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Webinars - at the HFMA Tennessee Chapter

Tennessee Trains On Tuesdays

 The healthcare industry is changing. From readmissions to ICD-10 to Accountable Care to the Patient Protection and Affordable Care Act. Hospitals and health systems are under tremendous pressure to not only keep up with the changes, but also to understand the drivers and how they affect their organizations. To strengthen its commitment to educating members, the Tennessee Chapter of HFMA is now offering Tennessee Trains on Tuesday, a once a month webinar series to discuss top trends in healthcare.

Tennessee Trains on Tuesday will occur the second Tuesday of every month and is complementary. Members who attend these sessions will walk away with key takeaways and actionable plans to keep their organizations on the path of success. Additionally, you can earn continuing education credits (CPE) by attending.

Questions about webinars should be sent to webinars@tnhfma.org.  If you’re interested in presenting a webinar, please complete our Presentation Proposal Form.




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Archived Webinars

To view or hear recordings of past webinars, please our On Stage channel. 

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  • Understanding Charity Care and Disporportionate Share Medicare Reimbursement

    23 Apr 2018 8:56 AM | Robert Mahoney (Administrator)

    Speakers: Scott Mertie, FHFMA, CMPA and Katie Reid, CPA, CHFP

    Slide Deck: Download Slides (PDF)

    Summary:  We will review the changes that CMS has made for Medicare DSH and Charity Care and how these calculations are made and how they affect hospital reimbursement on the Medicare cost report.

    Speaker Biographies:

    Scott Mertie, FHFMA, CMPA

    Bio:  Scott Mertie leads Kraft Healthcare Consulting, LLC -- an affiliate of KraftCPAs PLLC.With more than 20 years of reimbursement, operational and financial experience in thehealthcare industry, Scott consults on various areas involving reimbursement, includingMedicare and Medicaid cost reports, for healthcare clients throughout the United States.Scott performs other operational reviews and consults on other areas involving the revenuecycle. He also provides expert reports and testimony for healthcare related litigation. Hisclients include attorneys; medical/ surgical, psychiatric, rehabilitation and long- term acutecare hospitals; skilled nursing facilities; home health agencies; and rural health clinics.His previous experience includes 10 years as a senior healthcare consultant for a regionalCPA firm, developing and managing a freestanding ambulatory surgery center for a Nashville area hospital and accounting manager for a Nashville based hospital management company.

    Katie Reid, CPA, CHFP

    Bio:  Katie is the director of the advisory services practice at Kraft Healthcare Consulting, LLC, an affiliate of KraftCPAs PLLC, where she focuses on reimbursement and operations. Her job responsibilities consist of reviewing and preparing Medicare and Medicaid cost reports and working with clients on other reimbursement opportunities, such as Disproportionate Share (DSH) and provider-based options. Additionally, Katie performs healthcare operational assessments and operational projects such as reviews of hospital chargemasters and physician fee schedules. Katie also assists the audit team at KraftCPAs with healthcare-specific financial audits. Prior to joining the KHC team, she interned in the tax department at KraftCPAs.


  • A New Approach to Benchmarking and Performance Management: How One Health System Transformed Opportunities into 8% System-Wide Savings

    11 Apr 2017 12:06 PM | Ronald Gallagher (Administrator)
    Speaker: Linda Albery

    Summary:
    The imperative to elevate clinical, operational and financial performance to new levels remains clear, particularly with today’s uncertainty. Hospitals are dealing with ever-tightening operating margins and the need for greater cost effectiveness has moved from a conceptual goal to a critical requirement. How do you understand and benchmark your current cost position? How do you identify areas for possible improvement? How do you get your staff and physicians engaged in the process? How can you create a culture of collaboration, inclusion and excitement? Learn how one health system used accurate, meaningful comparisons across their system and across the industry and was able to:
    • Identify opportunities to streamline processes and understand labor costs
    • Integrate clinical and cost data to help identify gaps
    • Build trust in the data and drive engagement internally
    • Reduce costs and improve efficiency, generating $150 m in real savings
    Learning Objectives:
    • Define how rigorous and transparent benchmarking can show meaningful peer comparison, highlight internal variation and pinpoint opportunities which provide the best ROI.
    • Define actionable guidance on how to foster data-driven decision-making to build trust and collaboration between leaders, clinicians, finance and support departments
    • List ways your organization can identify appropriate targets by operational function and department and engage managers around the opportunities that the data reveals

    Speaker Biography:
    Ms. Albery’s 25 years of broad and diverse experience in healthcare leadership have included positions as senior vice president for business development and client operations with a major revenue cycle provider and chief operating officer with a large Midwest tertiary hospital.
    Field of Study: Specialized Knowledge
    Delivery Method: Group Internet Based
    Program Level: Intermediate
    Prerequisite(s): None
    Advanced Preparation: None
    Cost: Free
    CPE Hours: 1.0 Hours CPE

    Refund Policy:
    Request for cancellation and refund of registration fees must be received at least 10 business days prior to the event via e-mail to programs-education@tnhfma.org. An administrative fee may apply.

    Questions or Complaints:
    Please direct questions about CPE, including certificates, to our CPE Coordinator, Lee Ann Burney, at cpe@tnhfma.org. For complaints regarding educational programs provided by TNHFMA please contact our Programs and Education Chair, Pam Jones, at programs-education@tnhfma.org.

  • Trends and Best Practices to Encourage Patient Pay

    14 Mar 2017 9:12 AM | Ronald Gallagher (Administrator)
    Speaker: Pete Thompson

    Slide Deck: 
    Downloads Slides (PDF)

    Summary:
    As the prevalence of high deductibles and self-pay accounts increases, healthcare providers are evaluating new ways to work with consumers and ensure optimal recovery of patient pay. As a best practice, some healthcare organizations use a HFMA Peer Reviewed ROI Value Model to uncover patient pay improvement opportunity, in conjunction with an optimized revenue cycle workflow. In this session, learn how patient pay and consumerism are affecting healthcare organizations, and how they’re benefiting by creating a financially oriented consumer-centric care model.

    Learning Objectives:
    • Identify and adapt to market trends that are causing patients to assume greater financial burden for their care (i.e., patient pay).
    • Recommend and execute tactics that appeal to consumers/patients by making care affordable.
    • Give solution criteria, best practices and lessons learned to develop and execute a patient pay strategy.

    Take Away:
    The importance of the Occupational Mix Survey and its implications.

    Speaker Biography:
    Mr. Thompson has been focused on patient pay for more than a decade. He joined ClearBalance in 2004 and has served in myriad client program performance roles, including management of the funding department and director of client services. As senior solutions architect, Pete is responsible for client solution design, including financial modeling and ROI analysis. He also counsels prospective and current clients about their revenue cycle workflow to drive optimal results from the ClearBalance program. Pete is involved in client implementation to ensure all benefits are translated from paper to practice. Before ClearBalance, Pete was a senior analyst with Cardinal Health.

    Field of Study: Specialized Knowledge
    Delivery Method: Group Internet Based
    Program Level: Intermediate
    Prerequisite(s): None
    Advanced Preparation: None
    Cost: Free
    CPE Hours: 1.0 Hours CPE

  • Region V - Optimizing Reimbursement Through Clinical and Financial Collaboration

    23 Feb 2017 10:00 AM | Ronald Gallagher (Administrator)
    Speaker: Linda Corley

    Summary:
    Two healthcare reimbursement themes have taken center stage for 2017 — “pay for performance” and “proof of revenue integrity.” These interconnected clinical and financial requirements highlight the need for compliant processes that support collaboration of all hospital staff members. And, while the regulatory guidance is generally well-known, the structural and operational “how-to’s” for achieving clinical and financial joint performance outcomes are proving more difficult to define and implement. This missing structure for optimizing the new payment methodologies brings about a need for understanding and developing compliant “change management” strategies. Even though healthcare is experiencing its fifth year of value-based payment, many providers are still attempting to capture optimum cash utilizing outdated patient care management, charge capture, coding and billing processes and evaluation through misaligned performance metrics. This session will present practical and proven best practice revenue cycle leadership job roles and team member operational work flows to meet the challenges of 2017 compliant reimbursement.

    Learning Objectives:
    • Understand what regulatory changes have been made for 2017 payment methodologies, and why collaboration plays such an important role in optimum reimbursement.
    • Discuss how each revision to the major payment initiatives should be (and can be) successfully implemented in the revenue cycle through organizational and leadership changes in daily processes.
    • Define “patient care management” and its importance to optimum payment.
    • Know what best practice processes can be utilized to improve clinical and financial operations.
    • Discuss how “change management” should and can be used to drive permanent and sustainable improvement in compliant reimbursement that will withstand external audits through proof of revenue integrity.


  • Preparing Your Occupational Mix Survey

    14 Feb 2017 10:00 AM | Ronald Gallagher (Administrator)
    Speaker: K. Michael Webdale Jr.

    Slide Deck:
    Downloads Slides (PDF)
    Video:
    View on YouTube

    Summary:
    The occupational mix survey must be submitted to CMS every three years by IPPS hospitals. Using calendar 2016 salaries, the next survey’s deadline is July 3, 2017 and the data will affect the wage index for FFY 2019 through 2021.

    Learning Objectives:
    • List how to collect the data for the standard occupational categories.
    • Describe how the occupational mix adjustment factor is calculated.
    • Explain the impact it has on the wage index and payments to hospitals.

    Take Away:
    The importance of the Occupational Mix Survey and its implications.

    Speaker Biography:
    Mr. Webdale has calculated and projected area wage indices from annual CMS updates, trained wage index seminar participants and provided assistance to hospitals filing appeals with the fiscal intermediaries and CMS. Mr.Webdale has served as the Project Manager of the Occupational Mix Survey Program for numerous hospitals and hospital associations, analyzing hospitals’ Occupational Mix and support data and preparing survey forms (CMS10079) and support documentation packages.
    Field of Study: Specialized Knowledge
    Delivery Method: Group Internet Based
    Program Level: Intermediate
    Prerequisite(s): None
    Advanced Preparation: None
    Cost: Free
    CPE Hours: 1.0 Hours CPE

  • Uncovering the Episode Management Opportunities in Tennessee

    10 Jan 2017 10:00 AM | Ronald Gallagher (Administrator)
    Speaker: Kristi Short

    Slide Deck:
    Downloads Slides (PDF)

    Summary:
    Naavis has pulled together some unique data on the cost of episodes and bundles. This presentation will share the acute costs and post-acute costs and then map that to regional and national benchmarks. Strategies will be discussed that hospitals can use when thinking about bundled payments and the post-acute space.

    Learning Objectives:
    • Discuss why episode management is a mandate for your organization.
    • List what you need to do to improve cost efficiencies and outcomes for episodes.
    • List ways to leverage participation in bundles to grow market share.

    Take Away:
    Learn the specific episode management improvement opportunities in Tennessee.

    Speaker Biography:
    Kristi Short is the Senior Vice President of Navvis and Company. She leads business development and service line strategies for Navvis to equip physician groups and health system clients to manage episodes of care and succeed under evolving value-based payments. With more than 20 years’ experience in strategic planning, business development, and strategy implementation in the healthcare and financial services industries, she brings a valuable perspective to her work with client organizations having led broad-based initiatives in two heavily regulated and dynamic sectors.
    Field of Study: Specialized Knowledge
    Delivery Method: Group Internet Based
    Program Level: Intermediate
    Prerequisite(s): None
    Advanced Preparation: None
    Cost: Free
    CPE Hours: 1.0 Hours CPE

  • Achieving Optimal CDI ROI—Proper Alignment & Integration with Revenue Cycle

    13 Dec 2016 10:00 AM | Ronald Gallagher (Administrator)
    Speaker: Glenn Krauss

    Slide Deck:
    Downloads Slides (PDF)
    Video:
    View on YouTube

    Summary:
    Clinical documentation improvement programs have existed for sometime and in fact are mature programs at most hospital facilities. A recent Black Book survey of 907 healthcare leaders found that a majority of CFOs and other financial staff (87 percent) that case mix index improvement was the largest motivator for CDI adoption because of its potential to increase healthcare revenue and optimize high-value specialist utilization.

    The survey goes on to indicate healthcare leaders found that hospitals enhanced quality of care and the organization’s bottom line by choosing to use CDI programs after the ICD-10 transition. Approximately 85 percent of hospitals experienced quality improvements and case mix index increases after CDI implementation. This overwhelming support and embracement of CDI initiatives by healthcare leaders fails to acknowledge and take into account the increasing number of medical necessity denials, DRG downcodes and clinical validation denials directly attributable to these programs amounting to revenue leakage. Revenue leakage attributable to CDI, easily avoidable with process improvement in the current widespread framework in which CDI operates, perpetuates misalignment and close integration with established goals and objectives of the revenue cycle.

    Learning Objectives:
    • List the 5Rs associated with changing the framework of CDI
    • Be able to discuss the pitfalls of traditional CDI programs and identify opportunities to engage physicians in true CDI efforts that support the overall revenue-cycle process

    Take Away:
    Learn the significant limitations and after effects of current CDI programs that negatively impact the revenue cycle.

    Speaker Biography:
    Glenn Krauss is ZirMed’s Regional Director of Enterprise Solutions. Glenn brings more than 20 years as a professional in the Health Information Management field to his work at ZirMed; previously, he held executive and consulting positions including Revenue Systems Manager, CDI Director of both inpatient and outpatient programs, Director of Case Management and Revenue Enhancement, Director of Health Information Management, Corporate Director of Clinical Coding, and Data Quality Manager with major US hospital and health systems nationwide. He has successfully implemented numerous outpatient CDI programs at multi-hospital systems throughout the country with notable recognized returns while engaging physicians in achieving true documentation excellence through consistent adherence to best practice standards of clinical documentation.

    Field of Study: Specialized Knowledge
    Delivery Method: Group Internet Based
    Program Level: Intermediate
    Prerequisite(s): None
    Advanced Preparation: None
    Cost: Free
    CPE Hours: 1.0 Hours CPE

  • Navigating Medical Necessity Denials Management for All Payers

    8 Nov 2016 10:00 AM | Ronald Gallagher (Administrator)
    Speaker: John Zelem, MD

    Slide Deck:
    Downloads Slides (PDF)

    Summary:
    The resumption of audits from Quality Information Organizations (QIOs) and the impending referrals to Recovery Auditors has the potential to increase government denials and add to an already backlogged appeals caseload. The inevitable reality of claims denials plagues every hospital.
    Managing denial and appeal processes can be a long and frustrating undertaking. As commercial and managed Medicare/Medicaid denials continue to grow and QIO inquiries and ALJ backlog add additional uncertainty to government denials, hospitals face serious threats to their financial health from revenue lingering in denial limbo.

    Learning Objectives:
    • Identify the current environment for medical necessity denials from all payers
    • Discuss the standard appeal processes for medical necessity denials
    • List what should be included in a denials management and prevention strategy

    Take Away:
    This presentation provides best practices for managing medical necessity denials from all payers – commercial, managed Medicare/Medicaid, and government – and examples of how some facilities are addressing the growing threat to their revenue from medical necessity denials.

    Speaker Biography:
    Dr. Zelem is Vice President, Compliance and Physician Education, at Optum Executive Health Resources. Dr. Zelem is responsible for quality assessment and improvement at Optum Executive Health Resources’ client hospitals and works closely with Optum Executive Health Resources’ sales team. In addition, Dr. Zelem travels to Optum Executive Health Resources’ client hospitals regularly to provide medical executives and staff members with ongoing education on a variety of topics including Medicare and Medicaid compliance and regulations, medical necessity, Recovery Audit Contractors, utilization review, denials management and length of stay. Prior to joining Optum Executive Health Resources, Dr. Zelem practiced general surgery for 24 years at Griffin Hospital, a 160-bed acute care community hospital located in Derby, Conn., and then practiced general surgery for two years at Baptist Memorial Hospital-Booneville, a 67-bed acute care hospital located in Booneville, Miss. Dr. Zelem received his medical degree from Boston University School of Medicine and bachelor’s degree in biology from Boston College.
    Field of Study: Specialized Knowledge
    Delivery Method: Group Internet Based
    Program Level: Intermediate
    Prerequisite(s): None
    Advanced Preparation: None
    Cost: Free
    CPE Hours: 1.0 Hours CPE

  • Adapting Your Medical Necessity Compliance Program in an Evolving Regulatory Environment

    13 Oct 2016 11:00 AM | Ronald Gallagher (Administrator)
    Speaker: Dr. Joydip Roy

    Slide Deck:
    Downloads Slides (PDF)

    Summary:
    How will you ensure your hospital withstands auditor scrutiny in 2016 given the expected changes from Centers for Medicare & Medicaid Services (CMS) to address the persistently large improper payment rates in short-stay inpatient claims? Hospitals should evaluate their current compliance programs regularly. With medical necessity changes CMS is proposing, the best way to defend against inappropriate denials is to ensure a compliant process for review and certification of admission status on every patient that enters the hospital. With a renewed emphasis on physician judgment and medical necessity, not hospital level of care, providers must demonstrate a legitimate, defensible and consistent Utilization Review process to determine appropriate admission status. Hospitals across the country may struggle with this proposed shift, especially considering the time-based recommendations implemented in 2014. It is challenging to anticipate projected enforcement under the QIOs with their extensive referral possibilities. This session will provide guidance on the implications of proposed changes from CMS and the potential impacts to your medical necessity admission review program.

    Learning Objectives:
    • Discuss trends and lessons learned from Probe and Educate efforts.
    • Identify potential QIO enforcement ramifications and discuss the extensive referral opportunities that could impact hospitals.
    • Discuss policies and practices implemented under FY 2014 IPPS, related to the 2 midnight rule, and determine if current programs would align with a renewed emphasis on provider judgment and medical necessity for inpatient hospital admissions.

    Take Away:
    This session will assist hospitals in evaluating their current medical necessity admission review program and help determine if there could be a possible overuse of observation status at their facilities.

    Speaker Biography:
    Dr. Roy currently serves as Vice President, Compliance and Physician Education, at Executive Health Resources (EHR), a national organization that provides technology-enabled, expert Physician Advisor teams concentrating on managing Medicare and Medicaid regulatory compliance, minimizing inappropriate medical necessity denials and achieving appropriate lengths of stay in acute care hospitals and health systems. At present, EHR works with more than 2,300 hospital and healthcare organizations across the country, has an exclusive endorsement of the American Hospital Association and has received the elite Peer Reviewed designation from the Healthcare Financial Management Association.Board Certified in internal medicine, Dr. Roy completed training in internal medicine and pediatrics at Baylor College of Medicine. Dr. Roy is a member of the American College of Physicians. He earned his medical degree from the University of Tennessee College of Medicine in Memphis, Tenn.

    Field of Study: Specialized Knowledge
    Delivery Method: Group Internet Based
    Program Level: Intermediate 
    Prerequisite(s): None
    Advanced Preparation: None
    Cost: Free
    CPE Hours: 1.0 Hours CPE

  • Medicare DSH Payment

    11 Oct 2016 11:00 AM | Ronald Gallagher (Administrator)
    Speakers: Christopher Keough and Stephanie Webster

    Slide Deck:
    Downloads Slides (PDF)

    Summary:
    The Medicare DSH payment has undergone some changes in the last few years and will be facing bigger changes going forward. Join us for this outstanding webinar on the latest changes. Mr. Chris Keough and Ms. Stephanie Webster focus their practice on Medicare and Medicaid reimbursements and have significant experience with DSH payments.
    This presentation will cover recent developments concerning the Medicare DSH payment for uncompensated care and the traditional, “empirically justified” DSH payment. The presentation will include the final IPPS rule for FFY 2017, further related guidance from CMS, if any, and recent court decisions on the DSH payment.

    Learning Objectives:
    • Describe the updates to the Medicare DSH Payment related to uncompensated care.
    • List recent rule making and judicial decisions affecting the DSH payment.
    • Describe the FFY 2017 impact to DSH.

    Speaker Biography:
    Christopher Keough’s practice focuses on Medicare and Medicaid reimbursement and compliance. He regularly represents hospitals in reimbursement litigation involving payments for disproportionate share hospitals (DSH), the calculation of prospective payment system rates, payments for graduate medical education (GME) costs and other reimbursement issues. He has served as lead counsel in several of the largest reimbursement disputes in the history of the Medicare program, often prevailing on issues of first impression. He has been recognized among the nation’s leading health lawyers in Chambers USA, The Best Lawyers in America, Super Lawyers and Nightingale’s Healthcare News.

    Speaker Biography:
    Stephanie Webster’s practice focuses on the area of Medicare and Medicaid reimbursement. She represents hospitals in administrative and federal court litigation and counsels them regarding payment and compliance. Ms. Webster formerly served as an attorney for the Centers for Medicare and Medicaid Services (CMS), Division of the Office of General Counsel for the U.S. Department of Health and Human Services (HHS). She has been recognized as a leading health care lawyer by Chambers USA and Nightingale’s Healthcare News. Ms. Webster is a member of the firm’s regulatory practice steering committee.
    Field of Study: Specialized Knowledge
    Delivery Method: Group Internet Based
    Program Level: Intermediate
    Prerequisite(s): None
    Advanced Preparation: None
    Cost: Free
    CPE Hours: 1.0 Hours CPE
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