PEAKS - StarChapter · The Essential Elements of Comprehensive Care for Joint . Replacement (CJR)...

FIRST QUARTER | JULY 2016PEAKS amp plains

HFMA COLORADO CHAPTER

INSIDE THIS ISSUE

PRESIDENTrsquoS MESSAGE CHERYL CURRY p 2

MEMBER SPOTLIGHT KIM DAVIS p 5

GREAT FALL RETREAT p 7

PROVIDER SPOTLIGHT SCL HEALTH | ST JOSEPH

HOSPITAL p 12

WIN PRIZES IN OUR CHAPTER CONTESTS like us on facebook or submit a cover photo p4

The Essential Elements of Comprehensive Care for Joint Replacement (CJR) p 7

MARY MIRABELLI ROLLS OUT THE NEW 20162017 THEME p3

KEYS TO COLLECTING IN THE AGE OF PATIENT CONSUMERISM

p 16

CHA UPDATE p 20

10 THOUGHTS ABOUT LEADERSHIP p 23

COMMITTEE CORNER p 24

4

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JULY 26 2016 Rural Road Show - Pueblo

JULY 27 2016 Rural Road Show - Loveland

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AUGUST 9 2016 Webinar Provider-Based Section 603 Implementation and a Review of the Proposed Provider-Based Learning Objectives

SEPTEMBER 21-23 2016 Great Fall Rural Retreat Hotel Colorado Glenwood Springs

OCTOBER 4TH OCTOBER 18TH NOVEMBER 1ST amp NOVEMBER 15TH Medicare Bootcamp Webinar Series

JANUARY 15-18 2017 Region 10 amp 11 Symposium Las Vegas NV

FEBRUARY 16-17 2017 Compliance Conference Marriott Park Meadows Lone Tree CO

APRIL 19-21 2017 Annual Conference DoubleTree DTC Greenwood Village CO

UPCOMING EVENTSCHECK OUT OUR UPCOMING EVENTS FIND MORE DETAILS AND WAYS

TO REGISTER AT WWWHFMA-COORG

PAGE | 1

plainsPEAKSFIRST QUARTER 2016-2017 | JULYamp

PRESIDENTrsquoS MESSAGECheryl Curry HFMA Colorado Chapter President 2016-2017

I am looking forward to the year ahead and honored to serve as your Chapter President for the 20162017 Fiscal Year I especially

want to thank Tim Cashman for his dedication to our Chapter not only last year as our President but also in the previous several years when he served on educational conference committees and for his willingness to continue to volunteer his time and to transfer his knowledge to the rest of the volunteer team

Speaking of the volunteer team the reason our Chapter continues to grow and thrive is because so many of our members volunteer their time to help plan and facilitate high quality events

Without th is great team of dedicated volunteers we wouldnrsquot have been able to provide over 14000 hours of education last year - an average of over 19 hours per member

One of our members who has served as our Office Manager for the last several years is Hal Prink Hal will still be volunteering time as the Chair of the Revenue Summit and likely some other volunteer positions but he has retired from his Office Manager role Taking his place is Jessica Griffith who worked with Hal last year and will now be taking over this role full-time Jessicarsquos assistance to our Chapter in this Office Manager position is critical to the success of our well-run events and communication including coordination of our website Welcome Jessica We appreciate you very much

Several of us recently returned from HFMArsquos ANI in Las Vegas where we heard HFMArsquos Chair Mary Mirabelli challenge us to ldquoThriverdquo during these times of transformative change in health care

Our theme and focus for the year ahead will be to ldquoThriverdquo as a Chapter with innovative educational and networking events

While we were at ANI the CO Chapter was presented with 7 awards for our achievements las t year in the areas of Educat ion Cer t i f icat ion Membership Recrui tment G r o w t h amp R e t e n t i o n Mentorship Collaboration and for our new Mobile App You should download this free App if you havenrsquot already done so It has our Chapter Directory Upcoming Events and Volunteer Opportunities among many other things

HFMA Colorado in the iTunes store

HFMA Colorado in the Google Play store

To prepare for each year CO Chapter Board members Officers and Committee ChairsCo-Chairs get together for a full day of Planning We met in May to set priorities for the upcoming year The feedback we received from our members in the annual survey was reviewed and taken into consideration in our planning

Some of the events we are planning include 3-day Rural Road Show in July - bringing education to Pueblo Loveland and Glenwood Springs

Fall Retreat in Glenwood Springs that will include a full educational line-up plus several planned outdoor activities

1st time ever Region 21 (R21) conferencendash combin-ing the 14 Chapters in Regions 10 and 11 for a mega conference in Las Vegas

Compliance Conference Revenue Summit ndash covering payment strategies rang-ing from uninsured to government and insured pay-ers This conference will focus on strategies to Thrive during times of declining revenue

Annual Conference FREE Monthly Webinars Women in Leadership Events Early Careerist tracks and Pre-conference sessions Networking

I hope you can see why I am excited about the year ahead Itrsquos time to Thrive

Cheryl Curry

PRESIDENTrsquoS MESSAGE (continued)

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PAGE | 3



NEW HFMA CHAIR MARY MIRABELLI TAKES OFFICEJune 27 2016 Las Vegas ndash The Healthcare Financial Management Association (HFMA) inducted Mary Mirabelli FHFMA into office as Chair of its Board of Directors for the 2016-2017 term during HFMArsquos annual conference in Las Vegas Her term began on June 1 2016

In her role as the chief elected officer of HFMA Mary will be responsible for providing overall direction to the Association by actions such as establishing policies appointing key leaders planning educational programs choosing a program theme and representing the Association at various events

Mirabelli is Vice President Global Healthcare Practice at Hewlett Packard Enterprise (HPE) In this role Mirabelli works to bring the power of HPE for healthcare clients across the globe to sustain and grow their businesses in the provider payer and life sciences market segments

ldquoWith Maryrsquos global healthcare experience she brings a unique perspective to the associationrdquo said HFMA President and CEO Joseph J Fifer FHFMA CPA ldquoShe also has insights into improving the financial experience that will inform our consumerism initiatives Wersquore excited to welcome Mary as HFMA chairrdquo

Prior to joining HPE Mirabelli served as a senior executive at Hospital Corporation of America (HCA) Mary was Vice President of Implementation for HCArsquos Revenue Cycle Shared Services (now Parallon Business Solutions) and subsequently Vice President and Chief Program Officer in the Clinical Services Group At HCA Mary managed an extensive health IT portfolio and built a team of more than 200 health IT professionals

Earlier in her career Mirabelli was Senior Manager and Vice President in the Health Provider and Managed Care Practice at Ernst amp Young (now Capgemini) She started her healthcare management career as Director of Occupational Therapy at Christ Hospital and Medical Center Oak Lawn Ill which is now Advocate Christ Medical Center part of Advocate Health Care

A member of HFMA since 2003 Mirabelli has served on the National Board of Directors Governance Committee National Advisory Council Morgan Award Judging Committee Healthcare Leadership Council Early Careerist Task Force and Strategic Planning Committee She is also a recipient of the Reeves Silver and Follmer Bronze Award Other governance positions include the HCA Foundation Board and Vision Consulting Mirabelli also serves as Chair of the Federation of American Hospitals Health Information Technology Task Force

Mirabelli a Fellow of HFMA holds a masterrsquos degree in management from the JL Kellogg School of Management Northwestern University Evanston Ill and a bachelorrsquos degree in occupational therapy from the University of Illinois at Urbana-Champaign

Other new Board officers for 2016-2017 include Chair-elect Carol A Friesen Vice President of Health System Services Bryan Health Lincoln Neb and Secretary-Treasurer Kevin F Brennan Executive Vice President FinanceCFO Geisinger Health System Danville Pa

Additionally three newly elected members joined the HFMA Board for a three-year term ending in 2019 Dorothy A Coleman Executive Vice President and CFO Excellus BlueCrossBlue Shield Rochester NY Aaron R Crane CEO Propel Health Portland Ore Paula M Reichle Senior Vice President and CFO Sparrow Health System Lansing Mich

PAGE | 4


WIN SOME COOL STUFF HELP HFMA COLORADO GET 200 LIKES BEFORE AUGUST 15TH

ldquoLike usrdquo on Facebook for your chance at ONE FREE 2016-2017 CONFERENCE REGISTRATION (for single admission) We have to reach 200 likes to select a winnerhellip So go ahead hellipldquoLike usrdquo TODAY

COVER PHOTO CONTEST

Have a beautiful picture of our state It could be featured on the cover of our next issue of PEAKS amp plains Submit your high resolution photo to Jessica Griffith at adminhfma-coorg The featured photo will win a $10 Starbucks giftcard Make sure you let us know where the photo was taken You will receive a photo credit Help us showcase our beautiful state

PAGE | 5

MEMBER SPOTLIGHT

KIM DAVISDirector of Patient Accounts | University Physicians Inc

Kim Davis Director of Patient Accounts at University Physicians Inc lives out her philosophy of leadership - which is to help others become better at what they do and to lead in that endeavor by her own example Kim is personally very motivated to continuously improve herself and she inspires her team to do the same That is how she and her team dedicate themselves to effectively provide business operations and administrative support to the 2200 providers at the University of Colorado School of Medicine

Kim is responsible for managing and directing the overall billing and collection functions of the large centralized billing office for the multi-specialty academic medical practice Through her committed leadership Kim ensures optimal and best practice standards of compliance and revenue cycle performance managing a unit of 160 staff and 12 managers

Kim takes effective leadership very seriously and knows that encouraging the managers and other staff members in her unit is essential to inspiring them and motivating them to always strive to get better at what they do

An international authority and the leading academic medical institution in the West the University of Colorado School of Medicine (SOM) offers cutting-edge research and technologies and high quality medical treatment to patients at the University of Colorado Hospital Childrenrsquos Hospital Colorado and at sites throughout Colorado US News and World Report ranked University of Colorado Hospital the 1 hospital in Colorado for 2015-2016

Located adjacent to the new Anschutz Medical Campus in Aurora one of the largest and most advanced academic medical campuses in the country University Physicians Inc in addition to business and administration support serves as a resource for patients and physicians seeking information about the University of Colorado network The facility where the 300 or so University Physician Inc (UPI) employees reside is a new 184700-square-foot building

When I asked Kim what the most challenging issues that she finds in supporting University of Colorado SOM today this was her response was ldquoI think everyone would say that keeping up with CMS quality value and merit based payment programs is very challenging Although we are all invested in optimizing healthcare quality and controlling expenditures the effort to understand and implement the continuously evolving initiatives is a resource intense endeavorrdquo

Kimrsquos background and path leading to where she is today is interesting and filled with practical hard work and experiential teaching When I asked Kim to describe her progression to her current position her response told the entire story ldquoMy dad owned a physician billing company I learned billing rules and regulations as well as the nuance of managing operational processes from him and that experience I worked for him from the time I was 14 years old I started in the file room and worked for him for 13 years after I graduated collegerdquo

PAGE | 6

Kim graduated from Colorado State University with a Bachelorrsquos Degree in Business Administration Management and Operations

After her Dad sold the billing company business Kim worked in private practice for two years prior to joining UPI in 2007 In 2009 she was promoted to the Director of Patient Accounts position that she holds today

In the past Kim and I have discussed leadership and what that really means so when I asked her to describe her philosophy regarding her position and work and what inspires her to do what she does I was not surprised by her answer ldquoI am a motivated leader I am committed to iterative improvement and I challenge my team to commit themselves to the same My team is expert in the work that defines their responsibilities I am here to support them to challenge them to facilitate their success I believe that our obstacles and our missteps provide an opportunity to learn and improve and the best of us seize that opportunity and better ourselves and our performance as a result I also demonstrate and message that balance is important ndash work hardplay hard take time to breath and enjoy life outside of workrdquo

Kim has been an HFMA member for 5 years and attends conferences and education meetings based on topic content With the amount of responsibility that she has at UPI her time is a valuable quantity and requires that she choose her off-campus time selectively Kim told me ldquoHFMA offers valuable networking and educational opportunities Several members of our leadership take advantage of the resources offered by the Associationrdquo

I asked Kim what she considers her key success factor and some wisdom that she would like to share with others Her response was ldquoI think self-awareness is one of the most valuable tools that anyone can have in their toolkit Know yourself and how others perceive you This helps you not only recognize your own opportunities for development but it also enables you to appreciate teammates whose strengths are different from yoursrdquo

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HFMA_2016_85x11Cindd 1 6152016 40007 PM

Interview conducted by

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MEMBER SPOTLIGHT (continued)

7

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GREAT FALL RETREATSeptember 21-23 2016

Enjoy an exciting new format incorporating local adventures and taking advantage of all Glenwood has to offer alongside some OUTSTANDING education

Hike at Hanging Lake on Wednesday morning

Glenwood Caverns Adventure Park on Thursday

Guided Rafting on Friday

SPACE WILL BE LIMITED FOR ACTIVITIES

Mark your calendars now Registration and Full Brochure Coming Soon

PAGE | 8

INTRODUCTIONWhile the Comprehensive Care for Joint Replacement (CJR) program is positioned as a ldquotestrdquo given the infrastructure being put in place by CMS to run the program CJR is likely just the start of a larger effort by CMS to implement additional mandatory bundled payment programs Therefore itrsquos very important that hospital financial stakeholders become familiar with CJR even if their hospital isnrsquot currently a participant

PROGRAM SUMMARYThe Comprehensive Care for Joint Replacement (CJR) bundled payment model is effective April 1 2016 and is set to continue through five performance periods ending on December 31 2020 CMS is implementing this model via its authority under section 1115A of the Social Security Act as modified by Section 3021 of the Affordable Care Act which established the Center for Medicare and Medicaid Innovation (CMMI) CMMI was created to test new payment and service delivery models with the goals of reducing CMS program expenditures while maintaining or improving outcomes

CJR will test a new bundled payment model for inpatient lower extremity (ie hip and knee) joint replacements

Unlike voluntary programs such as BPCI with few exceptions participation in CJR is mandatory for hospitals in 67 selected MSAs

CJR EPISODESA CJR episode starts with admission of an eligible beneficiary for an LEJR procedure ultimately discharged under one of the following two MS-DRGs

MS-DRG 469 Major Joint Replacement or Reattachment of Lower Extremity with MCC

MS-DRG 470 Major Joint Replacement or Reattach-ment of Lower Extremity without MCC

CMS refers to these two MS-DRGs as ldquoanchor MS-DRGsrdquo

The episode also includes all related Medicare Part A and Part B care for 90 days after discharge This includes additional hospital stays care received at SNFs and other post-acute providers physician visits physical therapy etc unless the provided service is on a CMS exclusion list

The day of discharge counts as the first day of the 90 day post-discharge period

CMS will exclude subsequent unrelated hospital stays from the episode based on MS-DRG Similarly CMS will identify unrelated outpatient care based on ICD-9 ICD-10 code CMS will update the lists for both exclusion types on an annual basis at a minimum during the CJR program The exclusions will apply to the calculation of both target prices and episode spending

Whether you are a CJR participant or planning for it understanding your exposure and strategic position is key to success in this new era of mandatory bundled payment models

BESLERrsquos CJR Analysis amp Risk Assessment service examines the drivers that impact bundled payment success for you and identifies key performance indicators and risk factors including

middot Target price analysis discharge trends provider utilization and readmissionsmiddot Analysis of quality measures including HCAHPS and complication ratesmiddot Post-acute care summary and identification of potential collaboratorsmiddot Quarterly data analysis and year-end reconciliation

(877) 4BESLER | wwwbeslercom | BeslerDotComEnhancing and protecting Medicare revenue for hospitals

Visit beslercomCJR to download a Special Report that explains how CJR works and what your responsibilities are in this new environment

Are you ready for CJRTHE ESSENTIAL ELEMENTS OF CJRBy Jim Hoffman COO BESLER Consulting


TARGET PRICESCMS uses three years of historical data to set target prices The historical data will be updated every other year during the program Both hospital-specific and regional data is used Regional pricing is included in the calculations to provide gainsharing opportunities for hospitals that are already well-performing

CMS will provide hospitals with a number of target prices for each performance year segmented by MS-DRG presence of hip fracture and submission of optional quality data In addition since CMS will normalize prices based on various IPPS and OPPS program changes (which go into effect on 101 and 11 of each calendar year respectively) CMS will further distinguish target prices for episodes initiated between January 1 and September 30 vs episodes initiated between October 1 and December 31

CMS applies a discount factor to the target prices which is Medicarersquos portion of the reduced expenditures from the CJR episodes

EPISODE SPENDINGCMS calculates the spending for an episode by summing payments for qualified hospitalizations under MS-DRG 469 and 470 and all subsequent related Part A and Part B care for 90 days post-discharge

QUALITY MEASURESCMS is implementing a composite quality score to determine eligibility for reconciliation payments and to potentially reduce the discount factor applied to episode spending when determining the amount of repayment or reconciliation payment

The composite quality score is based on three weighted measures

Hospital-level risk-standardized complication rate follow-ing elective primary total hip arthroplasty (THA) and or total knee arthroplasty (TKA)

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey

THATKA voluntary patient-reported outcome and lim-ited risk variable data submission

RECONCILING PAYMENTSAfter each CJR performance year CMS will perform a retrospective reconciliation of CJR episode spending compared to the target prices by calculating the Net Payment Reconciliation Amount (NPRA) The NPRA is the sum of the amounts above and below the target price for each CJR episode in the performance period

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ELEMENTS OF CJR (continued)

PAGE | 10


If the final NPRA is below zero that amount is paid to the hospital as a ldquoreconciliation paymentrdquo as long as the hospital meets a minimum composite quality score If the NPRA is above zero that amount is owed to CMS by the hospital as a ldquorepayment amountrdquo

Hospitals will not be responsible for any repayment amount due for the first performance year but may earn reconciliation payments for all performance years

DATA SHARINGCMS will provide detailed and summary claim and payment data related to CJR episodes to participant hospitals so that they may better understand their target price calculations and operational performance and identify areas for improvement

FINANCIAL AGREEMENTS WITH OTHER PROVIDERSSince CMS considers care coordination critical for successful LEJR outcomes they are allowing CJR hospitals to establish risk-sharing and gain-sharing relationships (ldquosharing arrangementsrdquo described in ldquocollaborator agreementsrdquo) with other providers (ldquoCJR collaboratorsrdquo)

When risk-sharing payments are made to a hospital by a CJR collaborator CMS refers to the payment as an ldquoalignment paymentrdquo A hospital that shares a reconciliation payment with a CJR collaborator makes a insharing paymentrdquo


PAGE | 11


WAIVERSIn order to make the implementation and operation of the CJR program more efficient and potentially more effective CMS is introducing a number of program waivers related to home health visits telehealth and the SNF 3-Day Rule

CONCLUSIONProviders should be working now to proactively identify areas of risk under CJR and put a program in place that measures their ongoing performance

A special report is available at beslercomcjr that further explains how CJR works and expands on the responsibilities of participating providers

ABOUT THE AUTHORJim Hoffman serves as COO at BESLER Consulting where his responsibilities include sales marketing finance IT and service operations He brings over 25 years of technology and operations experience to BESLER having previously held executive positions at MedAssets Accuro Healthcare and Innovative Health Solutions Jim is a graduate of the University of Virginia


12

PATIENT ACCESS WEEKAPRIL 2016By Rose Bonet and Cally Christensen

Saint Joseph Hospital a 365-bed hospital in Denver Colorado is part of SCL Health a faith-based nonprofit healthcare organization that operates eight hospitals three safety net clinics one childrenrsquos mental health center and more than 190 ambulatory service centers in Colorado Kansas and Montana The hospital has recently been named one of ldquoAmericarsquos 100 Best Hospitalstraderdquo by Healthgradesreg for the third consecutive year In addition to being named as one of best hospitals in the country Saint Joseph Hospital is also a leading hospital when it comes to specialty care including cardiology critical care gastroenterology and pulmonology

In 2014 Saint Joseph Hospital and National Jewish Health created a joint operating agreement to strengthen patient care in Denver ldquoThe strong outpatient approach of National Jewish Health compliments the focused inpatient expertise of Saint Joseph Hospital increasing our ability to manage patients along the full continuum of carerdquo(httpwwwsaintjosephdenverorg)

Saint Joseph Hospital has also recently been accredited as a ldquoBaby Friendly Hospitalrdquo by Baby Friendly USA Inc an initiative with funding through UNICEF and WHO This certification encourages and recognizes hospitals and birthing centers that offer an optimal level of care for breastfeeding

mothers and their babies (eg information confidence and the skills needed to successfully initiate and continue breastfeeding their babies (Press Release June 20 2016)

It is easy to see why Saint Joseph Hospital has received so many national and international honors and accolades ndash itrsquos thanks to its staff and clinicians Recently Troy Spring Vice President of Revenue Services at SCL Health and Lynne Andrews Senior Director of Patient Access joined Rose Bonet Director of Patient Access at Saint Joseph Hospital to celebrate ldquoPatient Access Weekrdquo which took place April 3 ndash 9 2016 Rose said ldquoWe were excited to share our vision of the new cultural identity of lsquoPatient Accessrsquo found within the front of revenue cycle operationsrdquo Their fun informative and educational presentations were combined with games to help patients and care site partners better understand that Patient Access is the evolution of bringing together admitting processes and revenue cycle operations into one department

PROVIDER SPOTLIGHT

SCL HEALTH SAINT JOSEPH HOSPITAL

PAGE | 13


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Rose also used Patient Access Week to celebrate her well-deserving team with awards that ranged from ldquoMost Valuable Playerrdquo to ldquoService Excellencerdquo and ldquoLeadershiprdquo The gifts awards and giveaways were a great boost for employee morale and helped to jump start excitement around the week In all Rosersquos efforts helped the team reach their goal to identify and promote best practices in scheduling registration and insurance verification financial counseling and to increase their meaningful use scores through MyChart sign up

CHANGING CULTURAL IDENTITY

According to Rose they started planning for Patient Access Week in December 2015 Throughout the next few months the team worked closely on how to best celebrate their increasing importance within the front end Revenue Cycle One of their first educational opportunities was with current care site partners Rose and her team wanted to change the perception that the Patient Access Department was ldquojust registrationrdquo in a fun creative and lasting way

While registration is an important component of the overall cycle Patient Access is also responsible for insurance and benefit collection the acquisition of referrals and pre-certifications for procedures medical necessity validation and the collection of the patient financial liabilities They decided to represent the stages and overall cycle through full size color presentation boards The information presented flowed very smoothly from schedulingpre-certification to registration and then finally to financial counseling with a focus on Colorado Affordable Care

PAGE | 14


The team identified the ldquowhat when where why and howrdquo a patient moves through the healthcare continuum from the Patient Access perspective ldquoSome of the associates have been in a Patient Access position their entire career with Saint Joseph Hospital and their point of view around the evolution (from registrationhellip to admissionshellip and now Patient Access) was highlightedrdquo

When asked how the rollout went Rose said ldquoEducating our business partners and the community was our goal and we achieved it I am blessed to work with such an amazingly skilled team at Saint Joseph Hospital who love what they do because they genuinely love the people in our communityrdquo According to Rose ldquoNext year more celebration more education and more funrdquo

PROVIDER SPOTLIGHT (continued)

PAGE | 15

ROSE BONETRose Bonet is currently the Director of Patient Access at Saint Joseph Hospital she joined SCL Health in November of 2014 Rose has eight years of Patient Access experience that spans all areas of Patient Access including bed planning

Prior to joining SCL Health Rose served at Scott and White Hospital now Baylor Scott and White in Temple Texas for 17 years in several capacities Rosersquos health care career began in 1998 as a Health Unit Coordinator As doors continued to open for her she stepped into the world of Patient Access in 2008 as a Room Control clerk otherwise known as bed planner for a 644 bed facility She was quickly promoted to Patient Access Supervisor and shortly thereafter Hospital Access manager Rose is a HFMA Colorado member was recently elected Vice-President of COHAM and holds several industry certifications as well as Emergency Management Certifications She currently holds a degree in Business Administration and is seeking a second degree from Colorado Christian University

CALLY CHRISTENSEN

Cally leverages close to two decades in Healthcare Revenue Cycle to accelerate patient pay collections She is passionate about helping her clients create frictionless consumer experiences improved communicat ion and transitional management strategies

Her dynamic and engaging personality ensures that participants laugh learn and grow personally and professionally Callyrsquos strengths lay in her ability to quickly create rapport and identify efficiency opportunities within internal processes and procedures

She utilizes LEAN concepts to help mitigate growing Account Receivables and focuses on up-front revenue capture modalities that gain consumer engagement and brand activation before during and after the care event


Keys to Collecting in the Age of Patient Consumerism4

With high deductible insurance plans on the rise patients are increasingly expected to pay for more and more of their own healthcare expenses HDHPs (High Deductible Health Plans) tripled between 2009 and 2015 while average out of pocket costs per worker increased by 230

In the age of healthcare consumerism the old-school focus on insurance companies as primary payers has been replaced with a modern approach treat patients as your primary customers Patient satisfaction reports factor heavily into performance bonuses and penalties for healthcare providers This means that itrsquos crucial to make patient-friendly billing a priority

The goal now has become enabling the healthcare consumer to self-engage with their payment process and responsibility A key to succeeding in 2016 is to make it easy for consumers to make a comfortable well-informed purchasing decision Patients crave information up front and are prepared to reward practices that provide it 52 of consumers surveyed indicated that they would pay $200-$500 or more via debit or credit card if an estimate was provided during their visit

To collect more patient payments there are four keys on which to focus The tenets of securing a higher percentage of payment in the age of patient consumerism include transparency automation usability and immediacy

TRANSPARENCYOne of the ways that the healthcare industry is well behind the curve in the age of consumerism is in failing to treat care as a service to be purchased Similar to nearly every other purchasing situation consumers want to know the costs of their health care up front According to a recent TransUnion survey 80 of respondents would be more likely to use a healthcare provider that offers cost estimates up front Despite that only 30 were offered estimates prior to care

Though itrsquos impossible to give an exact quote high-performing practices are providing customers with estimates based on their unique situation including insurance coverage and any other relevant factors By answering the clear demand

Providing audit tax and consulting solutions to hospitals physician groups home health organizations post-acute care facilities and other healthcare organizations since 1978

For more information contact RyanSells Kelly Kozeliski or Scott Gunterat 3037409400 or visit us online

wwwekshcom

PAGE | 17

copy 2016 JPMorgan Chase Bank NA Member FDIC 208101

JP Morgan Proudly Supports the HFMA Colorado Chapter

for pre-treatment cost estimates practices give patients an important piece of the information necessary to purchase healthcare services

AUTOMATIONPractices that get sucked down into the bad debt cycle end up paying for their mistakes All too often staff members wind up inundated with paperwork and they or third-party agencies are left to chase small balances from non-payers Itrsquos inefficient and is a major hindrance to profitability and time efficiency

Technological advances spare practices significant administrative costs and free staff members to focus on providing excellent customer service in both patient care and other core duties Software solutions provide unparalleled accuracy security doggedness and cost efficiency for both practices and ambulatory care centers

USABILITYThe effectiveness of the technology you use is correlated with the ease of use If patients arenrsquot comfortable adopting a new system because it doesnrsquot function simply or provide added benefit practices canrsquot capitalize on it - no matter how wonderful its features may be

Enable a user-friendly device system or portal and reap the rewards Patients will easily see the value of getting accurate information up-front without having to stumble through complicated software or difficult tools Providing choices of which devices to use (like a mobile app or tablet compatibility) puts the power in the hands of the healthcare consumer

Check-in kiosks are one way to meet consumer demand for transparency in a way thatrsquos easy to use Patients can arrive at an office enter their relevant information and receive an estimate immediately Their information including a credit card number for later payment can be stored securely on file This eliminates redundancy and administrative burden while making it much easier and more likely to collect on a bill

IMMEDIACYPractices that intend to secure only the copay during the visit and then follow up months later (expecting to see full payment on patient bills) are setting themselves up for failure However did you know that greater than 90 of all patients are willing to pay for their care at the point of service ndash yet more than 30 walk out of a practice without paying a dime Clearly there is a tremendous opportunity that is missed when practices or ambulatory centers arenrsquot prepared to collect from the outset

The solution to this revenue loss is in collecting payment information up front Why wait months and hope theyrsquore still prepared to pay when consumers are ready able and willing to pay on the spot Your automated easy-to-use system should collect payment information prior to a patient visit immediately after theyrsquove seen an estimate Consumers appreciate the transparency and are more likely to pay when they feel as if accepting care is their choice and they are getting a fair deal

Implement the core principles of transparency automation usability and immediacy and yoursquoll see a significant uptick in revenue and a rapid decline in bad debt These operational changes could be enough to make a struggling practice profitable or an average practice thrive

4 KEYS TO COLLECTING (continued)

PAGE | 18

Randy Blue MEd CRCR is an Executive Director with HealthiPASS Randy is located in Seattle WA and has over 25 years

experience in sales and marketing specifically in the healthcare space Randy is committed to helping health systems and physician organizations manage the rapidly evolving healthcare landscape to improve business performance randyhealthipasscom

Sources1 Kaiser Family Foundation 20155

Health Benefits Survey Sep 22 20152 httpswwwcmsgovMedicareQuality-Initiatives-Patient-

Assessment-InstrumentsHospitalQualityInitsHospitalHighlightshtml

3 McKinsey and Company The next wave of change for healthcare payments May 2010

4 httpnewsroomtransunioncomtransunion-survey-half-of-americans-will-switch-healthcare-providers-if-the-supreme-court-iminates-subsidies

5 httpmptrmsmckessoncomrsMckessonPTimagesMcKesson20RMS20Patient20Payments20and20Collectionspdf

FOUNDERS MERIT AWARD

SERIES

Are you volunteering for HFMA If so you are eligible for

Founderrsquos Points

HFMA recognizes that its strength lies in volunteers who contribute their time ideas and energy to serve the healthcare indsutry their profession and one another The Founders Merit Award Series acknowledges the contributions made by HFMA members These awards are part of a merit-rating plan in which specific activities are assigned a range of point values Some of the activities for which you may be awarded points are

Write an article for the local chapter or na-tional

Chair or co-chair a committee Be a committee member Volunteer at an event Speak at an event

Please check your points frequently throughout the year at wwwhfmaorgAwardsFounders Point corrections are retroactive and are transferrable from one chapter to another

Report missing points to the Chapter Secretary Pilar Mank at pilarmankwha1org


PAGE | 19

JOIN HFMArsquoS MENTORSHIP PROGRAM Denzel Washington once said ldquoShow me a successful individual and Irsquoll show you someone who had real positive influences in his or her life I donrsquot care what you do for a livingmdashif you do it well Irsquom sure there was someone cheering you on or showing the way A mentorrdquo Mentoring relationships are a shared opportunity for learning and growth and many mentors say that the rewards they gain are as substantial as those for their mentees

The Colorado chapter of HFMA is excited to accept applications from

both mentors and mentees for the mentorship program Mentors will serve as an experienced point of contact for any Early Careerist joining HFMA and will help facilitate not only growth within our great chapter but potential career development as well Our mentorship committee will match mentors and mentees based on mutual interests and aims to not only provide Early Careerist with a rewarding relationship but also our mentors as well Once our committee has identified a match the pair will set an initial meeting to establish what each

individual would like to accomplish during the relationship The initial meeting should create an agenda for accomplishing goals time commitment of the individuals and frequency of meetings

Whether you are looking to become a mentor or a mentee this is a great opportunity to grow your personal network and more importantly our chapter Please show your support for our mentorship program and sign up now

PAGE | 20

CHA UPDATE ndash 2016 LEGISLATIVE WRAP-UPBy Ryan Westrom

After 120 days the Colorado General Assembly wrapped up the 2016 legislative session on May 12 This yearrsquos session saw a total of 686 bills introduced with slightly more than half being passed and sent to Governor John Hickenlooper for his signature More than 100 of the bills introduced were of interest the health care community Many of these fell into one of five common health care themes protecting critical state investments in health care supporting the promise of increased coverage and access pursuing efforts to contain health care costs improving clinical care and quality and building a strong health care workforce

However due to the bipartisan composition of the State House (Democratic) and Senate (Republican) most of the major initiatives identified by the Governor the Speaker of the House and the Senate President ultimately failed to pass While hospitals and health systems avoided every bill in this yearrsquos session that was considered unfavorable this session may be remembered for its lost opportunities

THE HOSPITAL PROVIDER FEE ENTERPRISE

House Bill 16-1420 ndash the Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) ndash would have transitioned the Hospital Provider Fee (HPF) to a government-owned enterprise The creation of this enterprise would have created long-term flexibility in the Colorado budget by freeing up more than $1 billion over the next five years by removing the HPF revenues from the Coloradorsquos Taxpayer Bill of Rights (TABOR) limit It was proposed that this $1 billion be used to fund other key state priorities such as transportation and education while relieving the state budget pressure of estimated large TABOR refunds in the years to come

The enterprise bill was a topic of discussion and debate even before the session began in January and continued until the second-to-last day of the 2016 legislative session Senate President Bill Cadman (R-Colorado Springs) publicly expressed his opposition to an HPF enterprise and specifically

PAGE | 21

called into question the constitutionality of such an enterprise In response an independent and bipartisan legal analysis was released by former chief legal counsels to Governors Bill Owens and Bill Ritter and was endorsed by former Attorney General and Colorado Springs Mayor John Suthers This legal opinion opposed Senator Cadmanrsquos claim and clarified that an HPF enterprise would in fact be constitutional Attorney General Cynthia Coffman also release her legal opinion that an HPF enterprise would be constitutional

Despite a strong coalition of more than 300 organizations across Colorado and the support of House Speaker Dickey Lee Hullinghorst (D-Boulder) and Governor Hickenlooper the bill was eventually killed in the Senate finance committee by a 3-2 party line vote

BEHAVIORAL HEALTH SERVICES

Under current state law and regulation patients placed on a 72-hour mental health hold must be taken to a facility designated by Colorado Department of Human Services (CDHS) for evaluation and treatment Many Colorado hospitals do not meet the CDHS requirement to be a designated facility ndash especially in rural areas of Colorado To address this Senate Bill (SB) 16-169 was developed by CHA and would have allowed patients to be taken to an ldquoemergency medical services facilityrdquo (ie a non-designated emergency department) if there was no designated facility available The bill also proposed data collection for these type of 72-hour mental health holds so that access to care could continue to be improved in future years as currently there is no sort of data available

Despite the fact that the bill passed both the Senate and House with 88 out of 100 votes in favor the bill was ultimately vetoed by Governor Hickenlooper The Governor agreed with the concept of the bill but expressed his concerns in his veto letter

CHA UPDATE (CONT)CHA (continued)

PAGE | 22


ldquoWe agree that appropriate mental health facilities are not always readily available to treat persons having a mental health crisis While well-intentioned we are concerned that SB 16-169 does not provide adequate due process for individualsrdquo

Additionally Governorrsquos Hickenlooperrsquos veto letter called upon CDHS to create a new task force to review and create solutions around the issues SB 16-169 attempted to address

It is anticipated that these issues along with other health care topics discussed during the 2016 session including pricing transparency and disclosures of free standing emergency departments (FSEDs) will be introduced again in the 2017 legislative session The unknown for next yearrsquos session is whether the November elections will change the outcomes of these important issues or if it will be another session of missed opportunities

BENCH STRENGTH

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CHA (continued)

PAGE | 23


1People follow the leader first and the leaderrsquos vision second - It doesnrsquot matter if the leader shares a powerful vision if the leader is not someone who people will

follow the vision will never be realized As a leader who you are makes a difference The most important message you can share is yourself

2 Trust is the force that connects people to the leader and hisher vision - Without trust there is a huge gap between the leader and the vision Without trust people

will stay off the bus However if people trust the leader they will hop on the bus with the leader and help move the bus forward towards the vision

3 Leadership is not just about what you do but what you can inspire encourage and empower others to do

4 A leader brings out the best within others by sharing the best within themselves

5 Just because yoursquore driving the bus doesnrsquot mean you have the right to run people over - Abraham Lincoln said Most anyone can stand adversity but to test a

manrsquos character give him power The more power you are granted the more it is your responsibility to serve develop and empower others When you help them grow theyrsquoll help you grow

6 ldquoRules without Relationship Leads to Rebellionrdquo - Andy Stanley said this and itrsquos one of my favorite quotes As a leader you can have all the rules you want but if you

donrsquot invest in your people and develop a relationship with them they will rebel This applies amazingly to children as well Itrsquos all about relationships

7 Lead with optimism enthusiasm and positive energy guard against pessimism and weed out negativity

8 Great Leaders know they donrsquot have all the answers Rather they build a team of people who either know the answers or will find them

9 Leaders inspire and teach their people to focus on solutions not complaints (The No Complaining Rule)

10 Great leaders know that success is a process not a destination - One of my heroes John Wooden the legendary UCLA basketball coach never focused

on winning He knew that winning was the by product of great leadership teamwork focus commitment and execution of the fundamentals As a leader focus on your people and process not the outcome

10 THOUGHTS ABOUT LEADERSHIP

Jon Gordon is a speaker consultant and author of several books including the recently released The No Complaining Rule Positive Ways to deal with Negativity at Work and the international best seller The Energy Bus 10 Rules to Fuel your Life Work and Team with Positive Energy which has captured the hearts of readers world-wide Jons proven solutions are being put to use by people and organizations worldwide and his tips have been featured on CNN the NBC Today Show The Wall Street Journal New York Times Forbes and more

At a time when the world is thinking a lot about leadership I believe itrsquos a great opportunity for each one of us to think about what leadership means to us Below Irsquove shared some of my thoughts on leadership and whether you are a leader of a business team hospital classroom church or home

PAGE | 24


C O R N E R

The lifeblood of COHFMA is its committee system Chapter volunteers work through a wide array of committees that organize the chapterrsquos programs educational efforts and internal operations With our new year underway our committees are jumping in and planning some great things Now is the time to Get Involved Learn more about what our committees do below and contact Volunteer Coordinator Tammy Rivera tjriverabkdcom to get involved and start making a difference

Advancement and CertificationThis Committee will develop and maintain processes to encourage members to be certified and to maintain their certification once earned The Committee will educate Chapter members about the availability and benefits

of status of certification and fellowship as a means of advancing knowledge and career The Committee will work with National the chapterrsquos Region andor within the Chapter itself to make available to chapter members self-study materials and live sessions in order to optimize the exam candidatersquos likelihood of passing

Audit and FinanceThe Audit and Finance Committee shall be a committee of the Chapter whose purpose it shall be to ensure that a financial review is performed on the books and financial records of the Chapter at the close of each fiscal year and is composed of at least one (1) Chapter member who shall be appointed by the Board of Directors for a one (1) year term The Committee meets at least once each fiscal year Duties include Perform or have performed an annual

CO

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Coding Self-Pay and HIM Assistance Our senior management team has

more than three decades of hospital revenue cycle experience We have

experience working with large non-profit and religious affiliated hospital

systems as well as some of the largest for-profit healthcare systems

Xtend Healthcare offers cutting-edge technology experienced staff 100

percent onshore solutions and 100 percent customer satisfaction

FOR MORE INFORMATION CONTACT

Kimberly GeorgeDirector of Business Development

kgeorgextendhealthcarenet

206-747-1811

XtendHealthcarenet bull 8008821325

CALLING ALL VOLUNTEERS GET TO KNOW YOUR COMMITTEES AND GET INVOLVED

PAGE | 25


review of the Chapterrsquos financial records and communicate the results in writing to the Board of Directors

Communications and MarketingThe Communications and Marketing Committee works with all committees to provide communication and education for members through the chapter newsletter website and other forms of electronic media such as LinkedIn Facebook Twitter etc The Communications Committee is responsible for the coordination and publication of four (4) newsletters for chapter members This committee is also responsible for planning social networking events that may or may not be in conjunction with a scheduled educational event These events may include the Annual Golf Tournament Rockies games Casino Night Networking After-Hours etc

SponsorshipThe Sponsorship Committee will be responsible for establishing and promoting the Annual Corporate Sponsorship Program to current and prospective sponsors either from the non-provider or the provider community The committee will be responsible for conveying the benefits of the sponsorship program and keeping abreast of changes that may be required to meet the needs of the sponsor and to provide the value for maintaining the sponsorship from year to yearThis committee also manages the maintenance and retention of current sponsors as well as promotes sponsorship and exhibits at Chapter programs

Educational ProgramsThe Educational Programs Committee is responsible for planning and coordinating educational sessions including speakers attendee registration site arrangements payment and meeting follow-up and evaluations The committee is comprised of the individual program Chairs Co-Chairs and Committee members who are charged with designing programs that may be on site or via webinars The committee will establish goals that will include net program income member and total attendance and member educational hours

MembershipThis committee is in charge of expanding and maintaining the Chapterrsquos membership based on the goals established by National HFMA To accomplish this a recruitment and retention plan for new and advanced members must be established and carried out each year in alignment with national initiatives These initiatives include Newsletter articles Prospective Membership recruitment Member-Get-A-Member Program Non-Renewal activities and formulation of a Student Liaison committee The committee is responsible for providing new member communications including access to membership lists descriptions of programs and information about committees

NominatingThe Nominating Committee shall meet at least once each fiscal year The Chairperson of the Committee shall report out the names of the candidates each of whom shall have provided written or electronic consent to stand for election to the President of the Chapter within ten (10) days of receipt of such consents but in no event later than February 15th of each year

COMMITTEE CORNER (continued)

PAGE | 26


Platinum Sponsors PFS Group Professional Finance Company Inc

Gold Sponsors BESLER Consulting BKD CPAs amp Advisors Clifton Larson Allen CSC ndash Credit Service Company Inc

Edge Process Consulting EKSampH Hall Render Killian Heath amp Lyman PC

Key Bank RSM

MMIC Revenue Enterprises LLC Western Healthcare Alliance

Silver Sponsors AppRev Avectus Healthcare Solutions BOK Financial Caplan amp Earnest Cirius Group Cleverley + Associates Colorado Health Facilities Authority

Cyberscience Ernst amp Young LLP HCFS Inc

Healthcare Outsourcing Network LLC

Healthcare Resource Group Instamed Integral Healthcare Solutions Inc JP Morgan Chase Pinnacle Healthcare Consulting Rocky Mountain Microfilm amp Imaging

TransUnion UMB Bank Xtend Healthcare

Provider Sponsors Vail Valley Medical Center Valley View Hospital

THANK YOUWersquod like to recognize and thank all of our annual sponsors Your generous support enables the chapter to provide and enhance the quality of education programs on healthcare financial issues as well as management technical topics communications and social events Many of the members reached by their support are key decision-makers within their own organizations and we encourage our members to utilize our sponsorsrsquo services A big WELCOME goes out to our new sponsors

Editorrsquos Disclaimer

PEAKS amp plains is published quarterly and provides general information for the entire Colorado HFMA Chapter Opinions expressed in articles are those of the authors and do not necessarily reflect the view of the Chapter and its members It is not designed to provide authoritative advice Please consult with an appropriate expert if issues confront your business Members are encouraged to submit articles or other information Articles may be edited for clarity grammar and length The editors reserve the right to accept or reject any submission

Information to be considered for publication may be submitted to Cally Christensen at cchristensenacsinet

Scott I Raberge Senior Vice President Marketing amp Sales9703525000 bull 8008644391 extension 321srabergepfccollectscom

5754 West 11th Street Suite 100 bull Greeley CO 80634wwwpfccollectscom

Professional Finance Company Inc

First Party Receivables Solut ion

bull SystemConvers ionAss is tanceampARClean-Upbull ExtendedBusinessOff ice Ear ly-Out Sel f -PayRecovery

bull Pr imaryampSecondaryBadDebt Col lect ionsbull Late-StageReceivablesPurchasing

Wersquore onThe Short List

JULY 26 2016 Rural Road Show - Pueblo

JULY 27 2016 Rural Road Show - Loveland

JULY 28 2016 Rural Road Show - Glenwood Springs

AUGUST 9 2016 Webinar Provider-Based Section 603 Implementation and a Review of the Proposed Provider-Based Learning Objectives

SEPTEMBER 21-23 2016 Great Fall Rural Retreat Hotel Colorado Glenwood Springs

OCTOBER 4TH OCTOBER 18TH NOVEMBER 1ST amp NOVEMBER 15TH Medicare Bootcamp Webinar Series

JANUARY 15-18 2017 Region 10 amp 11 Symposium Las Vegas NV

FEBRUARY 16-17 2017 Compliance Conference Marriott Park Meadows Lone Tree CO

APRIL 19-21 2017 Annual Conference DoubleTree DTC Greenwood Village CO

UPCOMING EVENTSCHECK OUT OUR UPCOMING EVENTS FIND MORE DETAILS AND WAYS

TO REGISTER AT WWWHFMA-COORG

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Cheryl Curry





A GUIDING LIGHT

Our Services




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COVER PHOTO CONTEST


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MEMBER SPOTLIGHT









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7

Join us for the








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rsm uscom


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PROVIDER SPOTLIGHT


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avectushealthcom






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CALLY CHRISTENSEN














wwwekshcom

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SERIES









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BENCH STRENGTH








Member FDIC

3038391300

CHA (continued)

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C O R N E R





CO

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206-747-1811



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Key Bank RSM












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C O R N E R





CO

MM

ITTE

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206-747-1811



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Key Bank RSM












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C O R N E R





CO

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ITTE

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206-747-1811



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Key Bank RSM












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Key Bank RSM












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Key Bank RSM












PEAKS - StarChapter · The Essential Elements of Comprehensive Care for Joint . Replacement (CJR)...

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Transcript of PEAKS - StarChapter · The Essential Elements of Comprehensive Care for Joint . Replacement (CJR)...