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www.sihfma.org *** Southern Illinois Share ***

April 2019 ISSUE 4, 2018-2019

In This Issue 1 Message From Your President

2 Chapter Officers and Directors

3 Save the Dates—local events

6 “How Medical Necessity Disputes Cause Hospitals to Leave Money on the Table”

7 Founders Merit Awards

8 Social Awareness Project

9 “The State of 340B: Challenges and Opportunities”

11 Spring Golf Outing Registration

13 “Developing a Comprehensive Audit & Education Program for Physicians”

15 Practice Management Summit

16 March Education Session

17 February Board Meeting Minutes

19 March Board Meeting Minutes

23 New members

25 Member Recognitions

26 2018-2019 Sponsors

I have been truly honored to serve as the President of SI HFMA in 2018-2019.

My term will end on May 31st so I offer my sincerest thanks to our dedicated

Officers, Directors, Volunteers and Members. I’m proud of our success this

year through your dedication and contributions.

Your leadership team will attend The Leadership Training Conference (LTC)

next week to begin discussing our strategy for 2019-2020 under the

competent leadership and guidance of Melissa Lucas, our incoming

President.

Last year at LTC, we focused on four separate chapter success plans and I’m

happy to report that we achieved our goals for 2018-2019!

In August we held a very well planned meeting focused on Early

Careerists

We held our physician practice collaboration with ICAHN and MGMA in

March of this year

We worked very hard to implement our event management system to

improve the registration process and relieve the volunteers from

some of the administrative burden.

We focused on our business partners’ needs to increase revenues that

would allow us to present quality education and networking to our

members.

We heard your requests, constructive feedback, and suggestions and

responded. You thanked us by giving us an unprecedented 97% member

satisfaction score. We will continue to work very hard for you to maintain that

level of satisfaction with your HFMA chapter.

Lastly, I want to say that my term as President has been both rewarding and

fun! Don’t miss your opportunity to grow in education and business

relationships. Get involved now-you won’t regret it.

(Continued on page 4)

April 2019 ISSUE 4: 2018-2019

Message From Your President

Shirley Mason

www.sihfma.org *** Southern Illinois Share *** 2

April 2019 ISSUE 4, 2018-2019

2018—2019

CHAPTER OFFICERS

President

Shirley D. Mason

Wakefield & Associates

551 Copper Meadows Lane

O'Fallon, MO 63368

Phone: 314-435-3377

[email protected]

President Elect

Gregory L. Wright ,FHFMA

Corporate Director of Finance

Southern Illinois Hospital

1239 E Main P.O. Box 3988

Carbondale, IL 62901-3114

Phone: 618-457-5200, ext. 67200

[email protected]

Secretary

Troy Lindsey

Director

BKD, LLP

211 N. Broadway Ste 600

St. Louis, MO 63102-2733

[email protected]

Treasurer

John Majchrzak

Chief Financial Officer

Southern Orthopaedic Associates

The Orthopaedic Institute of Southern

Illinois and Western Kentucky

510 Lincoln Drive

Herrin, IL 62948

Phone: 618-997-4310 ext. 1633

[email protected]

Vice President/Program Chair

Melissa L. Lucas ,FHFMA

Director of Accounting/Payroll Services

Harrisburg Medical Center

PO Box 428

Harrisburg, IL 62946-0428

Phone: 618-253-0278

[email protected]

Past Chapter President/

Regional Executive 3

Nikki Graves

Revenue Cycle Director

Touchette Regional Hospital

PO Box 185

East Saint Louis, IL 62202-0185

Phone: 618-482-7054

[email protected]

Second Year Directors

Stephan Taylor, CPA - CliftonLarsonAllen, LLP

Julie Aman, CMPE, CRCE-I - NextGen Healthcare

Keith Anderson - Southern Illinois Healthcare

First Year Directors

Terry Swan - Blue Cross Blue Shield of IL

Barbara Johnson, BSN, RN - Illinois SSM Health

Jennifer Grenados - Southern Illinois Healthcare

2018—2019

CHAPTER DIRECTORS

mailto:[email protected]






April 2019 ISSUE 4, 2018-2019

Our Mission

Statement

Our Chapter’s commitment is

to provide high quality,

economical and accessible

education necessary for

professional growth; to give

participants the opportunity

to network with peers and

excel in their careers within

HFMA. Our Chapter provides

member development through

education, certification, and

leadership training. The

Chapter promotes the highest

standards of professional and

ethical conduct.

SAVE THE DATES FOR

FUTURE EDUCATION

OFFERINGS and SPECIAL EVENTS

April 24—April 26, 2019

Multi-Chapter Spring

Conference

River City Casino

May 2, 2019

Mini LTC

SSM Health

Good Samaritan Hospital

May 23

Program Planning meeting

Fair Oaks Golf Club

Followed by

Spring Golf Outing

June 23-26

Annual Conference 2019

Orange County Convention

Center in Orlando, FL

Imagine Tomorrow. With so many challenges facing us in the

healthcare industry, and within HFMA, it’s not surprising we

sometimes feel overwhelmed. At such times, however, it’s important

to remember that we are more than capable of addressing these

challenges and achieving our goals.

We already have the necessary knowledge and skills, but success

will also require confidence, optimism, and a belief that we can do so

much more by working together. Most importantly, we need to tap

into our imaginations.

Editor’s note: The article concerning the SIUC student experience on page

12 in the previous edition of SHARE was written and submitted by Julie

Aman. My apologies to Julie and Jennifer for the error.


April 2019 ISSUE 4, 2018-2019

Join a committee. It doesn’t take much to start

learning. Watch for upcoming notices about our

Mini LTC in May and join us. Reach out to a

Board member or Officer and express your desire

to get involved.

Please feel free to contact me anytime.

[email protected]

314-435-3377

Sincerely,

Shirley Mason, President SI HFMA (2018-2019)

(Continued from page 1)



April 2019 ISSUE 4, 2018-2019


April 2019 ISSUE 4, 2018-2019

Proper Documentation Before Claim Denials is the Only Antidote

Medical necessity disputes are causing hospitals to leave revenue on the table.

Hospitals are already facing increased financial pressures as care moves outside of facility-based models and more of them adjust to value-based reimbursement. Added to that, payers under financial pressure themselves because of rising healthcare costs, are scrutinizing claims through increased medical necessity denials with hospitals.

Providers and health systems denied reimbursement for care by a payer can successfully appeal or ultimately litigate such disputes in many cases. But internal costs, and legal and consultant fees in support of the appeals and litigation process can be costly, and revenue can be degraded during the appeals and litigation process. Providers and health systems can take steps, however, to reduce the frequency of care ending up in dispute—and proper documentation before litigation is key.

Incomplete or ineffective documentation is a frequent cause of denials. It has often been said in healthcare, “If it wasn’t documented, it wasn’t done.” That’s true, but perhaps even more relevant in today’s healthcare world, “if it wasn’t documented, it may be considered medically unnecessary,” resulting in denied payer reimbursement. In fact, CMS could even consider billing for that service to be a false claim. Furthermore, poor documentation provides a weak defense in medical liability cases.

We have learned valuable lessons from evaluating thousands of medical records—including hundreds that have risen to the litigation phase. The following checklist can guide clinicians and their leaders in good documentation practices. At a minimum, providers should ensure that they clearly document the following elements for each hospital observation or admission.

While EMRs have automated and created prompts for many documentation requirements, a resulting new problem has been the increased lack of distinctive patient notes. Therefore, it is essential that providers avoid the overuse of templates and make sure they have typed information that clearly distinguishes notes between patients.

The order for observation or admission must include the diagnosis and be signed by a physician with a legible signature or electronic signature and with a date

and time.

Orders for labs, procedures and medications must be signed by a physician or midlevel (as the scope of practice allows in the particular state) with a legible signature or electronic signature and a date and time.

All notes must be legibly signed, dated and timed by the provider with regular evidence throughout the hospitalization of physician oversight documented in physician signed notes.

The admit note must clearly describe the patient’s condition and document the reasons for hospitalization, the particular level of care required and the expected length of stay. If the patient is hospitalized as a full admission, the expectation of the patient requiring a stay crossing two midnights needs to be documented. Or, on the rare occasion that a patient in a highly acute situation requires inpatient or even intensive-level care but possibly not needing to stay past two midnights, this must be explicitly documented.

Daily progress notes must be sufficiently detailed to clearly show the need for the continued hospitalization and the reasons for each service provided. Providers should ask themselves if a third-party provider would agree that the hospitalization and services are needed based on documentation.

Nursing, respiratory therapy, physical therapy and other care team notes also contribute to the story of what care is provided and the reasons for it. However, the notes by the physicians or midlevels need to be able to stand alone in supporting the need for continued hospitalization.

Discharge notes should again clearly articulate the reasons for admission, as well as the key services provided during the hospitalization that required the patient to remain hospitalized up until the time of discharge.

Health system leadership needs to ensure that their providers know the expectations for documentation, that the EMR system prompts the key documentation items without creating too much duplication, and that compensation incentives align with goals for appropriate documentation with fewer denials.

Annual training sessions with regulatory and compliance updates equip and remind the providers about documentation requirements. Regular internal chart sampling and reviews prior to claims


How Medical Necessity Disputes Cause Hospitals to Leave Revenue on the Table

By: Karen Meador


April 2019 ISSUE 4, 2018-2019

“Recognizing the Volunteer in You”

Founders Merit Awards

The William G. Follmer Bronze Award is awarded to an individual who has earned 25 member points.

This award is named after William G. Follmer, who is credited with the creation of the American Association of

Hospital Accountants (AAHA) now HFMA.

RECIPIENTS: Keith Anderson and Melissa Lucas

The Robert H. Reeves Silver Award is awarded to an

individual who has earned 50 total member points. Reeves, an

organizing member of the AAHA, was elected president of AAHA

in 1956 and was instrumental in creating the structure of AAHA.

RECIPIENT: Nikki Graves

The Frederick T. Muncie Gold Award is presented to a member who has

earned a total of 75 member points. This award honors Frederick T. Muncie, an

organizing member of the AAHA, and the first president of the association

(1947-1949). Muncie also assisted in the organization of the first AAHA chapter

(First Illinois).

RECIPIENTS: Nikki Graves and Shirley Mason

The Founders Medal of Honor recognizes an individual who

has been actively involved in HFMA for at least three years after

earning the Muncie Gold Award, has provided significant service

at the chapter, regional and/or national level in at least two of

those years, and remains a member in good standing.

RECIPIENT: April Peters


April 2019 ISSUE 4, 2018-2019

Gear-Up and Career Gear

This year the Southern Illinois Chapter will be assisting Gear-Up by collecting gently used professional clothing at education

seminars. Gear-Up is a free clothing service for men and women operated by the Belleville Council Society of St. Vincent de

Paul. Those who are seeking jobs can receive a complete outfit-a suit or business casual, shoes, and accessories free of

charge. Job candidates must be referred by any public or private agency that assists low income or displaced workers in

finding employment. Important services such as job interviewing tips, resume writing, training in life skills and referrals for

mentoring and literacy are also offered.

PLEASE CONSIDER DONATING YOUR GENTLY USED CLOTHES, SHOES AND ACCESSORIES TO GEAR-UP.

NANCY VOLLMER VP Sales & Marketing

2601 WEST FORREST HILL AVENUE

PEORIA, IL 61604-1812

P 309.272.4501 T 800.906.3210 F 309.272.1400 M 309.258.2424

[email protected]

www.eaglerecovery.net


April 2019 ISSUE 4, 2018-2019

The 340B drug pricing program is a vital part of our nation’s healthcare safety net. By lowering the cost of prescription drugs for hospitals, clinics, and health centers, 340B frees up revenue that is used to treat many more patients in need and offer more comprehensive services.

Congress created 340B in 1992 with strong bipartisan support and it was signed into law by then-President George H.W. Bush. The law requires pharmaceutical companies to sell outpatient drugs to qualified “covered entities” at lower prices and allows those providers to use the savings to improve care.

To qualify for 340B hospitals must meet a set of tough criteria. Hospitals with a disproportionate share (DSH) adjustment of 11.75 percent or higher can qualify. In addition, freestanding children’s and cancer hospitals can participate along with rural hospitals including critical access hospitals, rural referral centers, and sole community hospitals. Every year, hospitals must validate their eligibility for 340B with the federal Health Resources & Services Administration (HRSA).

In 2015, 340B hospitals provided 60 percent of all uncompensated care in the U.S. while representing only 38 percent of acute care hospitals in operation. In that year, 340B discounts saved hospitals and other entities a little more than $6 billion while the total amount of uncompensated care provided by 340B hospitals in that year was $26 billion. The savings also help to support vital services that are often underpaid by Medicaid and other payers including care for HIV/AIDS, diabetes, trauma, mental health, and substance abuse.

Among rural hospitals, the savings from 340B are often the difference between staying open or closing their doors. In the past decade, nearly 100 rural hospitals have closed and another 700 are at risk of closing. In a 2017 survey conducted by 340B Health, more than half of rural hospitals said a cut in the 340B savings they earn could force a decision to close.

Despite these successes, the 340B program has been the topic of tremendous debate in Washington. In 2018, Congress held four hearings to examine 340B. Lawmakers saw more than 20 pieces of legislation introduced to change 340B. Some of these proposals would have made sweeping changes to the law that would have negatively affected hospitals’ ability to participate. One proposal would have eliminated more than half of the DSH hospitals participating in the program. Others would have imposed a “freeze” or “moratorium” on any new hospitals or sites joining the program.

Hospitals and our allies objected to many of these proposals and, in the end, Congress did not vote on any of the bills

before adjourning for the year. Following the 2018 congressional elections, the new Congress has many new members and several new leaders of the key committees with jurisdiction over 340B. In the early months of this new Congress a great deal of attention is being focused on high drug prices. Hearings have been held in the House and Senate to explore a series of proposals to increase transparency in drug pricing and to rein in some of the more egregious industry practices. While 340B has been discussed briefly at some of these hearings it is not currently the focus of legislative action.

There were also some regulatory challenges. The Medicare program began reducing Part B payments to many 340B hospitals by nearly 30 percent, a move that we are challenging in federal courts. President Trump also began to lay out a series of policies designed to curb drug prices in what he called his “Blueprint to Lower Drug Prices.” In it, the administration posed a series of questions asking for public input. Of concern were a series of questions about 340B that may hint at action to come. In October, the President unveiled a plan to test a new way to pay for outpatient drugs under Medicare Part B. The International Pricing Index (IPI) model would base payments on an index of how much other countries pay for certain high-cost drugs. While the IPI wasn’t designed to impact 340B hospitals its construct could cause hospitals to lose their 340B discounts. 340B Health and others have called on the administration to exempt 340B hospitals from this model should it go forward.

We have also seen positive progress on the regulatory front. On Jan. 1, 2019, HRSA began enforcing new rules aimed at preventing manufacturers from “knowingly and intentionally” overcharging 340B providers. Congress called for these rules in 2010 legislation enacted after a series of reports by the Office of Inspector General of the Department of Health & Human Services documenting bad behavior. On Apr. 1, HRSA unveiled a new secure website that contains information about the “ceiling” prices that should be charged for 340B drugs. HRSA will continue to update that site as it collects more information. It is a welcome dose of sunlight into what has been a dark black box on drug pricing.

Advocates of 340B must continue to talk about the important ways the savings from the program allow them to maintain and expand care for those who often have nowhere else to turn. The more we share our stories the greater likelihood of 340B remaining a vigorous part of the safety net.

Maureen Testoni is the president and chief executive officer of 340B Health, the nation’s leading advocate for hospitals participating in the 340B drug pricing program. 340B Health represents more than 1,300 hospitals.

The State of 340B: Challenges and Opportunities

By: Maureen Testoni

https://www.hhs.gov/sites/default/files/AmericanPatientsFirst.pdf

https://innovation.cms.gov/initiatives/ipi-model/


April 2019 ISSUE 4, 2018-2019

submission to the payer are also educational to the providers in actively guiding better documentation in the future. They can also allow the immediate correction of inadequacies of documentation prior to claims submission so that denials are reduced.

Engaging an external team with expertise in clinical documentation and reduction of claims denials can ease the burden on leadership and staff and often will identify areas of needed improvement that may be overlooked when doing an internal evaluation.

When ongoing documentation education and reviews are done internally, an external team should conduct an annual

risk assessment and chart documentation audit. A feedback session should follow, with a detailed action plan to correct the identified deficiencies in documentation and to enhance the processes that support good documentation.

Karen Meador, MD, MBA

Managing Director and Senior Physician Executive

BDO Center for Healthcare Excellence & Innovation

[email protected]

Medical Necessity Disputes (Continued from page 6)

"HIPAAtrek leads the market in HIPAA compliance by offering a comprehensive platform that ensures an audit-ready trail of compliance."


April 2019 ISSUE 4, 2018-2019

Far Oaks Golf Club • 419 Old Collinsville Road Caseyville, IL, 62232

Phone: 618-628-2900

Time: Lunch served at 11:30 am (after the chapter planning meeting)

Registration opens at 11:30 am

Shotgun start at 12:30 pm

Happy Hour during awards presentation

Cost: $80 per person

Includes golf, cart, lunch, and great prizes

Complimentary Beverages on the course

Happy Hour during awards

Format: 4 person scramble

Prizes: Team prizes

On course contests

Attendee prizes

50/50 raffle ticket drawing- bring cash and win!

Reservations will be filled on a first-come-first-served basis according to payment received.

Spots fill up quickly……….

REGISTRATION FORM ON THE NEXT PAGE

SOUTHERN ILLINOIS CHAPTER

SPRING GOLF OUTING

THURSDAY, MAY 23, 2019


April 2019 ISSUE 4, 2018-2019

Team Registration:

Player 1_________________________________________

Company______________________________________

Email address___________________________________

Player 2_______________________________________

Company______________________________________

Email address___________________________________

Player 3_________________________________________

Company______________________________________

Email address___________________________________

Player 4_________________________________________

Company______________________________________

Email address___________________________________

Please send email confirmation and this completed form to

[email protected]

Send check payable to Southern Illinois Chapter HFMA and mail to our

Treasurer:

John W. Majchrzak

510 Lincoln Drive

Herrin, IL 62948

SOUTHERN ILLINOIS CHAPTER

SPRING GOLF OUTING

THURSDAY, MAY 23, 2019


April 2019 ISSUE 4, 2018-2019

Developing a Comprehensive Audit & Education Program for Physicians

By: Stacey Harper

In today’s environment, all health care providers are navigating complex government legislation, evolving regulations, and third-party audits with increased frequency. There is an increasing expectation of physicians and billing providers to fully understand coding and regulatory guidelines while still operating efficiently with a commitment to quality patient care.

One way to mitigate pressure from external factors is to ensure your organization has a comprehensive audit and education program for its physicians and billing providers. A formal program enhances the coding and documentation knowledge for providers and creates the necessary feedback loop enabling providers to focus more on patient care. Many organizations do have some form of audit plan in place, but there are ways to enhance and improve these plans to provide more value to providers.

SCOPE

For organizations initially developing an audit plan, its best to start out with manageable parameters. Consider the following details:

What providers & specialties should be included?

Ideally, you want to include all billing providers and those who would benefit from feedback and education related to coding and documentation. If resources are limited, start with the highest volume providers as well as those who may be operating in higher risk areas (relative to coding, i.e. complex procedural services or case mix)

What services should we include (inpatient, outpatient, procedural)

Focus on where providers in your organization are performing the bulk of their services. If you can include samples which include all relevant services rendered, you will get more value out of the review and have better feedback for the provider. If resources are limited, focus on high volume and high dollar areas.

Will we perform this concurrently or retrospectively?

While concurrent reviews tend to have more value for a provider because the information and feedback is provided almost real-time, most organizations opt to start with retrospective audits as they are easier to facilitate. Consider starting with a retrospective process and if you already have one in place, look at incorporating a concurrent component to your audit plan.

Who will perform the audit?

If you have in-house coding and auditing staff, this is one place to start. If the resources do not exist internally or they do not have room for expansion, there are numerous organizations which will support this process. We tend to find that clients benefit from an outside perspective and a trusted vendor can enhance the knowledge and efficiency of the entire program.

How frequently will we perform these audits?

Consider your resources and don’t choose a target that is unattainable. If no program is currently in place, simply providing this information annually is an improvement. Ideally, providers need quarterly feedback to ensure they are retaining and building upon their knowledge of coding and documentation guidelines. We also know that regulations change on a quarterly basis, so it provides a mechanism to transfer relevant details to the providers.

How will the charts be chosen and how will the providers be scored?

Audit programs in their infancy will benefit from random reviews that will provide insight into a broad spectrum of services and opportunities that may exist around coding and documentation. If an audit plan has been in place for a sustained period of time, it may warrant doing more focused reviews on areas of known issue or concern. Organizations can utilize prior results to hone their focus and develop a targeted sample to continue to refine education and training.

Scoring the provider or audit results is an area where providers should be engaged from the beginning to ensure they fully understand the information and accuracy rates they are receiving. We work with many organizations to develop various scoring methodologies such as code-over-code or chart-over-chart, but the most important detail is to keep scoring and reporting simplistic, but meaningful. It should be simple to understand and validate by those reviewing results yet detailed enough to provide meaningful insight into the data.



April 2019 ISSUE 4, 2018-2019

EDUCATION BEYOND BASICS

One of the largest areas of importance of an audit program is the education generated from its results. Education should always consider the audience and focus on the needs of the individual or group. Its important to ensure providers have a baseline knowledge of coding and regulatory information to include:

Evaluation & management coding

Modifiers

ICD-10-CM & CPT/HCPCS coding

Global periods, when relevant

Teaching physician guidelines & use of midlevel providers

New and established patient guidelines, consultations and shared visits

But beyond these basics is a myriad of complexities that may or may not be relevant to an individual provider or practice. The feedback we receive from many providers is that the education they receive always centers around the basics and that it never dives deep enough into the complex questions they have around their specialty or nuances of practice. From a resource perspective, it can be difficult to ensure education touches upon relevant basic concepts yet stretches enough to provide meaningful content to providers who require this level of education.

A comprehensive education plan will ensure that all providers are frequently receiving enough content and tools on basic coding concepts with targeted information relevant to their practice, workflow and specialty. As an audit program continues to evolve, focused audits and feedback can continue to focus on these more nuanced areas. Organizations can also consider leveraging vendors and outside resources to ensure providers are receiving education that spans beyond the basics.

EXPANDING AND ENHANCING THE PROGRAM

It takes time to ensure that an organization has a fully functioning, efficient and informative audit program. For those organizations that have something in place, it is important to continue to focus on opportunities to refine and improve the program so that it does not become stale. A few ways to do so were touched upon above and include:

Expanding samples to include varied services or places of service

Performing targeted audits on areas of concern or regulatory focus

Utilizing concurrent reviews to provide more timely feedback to providers

Expanding education to ensure it covers more complex topics and is relevant to providers

One additional way to consider expanding your program is to incorporate provider shadowing. Shadowing can be a form of retrospective or concurrent review process and incorporates reviewing the provider’s patient interaction and corresponding documentation real-time while advising the provider on areas for enhancement. These discussions can also be reconciled with documentation retrospectively to determine if relevant information did not make its way into the medical record.

Without a comprehensive audit and education program in place, there could be risk for your organization. The best way to mitigate this risk is to start with a basic, simple program that considers resources readily available internally and externally. As the organization continues to refine its program, it can expand and enhance the focus and educational outputs to ensure providers are well informed and better served to focus on patient care.

Stacey Harper is the Owner & Executive Director of Hyperion Advisory Services, LLC

Audit & Education Plan (Continued from page 13)


April 2019 ISSUE 4, 2018-2019

PRACTICE MANAGEMENT SUMMIT: ACHIEVING

OPERATIONAL EXCELLENCE took place form March

13th – March 15

th at the Regency Conference Center in

O’Fallon, Illinois. Over the three days, 17 speakers

from all over the country provided an amazing program

that was geared especially for Physician Practice

Management in our region.

If you weren’t there, you missed some very relevant

topics in healthcare. We covered malpractice, some

very interesting information on HIPAA, coding, risk

analysis, and MACRA. There were also benchmarking

and leadership topics to help an office both assess and

improve areas of concern.

Our event brought in over 80 registrations and we

enjoyed the company of 6

different sponsors who

contributed to heavily-attended

networking and celebrations

following both Wednesday

and Thursday evenings.

Thursday’s networking had a

photo booth and we all brought

out the luck of the Irish with a

St. Patrick’s Day theme.

Thank you again to the event Sponsors:

SENEX Services

Wakefield & Associates

Midwest Healthcare

PCIS

Health JPass

Ingenious Med

We truly enjoyed the collaboration with MGMA and

ICAHN and hope to continue to work together to

provide our chapters additional education in the

future. Thank you to Angie Charlet & Debra O’Shea

who contributed time and special effort. A special

thanks also goes out to Chastity Werner and her team

from HIPAATREK who worked with our team every

week for the past several months to ensure our

success.

Practice Management Summit

By: Nikki Graves, MBA


April 2019 ISSUE 4, 2018-2019

Our last meeting of the year, “The New Frontier” went out with a BANG! The March 24th meeting was located at

Southern Illinois Healthcare in Carbondale, Illinois, brought in 64 registrations and offered 6 CPE credits. This event focused on the future of Healthcare and what the landscape will look like from Population Health, 340B, Blockchain in Healthcare, Managing EHR and Consumerism.

It was a great day of education/networking and an honor to have nationally recognized experts that are leading the charge in this space come speak with the Southern Illinois HFMA chapter.

In addition, installation of 2019/2020 Chapter Directors and Officers took place, along with recognizing five recipients of the Founders Merit Award: April Peters, Keith Anderson Nikki Graves, Shirley Mason, and Melissa Lucas. (see page 7 for details and photos)

March Education Session

By: Jennifer Granados, CHFP

New 2019-2020 Chapter Officers

President: Melissa Lucas

President elect: Jennifer Durham

Secretary: Ken Werner

Treasurer: John Majchrzak

VP/Program Chair: Troy Lindsay

Past President Shirley Mason

Consumerism in

Healthcare

Maureen Testoni presents

340B Update

Matt Wolf and Rick Kes present

Consumerism in Healthcare

Jenny Hertter presents

Population Health Journey Penny Weinhold presents

Managing EHR Conversion Risks


April 2019 ISSUE 4, 2018-2019

Attendees: Shirley Mason, John Majchrzak, Nikki Graves, Stephan Taylor, Barb Johnson, Keith Anderson, Melissa Lucas, Troy Lindsey, Jennifer Grenados

Absent: Greg Wright, Terry Swan, Julie Aman

Guest: none

Welcome and Review Agenda

The president called the meeting to order at 3:00 pm Central

time. The president reviewed the agenda. There were no

additions to the agenda.

Consent Agenda

The Board of Directors approved the October 24, 2018 meeting minutes as presented. They approved the consent Agenda as presented:

Fiscal Year 2019 Treasurer Reports

Chapter DCMS / Dashboard reports

Review Committee Reports from

Scholarship

Certification

Golf

Founders

Programs

Social

Sponsorship

Membership

Newsletter / Communication

Website

Financial Reports: John discussed the current year financials. On the balance sheet, cash is approximately $67,000, which is made up of the money market account and checking account. Cash looks okay as of right now. In the income statement, John may need to do some reallocation of the expenses but all expenses are recorded as of now. The bottom line is a positive $6,600. The program net is lower than anticipated on the budget; however, some of the expenses are lower as well, which is resulting in positive variance. LTC is coming up in April and will mean additional travel expenses to be reflected during the year.

Receivables from other chapters: The Southern Illinois chapter still has not received the funding from the other

chapters for Nikki’s travel expenses. In addition, the Chapter does owe an amount to the Indiana Chapter. John and Nikki will need to review the Region 7 agreement to see if Nikki’s travel from the Region 7 meeting is reimbursable from the other regional chapters.

DCMS / Dashboard: The progress reports were sent before the meeting that were reviewed by Shirley during the call. Shirley was able to track down the educational hours, which stand at 2,257.8 hours at present with two educational meetings to go; the goal is for 2,412 educational hours this year. The goal for hours per member is 12 and is currently sitting at 11.2. The educational performance improvement is 6% improvement. The Certification Excellence Goal is sitting at 10.9% and is currently at a bronze level right now. Membership Retention is 89.6%, which is at a gold level currently. The membership growth is sitting at -3.0% as of right now. The manual hours for the mini LTC and the webinars will still need to be added to the hours reported.

Program events: Planning is complete and registration is open for the practice management summit in mid-March. Currently, 7 individuals are registered. Melissa will look into Cvent further on how to collect the sponsorship dollars for the meeting, which is causing issues in payment delays. We currently have 4 sponsors for the event. The sponsor’s emails will be needed in order to process these sponsorship payments.

For the regular March education event in Carbondale, the planning is underway and is close to be completed. The registration will be pushed out separately after the registration for the practice management summit registration has been out for a while to avoid confusion. A room block is still needed for this event in Carbondale. A new Hilton is available and may be a good option. Members are still planning on gathering at Fat Bottom Betty’s the night before for networking.

Nominations

President-elect is still open and the chapter is looking for nominations for this position. Currently, Shirley is not open to taking a second terms as president. An email to all members could be sent to do an additional ask for a member who would be open to being nominated for the president elect position.

Kenny is remote and would be Secretary for next year. He is prepared to work remotely in the officer role as he lives in Florida. Chastity is willing to work with Kenny in getting up to speed with the officer role. Kenny is working full time for a health care vendor as of right now. He will travel for some events but not all of the events for the year.

Next year may be an issue as well when looking for nominations for officer positions. General business membership notification is required 30 days before the meeting in March for the vote and will be sent out by Troy.

Under the current bylaws, voting can be done using regular mail, fax or email. This will be preferable in order to elect and


HFMA Southern Illinois Chapter Board Meeting

Conference Call, February 11, 2019


April 2019 ISSUE 4, 2018-2019

install the new officers to that they can register and make plans to attend LTC. Nikki will draft letter for nominations for the president elect that will be by Melissa or Shirley.

Innovation Funds

All of the $10,000 of the available innovation funds has been awarded will be received by the Chapter. These funds were applied for the early careerist meeting ($3,253.04), the payor initiative for the October meeting ($3,360) and the physician practice management meeting in March ($3,386.96). In addition, $2,000 of additional funds was awarded to the Chapter. As a result, $12,000 of additional funds was given to the Chapter.

Chapter Success Plans Updates

Cvent: No change from the earlier report. Cvent has been fully implemented and this plan has been met.

Sponsorship: The sponsorship goal of $22,800 has not been met and will not be met for the year at this point. The chapter is currently at $18,750 for the year.

Social Media: In addition to getting the Facebook page up and running, Keith has not launched the he Linked-In site for the Chapter.

Lifetime member award

Phyllis Braddock will be retiring in June 2019 and, as a result, her membership is currently expiring in July 2019. Shirley would like to recommend to nominate Phyllis for the life time membership award. The application and a $200 check will need to be sent to the national HFMA, which will cover her dues for 5 years. Shirley moved to nominate Phyllis, Nikki seconded, and the motion passed.

The August meeting for next year will be when it’s announced by Melissa.

Yerger Applications Shirley will write an application for the payor panel and networking event in October. Keith will write an application for the social media communications. Melissa will write on for the early careerists’ event. Nikki will write one for the physician event from last year. Shirley will submit one for the multi-chapter event for the Region 7 meeting, which would result in a Yerger for each chapter if awarded. The women’s in leadership conference last May would be eligible as well but unsure who would be able to write an application for this event. Connie or Jennifer Venable would be possibly be good options to reach out. Deadline for the applications is March 1st.

Chapter 2.0

The current push for Chapter 2.0 is to get a representative from the Chapter to go and attend these events and work thru the Chapter 2.0 information. The representative would need to attend the Chapter 2.0 sessions for LTC. The representative does not have to be a board member but will need to be very involved in the chapter. Jennifer Venable has previously been involved with Chapter 2.0 and may be a

good option. Melissa will reach out to Jennifer to see if she has an interest.

LTC

The rollout of LTC event and registration is taking longer than in previous years. The final agendas are not out yet, and Region 7 will be having a call to discuss the event that Nikki will be a part of. The chapter will need to get the people attending registered as soon as they are installed, which may be cause late registrations due to the timing of the March event. The chapter will need to take a look on who will be going and have those who can register make their travel plans. The current officers will need to go ahead register, including past-president and treasurer, president, president elect, Chapter 2.0 representative, secretary. Troy will not be able to attend due to timing of the event, and, as a result, the Chapter has an extra slot for an officer. Kenny will be a good option to attend the program track as the secretary sessions are light. Also, John will look to sit in as well on the Cvent courses. John looked for flights and indicated that the options are limited as of now and may present a challenge. The flight and hotel can still be booked as of right now even though the LTC registration is not up as of yet. The bylaws will allow one extra day for attendees, usually the day after as the chapter planning runs to 5 pm the last day of the conference. The chapter will need to make arrangements for a Chapter meeting for planning the last day, which these blocks are usually announced with the LTC final agenda email. Tuesday from 3 to 5 has been blocked out for the Chapter planning meeting from the basic agenda on the website. First Illinois is in charge of setting up the regional dinner on Sunday night, which may earlier due to the time change.

Since the vote will be done in the March 28th meeting to install the officers, this will result in late registrations. However, the vote appears to be done by email as well. Melissa will need to take a look at the bylaws to see what is allowed to ensure everyone gets registered timely.

Multi Chapter Event w/ the Heartland Chapter in May

The original budget for the event had a $9,700 loss with some of the loss being funded upfront by the Chapter. Shirley indicated that the Chapter should not have to fund a loss for this event. As a result, the event is not budgeted for a $4,700 loss and will be offset with innovation funds.

Shelton Award

A Shelton award demonstrates a sustained excellence in the Chapter. Shirley has provided a worksheet that shows how the Southern Illinois Chapter is looking as far as stats reviewed for this award. Member satisfaction result is 97% for the most recent results, which compares very well to other chapters. Days cash on hand is also factored in; John will take a look at to see how this is computed. Prior years is in the 350 to 360 range. Certification grew in previous years to 12.20% but has dipped to 10.9% for the current year.

Upcoming Meeting Dates

Upcoming meeting dates need to be set and will be looked at for the March board meeting. When setting the dates, we do not want to conflict with other dates set by the nearby

February Minutes (Continued from page 17)



April 2019 ISSUE 4, 2018-2019

chapters so attendance concerns. In the March meeting, we will discuss the possibility of pulling back the number of meetings for future years to less than 3 per year. Shirley has concerns getting all of the items completed with the current 3 meetings per year and would be more difficult with fewer meetings. Four board meeting will still be required as quarterly meetings are required by HFMA national.

The Mini LTC has not been planned yet; however, a venue is needed in order to get the planning on the way. A small classroom or board room will be needed. Will be in early May – usually the first Thursday. We will need to get a CAT facilitator scheduled in order to firm up a date. Kim Cooker indicated that she would be rolling off as a facilitator next year; as a result, she recommended that we set up two

facilitators in order to have her successor in place for the following year.

Webinar committee

The region webinar committee has proposed to do four webinars for each Chapter, which was discussed and decided in the mid-January committee call that was attended by Jenny.

Adjournment

Melissa motioned for adjournment, Keith seconded, and the

motion passed. The president thanked everyone for their

participation. The session adjourned at 4:10 Central time.

February Minutes (Continued from page 18)

HFMA Southern Illinois Chapter Board Meeting

SIH Headquarters, March 27, 2019

Attendees: Shirley Mason, Nikki Graves (phone), Barb Johnson, Keith Anderson, Melissa Lucas, Troy Lindsey, Jennifer Grenados, Greg Wright, Terry Swan, Lionel Montoya (phone), Julie Aman (phone)

Absent: John Majchrzak, Stephan Taylor,

Guest: none

Welcome and Review Agenda

The president called the meeting to order at 3:37 pm Central

time. The president reviewed the agenda. There were no

additions to the agenda.

Consent Agenda

The Board of Directors approved the February 11, 2019 board meeting minutes as presented. They approved the consent Agenda as presented:

Fiscal Year 2019 Treasurer Reports

Chapter DCMS / Dashboard reports

Review Committee Reports from

Scholarship

Certification

Golf

Founders

Programs

Social

Sponsorship

Membership

Newsletter / Communication

Website

Shirley discussed the consent agenda items, any updates on the items, and the most recent financial reports.

Chapter DCMS / Dashboard Reports: The progress reports were provided to the board members in advance to the meeting and were reviewed by Shirley during the meeting. Educational hours still needed to be added to the report for the recent Physician Summit event, which was a big success. In addition, 59 attendees are registered for the March educational meeting that will also add to the chapter educational hours for the year. Lastly, the joint spring meeting with the Greater Heartland Chapter will be held in this education year as well in April and will add to the total educational hours. As a result, our chapter should have no problem meeting the educational hour goal for the year.

Golf: The golf outing has been set for May 23 at 12:30 pm at Fair Oaks Golf Club. The program planning meeting will be held in the morning and should wrap up by 11:30 am so time is left for the attendees for lunch and networking. The venue has been changed this year and should be a great venue for the event. The planning meeting room will be a little smaller than in previous years but should be fine for our purposes. A continental breakfast will be served for the planners and lunch served after the planning meeting for the golfers. Jennifer Venable will serve as a golf co-chair as a provider with a focus on sponsors for the event. A save the date will be sent out to our members and others on our mailing list shortly. The invite can be sent on or forwarded to anyone once it has been sent out by the chapter.

Certification: During a recent regional call, First Illinois indicated that they have come out with a new outstanding training curriculum and materials for individuals who are looking to go through the certification process. The chapter can access these training materials for our members as well; Melissa has the contact information. In addition, with the changes in the pricing of the certification process for HFMA,



April 2019 ISSUE 4, 2018-2019

more individuals may be interested in pursuing certification.

Program events: There are currently 59 individuals registered for the education event tomorrow. $3,910 are the total registration fees currently which exceeds the budget of $3,600. However, there are no exhibitors for tomorrow’s meeting. Jenny took the lead on this event and has new fresh topics that has generated a good buzz for this meeting. Mary Jane Newby is a student member and will be attending tomorrow.

The recent Physician Summit event had 85 attendees and was a collaborative event with ICHAN and MGMA. With the three full days of education, it generated over $11,000 of registration fees. In addition, ICHAN is contributing $3,000 and HFMA National is $3,100 for innovation funds to help with the costs of putting on the event. The cost of venue was estimated around just over $7,000 currently. However, the final totals for the expenses will be coming soon.

The consent agenda approved as presented

Ballot and Vote

Due to the way the educational meetings fell during the current year, the vote for officers and directors was conducted electronically through a survey monkey, which had 35 responses. The survey was hold open until yesterday. The voting was 100% cast for the nominated individuals. The elected individuals will be installed at tomorrow meeting during the lunch break.

Chapter Success Plans Updates

Nikki is currently working on wrapping her chapter success plan document up and finalize the plan. All of the other chapter success plan documents have been updated and completed. The chapter has exceeded their goals with all plans with the exception of the sponsorship plan goals. In addition, the sponsorship chair unfortunately left the role during the year.

LTC

The LTC is being held on April 14 – 16 this year and is coming up shortly in Anaheim, CA. The chapter attendees

include: John Majchrzak, Melissa Lucas, Shirley Mason, Jennifer Durham and Jennifer Venable. Also, Jennifer Campbell and Terry Swan may attend the conference if their schedule works to represent membership track. There are several upcoming changes in HFMA coming from national, and it will be interesting and valuable to learn about these upcoming changes, including the membership dues and other changes. The chapter had budgeted for six attendees versus the seven positions with the extra coming from the Chapter 2.0 track. Melissa has recently emailed the agenda to the attendees and is working on getting a Monday night dinner planned. LTC will work a little different as there will be a regional initiative for a collaborative educational event (possibly a CFO forum event). This will be a new event and will help define what regional educational will look like in the future.

Mini LTC

The event will be held on in Mount Vernon this year on May 2nd. Barb was able to reserve a meeting room for the event that is able to hold 50 or more participants. Kim Coker will be the CAT facilitator again this year with Pete Sable assisting. This will be Kim’s final year as the CAT facilitator, and Pete will be taking over her role in future years. Melissa has had the first of series of call with Kim to discuss topics for this meeting.

Upcoming Meeting Dates

Possible meeting dates were discussed for the upcoming educational year. The August meeting will need to be coordinated with the Cardinal game networking game, which may be possible on August 21st. In addition, the chapter may want to consider replacing second day of October educational meeting with a revenue cycle education focused event. In addition, the dates for the upcoming educational year will need to be coordinated with the HFMA national dates. The dates will need to ironed out by when the planning meeting is held. With the upcoming HFMA changes, more educational hours of the chapter will be coming through webinars. The chapter will need to consider how to connect the sponsors with the providers for in person networking with the shift to online education. In addition, the vendor fair has not been well attended in past years and probably not worth the costs of having the fair. The chapter may revamp the fair into possibly having vendors in the meeting rooms or in the corridor that will have them be more

March Minutes (Continued from page 19)



April 2019 ISSUE 4, 2018-2019

in sight and provide all day signage for the vendors. In addition, this may provide more potential interaction during the breaks with our vendor sponsors. Other chapters are still having luck with their vendor fairs but our Chapter has had issues with attendance in past years. Another idea would be to have shorter breaks during the meetings to allow for earlier events in the afternoon and evening. ICHAN has recently taken the approach of a sponsorship spotlight with their webinars where a sponsor is highlighted during the beginning of the webinar and given some time to discuss their services. This would be a different type of exposure for our sponsors but possibly expanded exposure to a wider audience. In addition, sponsors can also be in the slide deck on the webinars for them to get greater exposure.

Webinar committee

Jenny provided an update on the Region 7 webinar committee. For the upcoming year, each chapter in the region will come up with 4 webinars (20 total) and relevant topics. Sponsors should be given first priority to present the webinars. We need to be aware of potential duplication of

topics of live educational meetings that are to be held during the year. The webinars are to be free once an individual is a HFMA member and will provide CPE credits as well. As a result of the expanded webinars, the chapter may have additional pressure on live meeting attendance. However, the chapter will still be getting the credit for these educational hours for these webinars. Our members will be replacing their live meeting hours with these webinars hours and may lower attendance at the live events. Live meeting topics have been kept broad for broad appeal to all of our members; however, the webinars can be more topic / niche specific. The upcoming younger generation may be more likely to attend a webinar versus a live meeting.

Adjournment

Greg motioned for adjournment, Melissa seconded, and the

motion passed. The president thanked everyone for their

participation and effort during the year. The session

adjourned at 4:35 Central time.

March Minutes (Continued from page 20)


April 2019 ISSUE 4, 2018-2019

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April 2019 ISSUE 4, 2018-2019

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April 2019 ISSUE 4, 2018-2019

I extend a sincere thank you to Jennifer Venable and Jennifer Durham for participating in a regional initiative to develop specific education for CFO and Finance members. Their work has been integral in the formulation of new and exciting education opportunities for those members.

Melissa Lucas, VP/ Program Chair


April 2019 ISSUE 4, 2018-2019

Shannon Tesio Earns Fellowship Designation from the

Healthcare Financial Management Association

Congratulations to Shannon Tesio on receiving the designation of FHFMA on May 31, 2018. To be awarded the

FHFMA distinction, applicants must be credentialed as a Certified Healthcare Financial Professional (CHFP); be

an HFMA member for at least five years; complete a bachelor’s degree or 120 semester hours from an

accredited college or university; and volunteer in HFMA or the healthcare industry. More than 1,700 HFMA

members nationwide have achieved this accomplishment in the organization’s 68-year history.

In addition to FHFMA, HFMA offers a variety of other certification programs: Certified Healthcare Financial

Professional® (CHFP

®), Certified Specialist Business Intelligence (CSBI), Certified Specialist Physician Practice

Management (CSPPM), Certified Specialist Managed Care (CSMC), and Certified Specialist Accounting &

Finance (CSAF).

Three current Chapter Directors were successful in earning the CHFP in the past fiscal year and are on their

way to achieving the distinguished honor of FHFMA. Jennifer Granados achieved the certification on June 15,

2018, Keith Anderson achieved it on October 10, 2018 and Barbara Johnson achieved it on March 31, 2019.

Certification is much more accessible to the Enterprise

members now that the fees are waived. What’s keeping

you from validating your skills and knowledge?

Learn more at hfma.org/certification.

http://www.hfma.org/certification


April 2019 ISSUE 4, 2018-2019

Through the generosity of these HFMA Southern

Illinois Chapter sponsors we are able to provide

our members with educational seminars and

networking activities. We wish to recognize and

thank them for their support in 2017-2018.

PLATINUM Clifton Larson Allen

HIPPATrek

GOLD Anders CPAs + Advisors

BKD CPAs & Advisors Kerber, Eck & Braeckel RSM US LLP Wakefield & Associates SILVER The Law Offices of Jay B. Umansky

BRONZE Avadyne Health

Credit Control, LLC

Eagle Recovery Associates, Inc.

Magnet Solutions

Midwest Health Care, Inc.

THANK YOU

2018-2019 SPONSORS

Southern Illinois Chapter

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January, April, July, and October

Editor

Barbara Johnson

618-899-1498

[email protected]

Assistant Editor

Kristie Snyder

618-239-6000

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Open Chair—Contact Melissa Lucas

for details if interested.

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Submission Deadlines:

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Healthcare Financial Management

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