HFMA 2015 ANI: Themes and Thought Leaders

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HealthWare Systems Blog

HFMA 2015 ANI: Themes and Thought Leaders

Posted on Mon, Jun 22, 2015

It’s always tempting to try and boil an event like HFMA’s Annual National Institute Conference down to two or three core themes. Last year, some industry observers cited pricing transparency and the new era of consumerism as the overarching messages at HFMA 2014.

Of course, the strongest, most resonant points will always depend on each attendee and his or her professional aims. Patient access directors will naturally lean into the RCM/patient experience discussions, while health system CFOs bookmark sessions on business intelligence and financial performance.

More importantly, different attendees come equipped with different capacities for absorbing and processing all the data that’s packed into these four days (and it’s a lot). Most will need time to reflect on their notes, speaker presentations, and post-event summaries, before bringing actionable items back to their various stakeholders.

Still, in an effort to make so many valuable learning opportunities more manageable… Here are a few of the themes we’ll be listening for, along with some Twitter-active thought leaders worth following during HFMA 2015:

Collaboration

Collaboration is hardly a cutting-edge theme, and yet plenty of healthcare facilities still struggle to monetize the benefits of organized teamwork and coordinated goal-setting. Part of the challenge is developing a shared definition; the other is modeling and fine-tuning a process for collaboration, beyond stating what end results should look like.

On this front, we’re excited to hear from Dr. Grace Terrell (@gracet22), physician and CEO of Cornerstone Health Care.

Dr. Terrell’s session, Physician Collaborations that Drive Value in Healthcare (FS5) on Wednesday at 8:00, will highlight Cornerstone Health Care’s strategies for establishing partnerships to achieve value in healthcare. She’ll discuss methods for overcoming barriers to collaboration and integration, plus approaches for developing physician leadership, motivating clinicians, and engaging patients.

We’re also looking forward to Dr. Kent Bottles’ session, Creating Clinical and Financial Data Mining Tools to Achieve the Triple Aim (IL5)on Thursday at 11:00. Dr. Bottles (@KentBottles) is a lecturer at Thomas Jefferson University School of Population Health, and the Chief Medical Officer at PYA Analytics.

Dr. Bottles will explain how forward-thinking health systems are using population health management tools to achieve the “Triple Aim.” He’ll identify which HIT functions are required, and define which community partners are essential to the success of population health management programs. The session touches on ways to avoid common pitfalls, and the culture needed to do data mining successfully.

Clinical Integration

As the Chief Scientific Officer and Chief Medical Officer at CVS/Caremark, William Shrank, MD (@WillShrank) is leading the lineup on clinical integration at HFMA 2015. Dr. Shrank’s presentation, Health System Innovation: Expanding the Network Into the Community (FS6) kicks off the day on Wednesday. It’s an overview of how retail medicine is helping to expand primary care delivery, and how retail clinic partnerships with providers support some pretty important mutual goals.

If you’re not already following Neel Shah, MD (@neel_shah), update your HFMA 2015 list right now. Dr. Shah is an advocate for more transparency, value and rationality in the healthcare system. He’s also the founder of a nonprofit called Costs Of Care, and an assistant professor at Harvard Medical School.

Shah’s session, The Physicians’ Role in Protecting Patients’ Financial Well-Being (FS1)will address the ACA,  its margin and cost pressures for healthcare finance leaders, and the changing approach to decision making felt by clinicians and caregivers. In this session, Dr. Shah will help connect the dots between clinical care and cost management to reduce the cost burden on caregivers and patients— without sacrificing quality outcomes.

Revenue Cycle and the Patient Experience

No, surprise, we’re excited to attend all the sessions in this category. Leading the pack is Yvonne Chase’s Monday afternoon talk on Improving the Patient Experience from Admission to Discharge. Chase will discuss patient satisfaction measures for the revenue cycle—outlining tools and processes to impact patient experience on the front end.

In terms of RCM thought leaders you can follow during HFMA 2015, take a moment to add our team to your Twitter streams. We’ll have several people from HealthWare Systems around and about the Orange County Convention Center. Let us know if you’re up for swapping notes, or just saying hello. See you there!

Revenue Cycle Software: 3 Steps to Stop Spinning Your RCM Wheels

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HealthWare Systems Blog

Revenue Cycle Software: 3 Steps to Stop Spinning Your RCM Wheels

Posted on Wed, Jun 17, 2015

Revenue cycle software virtually defines the success of today’s hospitals. When cash is coming in on a predictable, steady basis, facilities can manage expenses, retain top-tier medical talent, and roll out life-saving advances in patient care.

But healthcare revenue cycle management is more complex than RCM in other industries. For one thing, the payer mix is widely varied (and getting more complicated all the time). The chain of providers and care coordinators is also much longer than those in service models outside of healthcare.

Taming the complexity without creating redundant tasks and excessive positions fuels an ongoing debate—one that’s culminated in an official task force. Indeed, the RCITF is now calling for industry-wide collaboration to “rethink the current RCM model completely.”  But so far the RCITF’s vision for the “Patient Financial of the Future” has been solely focused on the what. In FY16, they will begin to spell out the how, in terms of workflows and technology systems.

What should your facility be doing in the meantime? These three steps and revenue cycle software options (sometimes described as “bolt on”) are still the cornerstone of any solid RCM strategy:

  1. Define and communicate each RCM employee’s role.

Lots of different employees play a role in revenue cycle management. One health system VP estimates roughly 250 people are involved in creating a single hospital bill. Hospitals need to standardize the process (to whatever degree possible among different departments), then clearly communicate the responsibilities assigned to different parties.

It may seem obvious that administrative staff understand their job duties, but plenty of physicians and nurses still don’t grasp (or follow) set procedures.  In the pre-arrival process, for example, clinical and financial clearance should be streamlined and benchmarked. Health management software for preregistration supports address verification, insurance eligibility, medical necessity, and other RCM-defining activities—which leads us to the second step…

  1. Provide the tools necessary to accomplish those roles.

It’s one thing, for example, to insist that intake staff vet physician orders for full detail and signature. It’s another to insist that rejections, follow-ups, and resolutions occur in a timely manner, when manual operations and paper-based exchanges are required. More than ever, healthcare employees need digital order management software to streamline revenue cycle activities. They need the ability to reject, return, or else re-route acceptable orders to the right department with a single click.

  1. Establish your most defining RCM metrics, and train teams to perform accordingly.

As Lindy Benton, CEO of MEA | NEA recently explained in HIT Consultant, “organizations provide enterprise-wide training, job aid and performance support for those engineering and operating the RCM chains.” Benton goes on to list some of the key performance metrics that dictate ROI on revenue cycle efforts.

Can your hospital leaders can get their hands on real-time RCM data—like, what’s your average patient registration accuracy figure? How effective are your POS collections? There’s already an easy, cost-effective way to monitor metrics like these on a daily basis. And when you have an RCM dashboard  at your fingertips, decisions about training and job aid become a lot simpler.

What are your thoughts on revenue cycle software with “revolutionized” RCM in the offing? What’s your stance when it comes to rethinking RCM? Please share your comments below, or follow and DM us on Twitter.