no legislation in sight to change that. Many groups, such as the American Medical Association (AMA), were disappointed in this aspect of PAMA and continue to push for a permanent fix to the Medicare cuts. It remains to be seen whether those efforts will prove to be fruitful. For now, PAMA is garnering attention not for the highly discussed Medicare cuts, rather for other provisions that are beginning implementation.

Paying for Performance

One of the core sections to come from the PAMA is section 215 which discusses the shift to a value-based purchasing (VBP) system. VBP is a demand side strategy to measure, report and reward excellence in healthcare delivery.   The transition to a VBP system typically occurs over many years with a transition period during which revenue decreases (Figure 1).


Beginning on Oct. 1, 2018, Medicare reimbursement for SNFs will be tied to performance and quality of care rather than the traditional “fee-for-service” model. The VBP program looks at one quality measure defined by Health and Human Services (HHS) to determine the Medicare reimbursement that the facility will receive. High performers will receive incentive payments and low performers will be subject to penalties.

In order to create the incentive pool, SNF’s Medicare per-diem payments will be reduced by 2%. Out of the money collected, 50-70% of it will be available for the incentive pool. Not all of the 2% reduction is going back to SNFs, as it is also a means to save Medicare money, a projected $2 billion over 10 years. Top performing SNFs will see most, if not all, of their 2% withhold returned through incentive payments, and possibly more. SNFs that perform in the middle level are expected to see a portion of their 2% withhold returned, while bottom performers will receive less than their withholding or nothing.

To quantify a SNF’s performance in the VBP program, HHS will use one of two quality measures: a hospital readmissions measure based of all causes and conditions, or a “resource use” measure of “all-condition risk adjusted potentially preventable hospital readmissions” for SNFs. Initially, the VBP performance will be measured using the all-encompassing readmission measure, however, the PAMA requires that the more specific “resource use” measure be implemented as soon as possible. 

HHS will provide SNFs with confidential feedback on the initial results from both measures in 2016 and will publicly report data on both measures by Oct. 1, 2017. The proposed VBP rule will be published in 2018 and the first adjustments to a SNF’s payments will begin in 2019.

Ultimately, the VBP program should affect providers, beneficiaries and lenders in a positive way. The programs afford health care providers the opportunity to stand out from a quality of care, service and hospitality perspective by making global initiatives to enhance their operations. This methodology forces health care providers to refocus and reconsider their why statement (“why we are here and why are we doing this?”) Hospitals and other health programs were created to care for the sick by those who had a passion for helping others. Effectively implementing a VBP program within a health care organization returns to the original principals that guided the creation of health care in society today. 

Hospitals Feel the Effects

The changes in the PAMA affect hospitals in a variety of ways. Typically, Medicare sets annual beneficiary payment limits for outpatient therapy services. The PAMA allowed the temporary expansion of the cap on outpatient therapy services provided in Hospital Outpatient Departments (HOPDs) if the therapy is deemed medically necessary. The extension of the therapy cap was permanently extended by the Centers for Medicare & Medicaid Services (CMS) for Critical Access Hospitals (CAHs). From both an operational, beneficiary, and financial perspective, this is key as it drives additional patients to hospitals to supplement Medicare revenue and it allows patients to receive higher quality care for longer time periods through what is likely to be a better therapy program.

Concentrating more on rural hospitals, Section 106 details plans to spend $100 million over 10 years, focusing on extending the Medicare-Dependent Hospital (MDH) program. Established in 1987, the MDH helps support small rural hospitals for which Medicare patients make up a majority of their inpatient days or discharges. To qualify as an MDH, the hospital must be located in a rural area, have 100 beds or less, not be classified as a sole community hospital, and have at least 60% of discharges or inpatient days covered by Medicare. These hospitals are able to receive the inpatient price per service (PPS) rate plus three-quarters of the amount by which their costs per discharge exceed the (PPS) rate. For example: ABC hospital discharges Patient X who had a one night stay. Patient X had a PPS rate of $150. The cost to discharge Patient X is $300. The hospital will receive $262.50. This is determined by taking the difference between the PPS rate and the discharge cost ($300-$150), multiplying it by .75 and adding it to the PPS rate which amounts to $112.50. This boost in rates is invaluable to operators as it helps to bridge the gap between costly discharges and low PPS rates. Additionally, MDH will help decrease expense margins and boost Medicare revenue.

Section 212 has received a lot of attention due to its focus on technology and effect on monetary means of providers. HHS Secretary Sylvia Burwell delayed the adoption of ICD-10 as the standard code for medical data from Oct. 1, 2014 to Oct. 1, 2015. There was significant opposition regarding the delays in implementing the ICD-10 coding system. Many hospitals had incurred substantial financial obligations in implementing ICD-10. This delay ultimately slowed down the transition to value-based payment in the health system.

​A Clear Shift

The PAMA, like a lot of legislation, has noble goals but is imperfect. While some sections in the PAMA are steering health care in the direction of realizing a true value-based payment system, some components of the legislation such as the ICD-10 coding have slowed down this process. Overall, however, the trend is clear; health care is moving towards a pay-for-performance model and PAMA represents a significant step in that direction.

Source: American Hospital Association, “Legislative Advisory, The Protecting Access to Medicare Act of 2014,” April 2014.

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  • By Jessica Rosenberg

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Wausau Wisconsin Educational Event March ReCap: Provider-Based Departments- Are We Compliant?

4/19/2016

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Vicki Mueller, CPA, Director – Wipfli LLP, provided an informative presentation on provider based Medicare compliance.  Vicki shared with the attendees details on the effects of the CMS’s focus on compliance of Medicare reimbursement and how it is effecting many provider-based departments. 

​Vicki shared the history of provider-based, important dates that may impact your provider-based status, and criteria that needs to be considered when assessing your provider-based department(s) for compliance with the provider-based regulations. 

This event was hosted by Wisconsin’s HFMA Northern Director, Pat Tincher along the help of event coordinators, Luke Foslien and Kari Karaffa.
 
 Submitted by Kari Karaffa

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Register for Duluth Conference on May 5th

4/19/2016

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You don't want to miss this panel of experts

Fitzger's Hotel
Duluth, MN
May 5th 1:00 pm - 6:00 pm

 Register Today!

The Transition to Accountable Care
 Different perspectives on change
  



We will hear from a panel of six experts from the healthcare industry who will share with us their perspectives on the ACO and what they are seeing in the market.  The panelist will represent views from various areas of health care, including:  Payor, Hospital Finance, Medical Director, Patient and Long Term Care and Consulting.  After sharing their views the speakers will sit as a a panel for further discussion.

Agenda
1:00 pm - 3:00 pm - 6 speakers (20 minutes each to share their perspectives)
3:00 pm - 3:15 pm Break
3:15 pm - 4:00 pm Q/A Session
4:00 pm - 5:30 pm Networking / Cocktails & Food

Panel of Experts:

Kevin Boren (CFO) of Essentia Health
 - Mr. Boren is the Chief financial officer (CFO) and Vice President of Finance for Essentia Health's east region.  Headquartered in Duluth, MN, Essentia Health's east region, for which Mr. Boren has financial accountability, includes 7 hospitals and more than 24 clinics located throughout northwest Wisconsin and Northeast Minnesota.  Prior to joining Essentia, Mr. Boren was the CFO for Meriter Hospital in Madison, WI, and was previously the director of finance for Hennepin County Medical Center in Minneapolis.  Mr. Boren has an undergraduate degree in finance, as well as an MBA in health care administration and strategic management, from the University of Minnesota's Carlson School of Management.  Mr. Boren also earned a masters degree in accounting and finance from the London School of Economics in London, UK.  Mr. Boren has earned his Fellow status from HFMA and serves as the President of the Wisconsin chapter of HFMA.

Lisa Bjerga  Revenue Cycle Director at Lakewood Health System
 - located in central Minnesota. In her role, Lisa is responsible for hospital and physician revenue cycle as well as the revenue cycle related to the organization's assisted living sites and long term care facility. Lisa began her career at Lakewood Health System in 2008 as the organization's Finance Director prior to moving into her role as Revenue Cycle Director in 2012. In addition to her Revenue Cycle management she also serves as the Chair of Lakewood's Care Coordination committee. Lisa holds an active CPA license and FHFMA designation through HFMA. She is a member of MNCPA, AICPA in addition to serving on the Board of Directors of the Minnesota HFMA chapter. Lisa has a BS in Accounting and an MBA with a healthcare emphasis...

Mike Van Scoy Internist at Essentia Health
 - , certified in Hospice & Palliative Care Medicine, and a Certified Medical Director with the American Board of Post-Acute and Long-Term Care Medicine.  He serves as medical director for several ACO programs, including dual-eligible, Medicare Advantage, Medicare Shared Savings, State of MN Medicaid, and commercial contracts.  Areas of interest include risk stratification, innovative clinical models, pharmacy care management, documentation and coding, and readmission reduction.

Tanya Bartley Network Navigator for Ridgeview Community Network, an accountable care organization providing local, personalized care at one of the few independent health care systems in Minnesota.  She acts as an advocate for nearly 3,000 members, answering questions about the network and services, assisting with choosing a primary care provider, offering information about community agencies, wellness services and much more. She received her B.S. in Kinesiology with a concentration in health promotion and wellness from the University of Texas and has been focused on population health management and efforts to build healthier workforces for the past 24 years.   She left Texas in 1995 and hasn't looked back. After a 12-year career in National Accounts with Cigna Healthcare, working all over the country with large national employer groups including Geisinger Health Plan, Disney, DaVita and Safeway, she has stepped off the airplanes to follow her passion to personally help people. Now she makes a difference one person at a time, partnering with more than 300 physicians and nearly 2,000 medical and support staff - focused on delivering coordinated care throughout a five-county area in the southwest metro and beyond. 
She lives in Saint Bonifacius, Minn., with husband Pat, little Bartleys Alex and Mackenzie, Goose the golden retriever and Spike the bearded dragon.  She can be contacted at tanya.bartley@ridgeviewmedical.org.

Lisa Spann is the Director of Market & Product Efficiencies for the commercial markets division at Medica.  Ms. Spann is responsible for leading development of Medica's ACO product strategy and managing network-based products.   In addition, she and her team manage Medica's transparency solutions. Prior to joining Medica in 2007, Ms. Spann held various positions at Fairview Health Services, which included experience in areas of clinic operations, provider contracting, quality measurement and data analysis.Most recently, she was the director of Analysis and Network Management at Fairview Physician Associates.Ms. Spann holds a bachelor of science degree in biology from the University of Minnesota and a master's degree in Healthcare Administration from the University of St. Francis. 

Jennifer D. Leazzo, FSA, MAAA, Director, Actuarial Consulting, Optuminsight -  The consulting division of Optum. She has over 20 years of experience working in the health insurance industry. She has extensive experience in provider contracting, medical plan design, health cost projections, experience analysis, and strategic planning and forecasting.  While at Optum, Jennifer has predominantly worked with provider organizations taking risk from the federal and state governments for Medicare and Medicaid members as well from carriers on Commercial members. This includes providing financial projections for the provider, drill down reporting to find areas to improve results, and communication with Senior Management and regional leadership. She has also worked with payer organizations on projecting the impact of health care reform to enrollment and financials, analyzing the competitiveness and adequacy of premium and provider capitation rates and other reimbursement methodologies.  Prior to joining Optum, Jennifer spent 20 years with insurance carriers ranging in size from regional to national. She has extensive experience in evaluating financial terms of provider contracts; selection of ancillary vendors, provider profiling, projecting medical cost trends, network benchmarking, medical plan design, product implementation, narrow provider network design, competitive analysis, book of business pricing, rating tool maintenance, line of business reserving, and strategic planning and forecasting. She was the appointed actuary for a local health plan subsidiary and responsible for their reserve calculations.  Jennifer received her Bachelor of Science degree in Mathematics and Statistics from the Purdue University. She is a Fellow of the Society of Actuaries and a Member of the American Academy of Actuaries.

Register Today!
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President’s Message: End of Chapter Year

4/18/2016

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So, as the chapter year is coming to a close, and the weather is turning nicer, even in Duluth, I want to take an opportunity to thank everyone for a great year.  We recently were notified by HFMA national that the chapter hit all of its balanced scorecard targets for the 2015-2016 chapter year.  While that is great and should be celebrated, what is more important is the meaning that has for our membership. We’ve grown our membership, improved satisfaction, and increased the number of education hours for this year by diversifying our format and content.  We have a lot of work to do still in working to keep our chapter relevant, but it is a milestone and should be celebrated.

I want to thank all of the volunteers who made that possible.  We have an excellent slate of officers and board, and there are dozens of people who have volunteered their time to make the chapter work the way it does.  Thanks for all that you do, I know it takes time away from other things, but it does pay off for our members when we can offer excellent education, networking opportunities, and health care insights that can provide value for our employers.  I’ve also been reminded this year that we have a fun and energetic chapter, and it has been genuinely pleasure working with them over the past year.

The board held our annual board retreat in Madison on March 10-11th and you will be hearing more about our strategic plan for 2016-2017.  We have a great slate of leaders preparing for the next year and I’m really excited about what they will do under Shawn Gretz’s leadership.

We have a few excellent educational events to look forward to as the year winds down.  First, for any who live in the northland or are interested in travelling to visit the beautiful scenery of Duluth, we are pleased to be co-sponsoring with the Minnesota chapter a panel discussion on ACO’s in Duluth on May 5th.   We will be back at the Osthoff for our annual meeting on May 26-27.  For those of you who were there last time, it is a beautiful location and not too far to drive from most of the state.  Finally, we are excited to co-host an HFMA region 7 conference in Lake Geneva from July 17-19.  We will be pretty spoiled in conference locations as I think these are some of the prettiest regions of the state.  We also hope to keep delivering on our promise to have more provider speakers, shorter talks, and speakers who bring unique insights.  It will be an exciting time!

​Thanks for your support and a great year so far.  We look forward to seeing you at a future event or hearing from you soon. 
 
 


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Region 7 Conference Speaker: Ken Kaufman

4/18/2016

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3 Weeks Until the Brochure is Released!

 
 
 

 
Opening Keynote:
Ken Kaufman, Kaufman Hall -  
Titled: Hospitals in the Internet Economy
 
Session Description: Why should a patient/consumer choose your healthcare services as opposed to  all of the expanding choices? This is the central question for hospitals in the Internet economy. This presentation reviews lessons learned from successful companies in the Internet era and what changes will allow hospitals to be effective competitors in this environment.
After attending this presentation, attendees will be able to:
  • Identify characteristics of success in the Internet economy, such as driving traffic and making transactions smooth
  • Describe a new relationship to consumers that hospitals need to establish
  • Describe a new hospital value proposition for the Internet economy

 
Providers ONLY $100 to Attend
If you work for a healthcare provider, HFMA Region 7 is giving an early registration discount!
 
Offer Expires: 5/31/2016
 

 
4 Tracks Including Revenue Cycle, Finance and Accounting, Leadership, & Critical Access Hospitals! 

Revenue Cycle Breakout Sessions: 


1. Panel: Integrating Physician Billing with Hospital Revenue Cycle

2. The Bundled Payment Imperative: Successfully Navigating Payment Transformation

3. From the Accidental Profession to a Career of Choice: Transforming Revenue Cycle Through Postsecondary Education

Click Here to Learn More
 

 

 

 

 


 
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HFMA Region 7 Summer Conference in Lake Geneva

4/18/2016

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​
HFMA Region 7 "WI be ch IL'IN by the Lake" Conference!
When: July 17-19, 2016
Where: Grand Geneva Resort and Spa in Lake Geneva, WI.

ONLY $100 for Healthcare Providers!
SAVE THE DATE
Website for More Information: www.hfmaregion7.com
Over 48 speakers including a NEW Ted Talk format. 

Keynotes Confirmed are:
  • Ken Kaufman - Hospitals in the Internet Economy
  • Zubin Damania (ZDogg) -  Of Ted Talk Fame
  • Susan Frampton - The Brave New World of Patient and Family Engagement-2016 Policy and Practice Update
  • Laurie Guest - Life in the Espresso Lane!
 Breakouts Include:
  • CFO Perspectives on Capital Funding Strategies
  • Cost Reporting 101: What's an A-8-1?
  • Cost Reporting 201: Advanced Cost Report Strategies
  • Critical Access Hospital CFO Forum
  • Educating the Front Line
  • Employee Engagement & Workplace Culture
  • H20 Talk: Engineering Aligned Physician Incentives
  • H20 Talk: Expense Monitoring in Supply Chains & Labor Management
  • H20 Talk: Financial Integration - Successes & Challenges
  • H20 Talk: Forming Successful Partnerships to Stay Independent
  • H20 Talk: Leadership Pipeline: Succession Planning
  • H20 Talk: Managing New Hire Expectations: No, you are not the CFO already
  • H20 Talk: Millennial - It's not stopping with us!
  • H20 Talk: Navigating Price Transparency & Out of Pocket Estimation
  • H20 Talk: Rural Strategies: Building Relationships with Clinical Departments
  • H20 Talk: Sustaining Revenue Cycle Excellence
  • H20 Talk: Telemedicine Strategies: Keeping Care Close to Home
  • H20 Talk: Value-based Performance & Payment
  • Managed Care Contracting: The Do's and Don'ts of Narrow Networks
  • Mission Possible: An Effective Provider Compensation Plan
  • Panel: CFO Forum: Present, Past, & Future
  • Panel: Diversity in Leadership
  • Panel: Integrating Physician Billing with Hospital Revenue Cycle
  • The Bundled Payment Imperative: Successfully Navigating Payment Transformation

Brochures released and online registration open around May 1st!
If you would like more information on HFMA WI be Ch IL'IN by the Lake Conference contact:
Wendy Ellwein
info@hfmaregion7.com
or
(651)340-6426
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Register for Maximizing Revenue Conference

4/18/2016

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Please register for Maximizing Revenue on Apr 28, 2016 12:00 PM-1:00 PM Central Time: 
 
 https://attendee.gotowebinar.com/register/1088434420770232834
 
Issues that keep hospitals from collecting every dollar do them.

Description of the goals of the presentation: 
1.To identify areas of opportunity in Revenues Maximization
2.To identify proper appeal procedures for revenue collection related to underpayments
3.To identify opportunities to streamline workflow processes
4.To identify the necessary organizational structures to maximize revenues
5.To identify opportunities for technology to improve revenue maximization

Learning objectives: 
1. What are the causes of the lost reimbursement.
2. Solutions on how to minimize those losses.
3. Everyday processes to help maximize revenues.

Targeted Audience:
CFOs, Managers of Revenue Cycle, Directors of Managed Care and Patient Accounting

Presented by: Thomas Gregor,President of Parathon Recovery Services
After registering, you will receive a confirmation email containing information about joining the webinar.
 
 

Please register for From Bricks and Mortar to New Models of Healthcare Delivery on May 12, 2016 12:00 PM CDT at: 
 
 https://attendee.gotowebinar.com/register/7890170580511651076
 
Review the guiding principles of associated with Accountable Care and movement from Volume to Value, including the movement of Fee for Service to Capitation. Review the Care characteristics of Population Health and assumptions associated with Population Health Management. Identify and explore some new care models related to the risk based health plans. 

Description of the goals of the presentation: 
* Define "Market share in An Era of Accountable Care" 
* Identify which patients are utilizing your organization's resources 
* Explain the importance of Care Management in the Era of Accountable Care 
* Describe at least one new Care Delivery Model for "at risk" patients 
* Identify five predictions on "The Future of Healthcare" 

Learning objectives: 
* Define "Market share in An Era of Accountable Care" 
* Identify which patients are utilizing your organization's resources 
* Explain the importance of Care Management in the Era of Accountable Care 
* Describe at least one new Care Delivery Model for "at risk" patients 
* Identify five predictions on "The Future of Healthcare" 

Targeted Audience: 
All HFMA members 

Presented by: 
Larry Volkmar, Managing Director in the Performance Improvement Practice of The Claro Group.

After registering, you will receive a confirmation email containing information about joining the webinar.
 
 
 
Please register for Striking the Right Patient Balance: How Two Hospitals Are Turning High Deductibles into Cash on May 24, 2016 12:00 PM CDT at: 
 
 https://attendee.gotowebinar.com/register/5718314058770754819
 
High deductibles and the impact on patient responsibility is a priority for most revenue cycle executives. The same collection methods are no longer enough to meet performance targets. This session will feature two hospitals that implemented a data-driven payment program to address their rising balances after insurance - and how they approached the problem and what they achieved. Further, we will explore and explain how to prevent against credit card theft, and how most healthcare providers today are at significant risk of compromise to their payments environment. 

Learning objectives: 
1) Learn how to segment patient balances and automate payment arrangements for patients that need it. 
2) Learn how to integrate data-driven payments into current workflow - what works and what doesn't.
3) Learn what KPIs can be achieved/expected by changing your approach.
4) Learn how to identify security gaps in your payment process, and what to do about it.

Description of the goals of the presentation: 
Attendees will leave the session with working examples of:
* How emerging payment technology and techniques are driving results
* What KPIs can be expected by leveraging automated payment plans
* What it takes to implement and manage a data-driven payment program
* How to secure their customer service payments environment and reduce risk

Targeted Audience:
CEO,CFO,Directors and anyone involved with Revenue Cycle

Presented by:
John Talaga, David King, and Jeff Porter all with OnPlanHealth

After registering, you will receive a confirmation email containing information about joining the webinar.

 


 


 
 


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Welcome New WI HFMA Members

4/18/2016

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​Kathy
 Abt-Glynn
 Patient Financial Counselor
 Orthopaedic Associates of Wausau S.C.
 Wausau
 WI

 Paul
 Andres
 New Business Development
 The Billing Pros - Powered by Cvikota
 La Crosse
 WI

 Dennis
 Bangart
 Accountant
 Beaver Dam Community Hospital
 Fond Du Lac
 WI

 Aaron
 Bridgeland
 Director of Finance
 Wheaton Franciscan Healthcare
 Glendale
 WI

 Beth
 Griffin
 Chief Product & Marketing Officer
 Health Payment System
 Milwaukee
 WI

 Matt
 Huff
 Chief Finance Officer
 Bay Area Medical Center, Inc.
 Marinette
 WI

 Nicole
 Kopacz
 Administrative Assistant
 Waukesha
 WI

 Dave
 Krueger, MD
 Executive Director
 Bellin Thedacare Healthcare Partners
 Green Bay
 WI

 Gina
 LaFaunge
 Revenue Cycle Director
 Black River Memorial Hospital
 Black River Falls
 WI

 Amanda
 Larson
 Accountant
 Bellin Health
 Green Bay
 WI

 Moira
 Lechtenberg
 Director of Client Services
 Healthfuse
 Grafton
 WI

 Andrew
 Marsh
 Client Relationship Representative
 Kforce
 Milwaukee
 WI

 Matt
 Mueller
 Senior Accountant
 Wipfli LLP
 Milwaukee
 WI

 Jacqueline Marie
 Nowak
 System Director of Patient Scheduling
 Aspirus, Inc.
 Wausau
 WI

 Wendy
 Ostrander
 Director Hlth
 Beaver Dam Community Hospital
 Beaver Dam
 WI

 Marcie
 Peirick
 Market Mgr, Primary & Specialty Clinics
 Watertown Regional Medical Center
 Watertown
 WI

 Terri
 Rexrode
 Tax Senior Manager
 Wipfli LLP
 Green Bay
 WI

 Rebecca
 Swanson
 Revenue Charge Capture
 Froedtert Health
 Menomonee Falls
 WI

 Marcel
 Tetzlaff
 Director of Program Implementation
 Integrated Health Network of Wisconsin
 Brookfield
 WI

 Leo
 Zalaznik
 Account Business Manager
 Baxalta
 Green Bay
 WI
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