Fall Conference October 9, 2013 to October 11, 2013 Oglebay Resort Wheeling Co-sponsored with The WV Society of CPA’s (12 CPE Credits) West Virginia Healthcare Financial Management Fall Education Meeting Agenda October 9-11, 2013 Oglebay Resort – Wheeling WV Wednesday, October 09, 2013 3:00 pm - 6:00 pm Vendor Set Up 4:00 pm – 5:00 pm WV HFMA Board Meeting 6:00 pm – 7:00 pm Networking Reception – Vendor Hall 7:00 pm – 10:00 pm Evening Entertainment Thursday, October 10, 2013 7:00 am – 8:00 am BREAKFAST - Vendor Hall 8:00 am – 8:15 am Opening Remarks – Belinda Bennett – President WV HFMA 8:15 am – 9:55 am Ten Critical Questions For Healthcare Financial Management General Session Scott Houk – Cleverley & Associates 2 CPE Session will identify ten critical financial questions that are often raised by healthcare boards and executives. The questions address areas of financial performance, profitability and cash targets, and facility level hospital operational issues of overall cost and price defensibility. The presentation will address each question using actual case-hospital data. Objectives: Highlight ten critical questions frequently asked by US hospital governing boards Determine relevant financial metrics to help answer the question Illustrate how the use of comparative benchmarking can impact current and future organizational performance 9:55 am – 10:15 am BREAK – Vendor Hall 10:15 am – 11:05 am WV Hospital Association Update General Session Joe Letnaunchyn - President WV Hospital Association 1CPE Session will provide a status on the latest developments at the state level with coverage expansion under Medicaid and the insurance exchanges/marketplace and with Medicaid regulatory and operational issues. Washington issues will include a focus on the federal budget; the deficit and Medicare and Medicaid legislative and regulatory issues affecting hospital, health systems and other providers. 11:05 am – 11:55 am PFS Breakout Session Breakout Sessions Patient Centered Medical Homes – Care Coordination and New Payment Models in WV 1 CPE Dr. James Becker – WV Insurance Session will provide an overview of the concept of patient-centered medical homes (PCMH). It will review the history, goals and methods of PCMH. He will describe several programs in WV that utilize care coordination and the outcomes for these programs. It will also describe some of the reimbursement models currently in place. CFO Breakout Session Exchanges, Medicaid Expansion and Payer Initiatives Bill Maclean – Vice President Insurance Services – West Virginia United Health System Objectives: How will West Virginia’s exchange operate What payers are planning to participate How will the exchange and the Medicaid expansion interact What will the exchange mean for providers and insurers Will the exchange be used for Medicaid What to watch out for 11:55 pm – 1:00 pm LUNCH 1:00 pm – 2:45 pm Professional Ethics: A Preventive Maintenance Approach General Session Christopher Bauer 2 CPE Session will help attendees gain insight on how to prevent costly ethical problems on the job rather than paying the high financial and reputational costs of cleaning up after them. Objectives: Articulate a minimum of five often-ignored or overlooked red flags for ethical risks that are actually easy to spot Four values on which it is essential to focus in order to reduce ethical risks How a small change in focus on ethics can significantly improve their organization’s bottom line 2:45 pm – 3:05 pm BREAK – Vendor Hall 3:05 pm – 3:55 pm PFS Breakout Session Breakout Sessions ICD-10: Financial Impacts and Insights 1 CPE Douglas Whinnie – Principal with The Wellington Group LL.C. Objectives: While CMS says the national financial impact of ICD-10 will be minimal, individual hospital impacts will vary Within a hospital, impacts can vary significantly by line of business and by payer ICD-10 training plans should take into account physicians and services whose DRG reimbursement will be heavily affected CFO Breakout Session State of the Capital Markets, Credit Trends and Borrowing Solutions for Not For Profit Hospitals Christopher M. Buehler – Director Healthcare Public Finance Objectives: General market conditions Overview of recent tax-exempt hospital bond financing Continuing disclosure requirements for hospitals Rating agency perspective on healthcare borrowers (credit medians and trends: anticipated byer covenants, etc.) 3:55 pm – 4:45 pm What You Don’t Know Can Cost You – HIPAA In A HITECH World General Session Alaina N. Crislip – Counsel with Jackson Kelly PLLC 1 CPE Objectives: Overview of increased individual rights to access Update on new breach notification requirements Review of enforcement changes to HIPAA and penalties for HIPAA violations Analysis of recent OCR enforcement activity 4:45 pm – 5:30 pm Program Committee Meeting 6:00 pm – 7:00 pm Reception – Vendor Hall 7:00 pm – 10:00 pm Dinner, Dancing and Music by TNT DJ’s Friday, October 11, 2013 7:00 am – 8:00 am BREAKFAST – Vendor Hall 8:00 am – 8:15 pm Opening Remarks – Belinda Bennett – WVHFMA President FY 14 – Inpatient CMS Payment Programs Frank Briggs – Vice President, Quality and Patient Safety WVU Healthcare 8:15 am – 9:05 am General Session 1 CPE Objectives: Describe the changes in Value Based Purchasing (VBP) Explain the Hospital Acquired Condition (HAC) penalty program Estimate the impact of changes in the Inpatient Prospective Payment System (IPPS) 9:05 am – 10:00 am Medicaid Expansion General Session Michael D. Wilmoth– Advanced Patient Advocacy 1 CPE Objectives: Illustrate how healthcare reform will affect provider enrollment programs Build strategies to mitigate the risk and maximize the revenue from uninsured patients Techniques to integrate Health Insurance Exchange enrollment 10:00 am – 10:20am BREAK – Vendor Hall 10:20 am – 12:00 pm Vendor Tear Down 10:20 am – 11:10 am 990 Schedule H General Session Rod Hardy – Arnett Foster Toothman, PLLC 1 CPE Objectives: What are requirements for reporting information from your hospital’s Community Health Needs Assessment Have you considered hospital services that may meet the definition as a “subsidized health service” What options are available to calculate “unreimbursed charity” and “unreimbursed Medicaid” cost 11:10 am – 12:00 pm Hot Topics: Maintaining Compliance in Times of Change General Session Jill Newberry – Senior Manager Arnett Foster Toothman, PLLC 1 CPE Objectives: 12:00 pm – 12:15 pm Proposed changes in the 2013 OPPS rules involving the changes to inpatient and observation status as well as physician supervision Updates on the latest medical necessity battles Updates on the quickly approaching transition to ICD-10 Review of new RAC approved items Door Prized and Closing Comments – Belinda Bennett - President Speaker Biographies Scott Houk, CPA – Senior Strategic Advisor Cleverley + Associates Mr. Houk consults with hospital and healthcare organization to identify financial and operating opportunities, as well as related strategies for performance improvement. Prior to joining the firm, he was a Senior Manager in the health Sciences Advisory Services division of Ernst & Young. He has 20 years of experience working with hospital financial managers across the United States. His experience includes performing hospital cost-reduction studies and procedures pricing studies, analyzing Medicare Disproportionate Share, completing financial audits of hospitals and healthcare systems, and performing many other financial Analyses. Mr. Houk received his B.A. in Business Administration with accounting emphasis form Transylvania University in Lexington, KY. He is a current member of the Healthcare Financial Management Association and the Ohio Society of CPAs Joe Letnaunchyn – President and CEO West Virginia Hospital Association Mr. Letnaunchyn has over 38 years of healthcare experience, 26 of those years working with state hospital associations representing multi-hospital health systems specialty hospitals and small, rural and critical access hospitals. He is actively involved in state and federal legislative activities and participates in several business and other healthcare related organizations that interact with hospitals. He has been with WVHA since 2006. Dr. James Becker – Medical Director WV Bureau for Medical Services and Physician Director WV Offices of the Insurance Commissioner Dr. James Becker of Huntington, WV, is an Associate Professor in the Department of Family and Community Health at Marshall University Joan C. Edwards School of Medicine. Dr. Becker joined the West Virginia Workers’ Compensation Commission in July 2003 as the system began a major overhaul process. He served as the Medical Director from July 2003 until January 2006 when the system was privatized. He continued as Medical Director of Brick Street Insurance until January 2007. In 2008 he joined the Department of Health and Human Resources, first as a consultant and then as medical director. Dr. Becker is a graduate of Marshall University School of Medicine. He is board certified in family practice. He was chief of the Section of Industrial, Occupational and Environmental Medicine from January 1996 to 2005. Dr. Becker is a clinical professor at West Virginia University, Department of Community Medicine and serves on the Resident Advisory Committee for the Department of Occupational Medicine at West Virginia University. In his role as Medical Director at Medicaid, Dr. Becker has responsibility for many of the policies that guide coverage decisions for various medical therapies. He reviews appeals on individual cases and has helped develop policy related to drug treatment programs, coverage for medical devices and new diagnostic tools. Dr. Becker is actively involved in Department’s grants and the effort to create health homes for Medicaid members with chronic health conditions. William G MacLean – Vice President Of Insurance Services – West Virginia United Health System and Chief Operating Office Of Health Partners Network Health Partners Network is a non-integrated PHO with 1,200 physician participants and 13 hospital participants with contracts covering eighteen product lines of thirteen third party payers. William’s office handles over 180 managed care contracts and has delegated credentialing authority from most payers. He created and manages the WVUHS stop loss shared risk arrangement and high deductible plans, both of which have resulted in significant savings. He also analyzes and recommends changes to the employee health plans of WVUHS and the faculty practice plans covering over 20,000 lives. William l is the chair of the WVUHS Patient-Centered Medical Home Committee and he is the project leader for WVUH’s initiative in PCMH and Population Health with Geisinger Health Plan. He is a CPA and has degrees form William and Mary ad George Washington University. Christopher Bauer, PhD, HSP, CSP, CFS – Bauer Ethics Seminars Dr. Bauer is a clinical psychologist by training with over twenty-five years of experience as a speaker, trainer, consultant and author on both professional ethics and values-driven business strategies. Between speaking, coaching and consulting, his clients have run the gamut from small and mediumsized organizations to every level of staff and management at Fortune 500 companies. He works primarily with financial and healthcare organizations and is a frequent speaker at HFMA chapters and conferences. Dr. Bauer’s articles on building personal and organizational ethics have appeared in CEO Refresher, CRO Magazine, Financial Executive, Internal Auditor and many other print and online outlets. The latest edition of his book, “Better Ethics NOW: How To Avoid the Ethics Disaster You Never Saw Coming” has been a business ethics top seller on Amazon.com. Dr. Bauer has been awarded the Certified Fraud Specialist designation from the Association of Certified Fraud Specialist and the Certified Speaking Professional designation by the National Speakers Association. Douglas Whinnie – Principal with The Wellington Group, L.L.C. Mr. Whinnie has over 30+ years of healthcare experience with a background in systems analysis prospective payment systems, large database modeling, and analysis and project management. His responsibilities have included development of ICD-10 coding and financial modeling system. Denial reporting systems. APC assessments for multi-hospital systems, academic medical centers and community hospitals. Development of utilization and state regulatory reporting for Medicaid HMO’s. Conducted HMO operations and compliance reviews including work flows, organizational structuring, staffing, Federal compliance audits, benefits design and claims payment system evaluations. Mr. Whinnie has associate degrees in business and marketing and holds a bachelor’s degree in Economics from St. Martin’s University in Lacey, Washington. Alaina N. Crislip – Counsel with Jackson Kelly PLLC Ms. Crislip works in the HealthCare and Finance Practice Group. She represents a variety of health care provider organizations, including hospitals and physicians. Ms. Crislip routinely advises clients in matters involving healthcare regulation and litigation, with an emphasis on compliance advice to providers under HIPAA, Stark, Anti-Kickback and other state and federal laws. In addition, she assists with corporate structuring, provider accreditation and certification, medical staff affairs, certificate of need, professional licensure, health insurance regulation, health information technology and e-health matters. Most recently, Ms. Crislip has been involved in the development of a statewide health information exchange in West Virginia, having advised the exchange on its contracts, policies, procedures, and other operational issues. Ms. Crislip is active in the American Health Lawyers Association and is a frequent author and speaker on multiple emerging health law issues. Frank Briggs – Vice President, Quality and Patient Safety WVU Healthcare Dr. Briggs is currently the Vice President of Quality and Patient Safety at West Virginia University Healthcare. He is a pharmacist by training completing both his Bachelor of Science and Doctor of Pharmacy training at Massachusetts College of Pharmacy in Boston. He completed three years of residency training in pharmacy and administration at The Johns Hopkins Hospital. While in Baltimore, he earned his Master of Public Health and Certificate in Healthcare Finance and Administration from The Johns Hopkins University Bloomberg School of Public Health. Frank joined West Virginia University Healthcare in 2002 as a manager in the pharmacy. He became the first director of the Center for Quality Outcomes in 2006 and in 2012 became Vice President. In his current role, Frank has reporting responsibility for inpatient and ambulatory quality, patient safety, employee safety, patient satisfaction, care management, and performance improvement. Frank has published in the field of quality and currently serves on the CMS Technical Expert Panel for the development of new quality measures. Mike Wilmoth – Advanced Patient Advocacy Mr. Wilmoth is the Chief Operating Officer for Advanced Patient Advocacy. He has worked for more than 15 years helping patients access the resources that cover the cost of care. His background as a litigator, regulatory specialist and lobbyist has helped influence state and federal health policy. His most recent focus has been on developing public/private partnerships that streamline the enrollment process for Medicaid applicants. His areas of expertise include: improving enrollment strategies & results, healthcare reform’s impact on enrollment, Social Security Disability and Exchange preppers. Rod Hardy – Member – Arnett Foster Toothman, PLLC Mr. Hardy is a member of the healthcare consulting practice. He is a CPA with approximately thirty years of healthcare finance experience with a primary focus on Medicare and Medicaid reimbursement issues. He has been providing consulting services to large tertiary teaching hospitals, community-based hospitals (including critical access hospitals) for thirteen years. His prior experience included work as a Medicare auditor as well as serving as a Director of Reimbursement in a tertiary care hospital. Rod is a member of the Healthcare Financial Management Association and the American Institute of Certified Public Accountants. He graduated from Marshall University. Jill Newberry – Senior Manager – Arnett Foster Toothman, PLLC Mrs. Newberry is a CPA and a Certified Professional Coder. Her expertise in the health care regulatory field includes twenty eight years of auditing and reimbursement functions related to healthcare entities as well as establishing and implementing ethics and compliance programs. She has eleven years of experience in large tertiary teaching hospitals including four years with OhioHealth Corporation in Columbus, OH where she was the system Corporate Director for Reimbursement and the Interim Director of Ethics and Compliance and 5 years with CAMC where she developed and implemented the system’s corporate compliance program. She is a member of the American Institute of Certified Public Accountants, Healthcare Compliance Association, Healthcare Financial Management Association, Association of Certified Fraud Examiners and American Academy of Professional Coders. Jill graduated from the University of Charleston. Meeting Information MEETING LOCATION The meeting will be held at Oglebay Resort in Wheeling, WV. A block of rooms has been reserved for the conference. They are available at a special group rate of $119 for a traditional room, $139 for an intermediate room, $159 for a deluxe room, $169 for a premium room, $250 for a suite and $750 for a mansion suite. Rates quoted are subject to the addition of the city hotel tax (currently 6%) and the WV state sales tax (currently 6%) unless otherwise stated. All groups and individuals are subject to the city hotel tax. Individual guests will make their own reservations directly with Oglebay Resort. Guaranteed room reservations at these rates can be made through September 9, 2013 by calling 304-243-4000. After September 9, 2013 the rate will not be guaranteed. A deposit equal to one night’s rate plus taxes will be due with each room reservation request. Check in at Wilson Lodge begins at 3:00 PM and check out is at 11:00 AM. SMOKING The Wheeling Park Commission promotes safe and healthy lifestyles in all areas of the Park System. In accordance with the Clean Indoor Air Regulations of the Wheeling-Ohio County Board of Health, all indoor public spaces at Oglebay and Wheeling Park are smoke free and the staff will enforce the regulation. REGISTRATION INFORMATION Registration for the program includes all meals and breaks during the program. The registration fee is set by the Board of Director for members and non-members. There is also a special fee of $75 for guests who want to attend the social/meal functions of the group. Members of the WV Chapter should register as a member all other attendees should register as a non-member. All attendees must register including speakers and vendors. Online registration can be access through the chapter website www.wvhfma.org. REFUND POLICY Requests for refunds made at least 2 weeks prior to the meeting (September 25, 2013) will be 100% refunded. Requests at least 3 days prior to the meeting (October 6, 2013) will be 80% refunded. Requests made less than 3 days prior to the meeting will not be refunded. GOLF Members who would like to play golf on Wednesday afternoon October 9, 2013 should contact Okey Silman at 304-637-3439 or silman.okey@davishealthsystem.org. The fee to play golf will be $73 per round. The first tee time will be 12:00 pm. For tracking purposes please refer to the booking ID 16003 during any communication regarding this event. No adjustments or rain checks will be given unless the courses are closed for the day due to inclement weather. Golf is scheduled for the Palmer Course but the resort reserves the right to switch golf courses up to 60 days prior to the scheduled event. CONTINUING EDUCATION Up to 12 CPE credits will be provided by the WV Society of CPAs for attendance at this meeting. Sign-up sheets will be provided at each session to validate session attendance. A summary sheet will be provided in the program packet. Attendees need to have the summary sheet signed off by one of the program chairs. Questions regarding registration can be directed to Lisa Simmons 304-598-6247 simmonsl@wvuhealthcare.com or Nikki Carper 304-267-8985 nrcarper@martinandseibert.com. Registration Form October 9 – 11, 2013 – Oglebay Resort Wheeling, WV NAME: _____________________________________________________________________________ E-MAIL: _______________________________________ MEMBER #/CHAPTER: _________________ POSITION/TITLE: ____________________________________________________________________ EMPLOYER: _____________________________________________ CPA ___ CHFP ___ FHFMA ___ ADDRESS: _________________________________________________________________________ CITY: ________________________________________________ STATE: ______ ZIP: ____________ PHONE NUMBER: ___________________________________________________________________ MEMBER: _____ NON-MEMBER:_____ SPEAKER: ______ VENDOR: _____ OFFICER: _________ In order to help us better prepare and minimize costly waste, please indicate which or the following events you will be attending: Wednesday: Reception/Entertainment ______ Thursday: Breakfast ___________ _______ Lunch _______ Friday: Breakfast ______ ___________________________ Do Dinner you Will a guest be joining you? ______________________________________________ ______ Reception/Entertainment have any If dietary yes restrictions? – RATES: HFMA/CPA MEMBER – before September 9th $200 _____ HFMA/CPA NON-MEMBER – before September 9th $250 _____ HFMA/CPA MEMBER – after September 9th $210 _____ HFMA/CPA NON- MEMBER – after September 9th $260 _____ GUEST FEE (includes meals only) $75 _____ WV HFMA SPONSOR 2013-2014 (are you using you free registration yes or no?) $275 _____ NON WV HFMA SPONSOR $350 _____ PAST PRESIDENT $75 _____ OFFICER (President, President Elect, Treasurer, Secretary) $00 _____ SPEAKER $00 _____ Make Checks payable to “West Virginia HFMA Chapter” Mail checks and registration form to: Lisa Simmons 231 Wayland Street Morgantown, WV 26505 NAME: 2013 – 2014 WV HFMA Corporate Sponsors EMERALD SPONSOR Healthcare Financial Services RUBY SPONSOR Arnett Foster Toothman, PLLC Helvey & Associates, Inc. SAPPHIRE SPONSOR Advanced Patient Advocacy, LLC Credit Bureau Systems, Inc. Credit Management Co. Highmark West Virginia The Mash Program ParenteBeard Passport Health Communications, Inc. Quadax, Inc. United Collection Bureau, Inc. The Wellington Group, LLC PEARL SPONSOR CBCS Collection Service Center, Inc. HealthNet Aeromedical Services RevSpring **This list of sponsors is based upon sponsorship renewals or additions received at the time of this publication **