Author: Maureen Kelly, Executive Director, Axea Solutions
This year’s Florida Hospital Financial Management Association (HFMA) Fall Conference at the Margaritaville Beach Resort in Hollywood, Florida on September 5 – 7, was the perfect location for their fast-paced and innovative program. Attendees packed the sessions, networking events, and exhibitor hall throughout the conference and took advantage of networking time to discuss strategies and share inventive ideas about navigating the upheaval going on in healthcare revenue cycle operations.
The kick-off speaker, Jacque Sokolov, MD, spoke about the continued evolution of healthcare and why healthcare organizations need to plan for an upheaval in healthcare operations and revenue cycle in his presentation, Management of Transformative Healthcare Trends – How to Expect the Unexpected. In particular, he discussed the many disruptions that healthcare organizations are experiencing, including:
· New revenue cycle methodologies,
· Payment and reimbursement challenges, such as the impact of quality metrics and at-risk payment models, and
· Aligning hospital and professional services and billing, as the move to value-based healthcare continues, direct employment of physicians increases, and managed care plans require documentation such as hierarchical condition coding
New entries into the traditional healthcare delivery system such as Amazon, Uber, and Microsoft, to name a few, are creating alternatives for healthcare organizations and consumers that are both beneficial and competitive to hospital operations. Healthcare executives will need to carefully decide how, when, and with whom to align to optimize their business models and serve their communities.
If you have the opportunity to hear Dr. Sokolov speak at an upcoming event, you should run (not walk) to the meeting room and prepare to be amazed. He definitely has his hand on the pulse of change.
Compliance Programs: More Important Than Ever
There is a lot going on in the compliance world, and it takes input from everyone in a healthcare organization to ensure that they are meeting compliance goals and objectives. As Joanne Byron, Chief Executive Officer, American Institute of Healthcare Compliance (AIHC) noted in her presentation, 7 Habits of Highly Successful Compliance Programs, an effective program includes:
· Continued evaluation of medical practices, especially those deemed as high risk,
· Monitoring for potential conflict of interests,
· Managing the OIG 7 Step Program, and
· Handling OIG and CMS self-disclosures.
The good news is that there are many free government toolkits to help healthcare organizations to comply with the mandated programs via the OIG website.
Florida State Legislative Initiatives
Ashley Boxer, Corporate Director Government Relations at Memorial Healthcare System, provided an insider’s view to the many healthcare issues that the Florida State Legislature has under consideration. The pending issues include:
· Overall healthcare funding,
· Possible expansion of the state’s Medicaid program, and
· Potential Certificate of Need (CON) new legislation.
Ashley provided some essential guidelines on how to communicate with hospitals’ respective representatives to gain their support for legislation important to the hospital. Most important is to be in regular contact with the representative and their administrative staff, provide high-level responses to questions asked by the representative (bullet points that can be opened on their phone while in session is in progress), and network with lobbyists and government relations personnel from other health systems.
Click here to learn more about upcoming events hosted by the Florida Hospital Financial Management Association.
Axea Solutions’ team of credentialed HIM and Revenue Cycle experts assist healthcare organizations to review their compliance processes and identify any areas of high performance and those that need improvement. Customized for each healthcare organization, Axea offers one-time service, periodic reviews, or fully managed services. Contact Axea at email@example.com or 855.424.4249 to learn more.