South Texas 2011 Annual Institute Agenda/Topics

May May 26-27, 2011

►Register On-Line Here

►Printable Registration

Up to 12.5 CPE Credits Available
Sponsored by the South Texas Chapter of HFMA Sponsor#009106. See individual topic descriptions for prerequisite requirements.

Conference Location:
Isla Grand Beach Resort
500 Padre Blvd. | South Padre Island, Texas

Thursday, May 26

12:00 - 5:30 pm Conference Registration

1:00 - 3:05 pm (Concurrent Sessions)

HFMA Certification Coaching Course

Course: 1105-01 | CPE Credits: 2.5 | Level: Intermediate | Prerequisites: None

Course Description: This practicum is to aid Certification exam candidates in developing an integrated understanding of key financial issues and be able to form reasonable solutions and practical courses for healthcare finance problems. This purpose is achieved through dialogue and networking with peers.

Learning Objectives: After this session, attendees will be able to familiarize certification exam candidates with exam content and layout as well as offer examples of test scenarios.

Target Audience: Mid-level healthcare finance professionals with 3 to 5 years experience

Brenda Cox, FHFMA, CPC - Practice Manager, Pathology Resource Consultants | Brenda Cox, FHFMA, CPC currently serves as Practice Manager for hospital based pathology groups. She has also served as Chair for the Certification Committee for South Texas HFMA in 2005 to 2008. She also recently participated on the national Chapter Certification Advisory Committee in preparation of the new certification program design. Brenda is currently serves as President of our chapter.

George K. Hill, CHFP, CPA - V.P. Health Plan Contracting/Reimbursements - Community Hospital Corporation | George Hill is responsible for managing relationships with all health plans and managed care organizations including contract negotiations, performance and compliance. Prior to joining CHC, George was the Regional Director of Network Development and Contracting for Blue Cross and Blue Shield of Texas. There he had responsibility for developing networks and managing contractual relationships with all hospital and facility providers in the southwest region of Texas.

1:00 - 3:05 pm (Concurrent Sessions

HFMA's Evidence-Based Revenue Cycle Improvement

Course: 1105-02 | CPE Credits: 2.5 | Level: Intermediate/Advanced | Prerequisites: No prerequisite but a recommended three to five years experience in healthcare

Course Description: Given the twin pressures of reform and a tight economy, hospitals are depending on their revenue cycles to run efficiently and captureall payments the hospital is due. For years, hospitals have been improving their revenue cycle, but today they need even higher
performance--in many cases with fewer resources.The solution is a continuous, evidence-based approach to revenue cycle improvement. Evidence-based improvement requires using industry-standard key performance indicators to measure performance, comparing results over time with peers and high performers, and reviewing and using successful practices of high-performing organizations.

This program is a combination of live discussion and video. The video portion, presented by Suzanne Lestina, HFMA’s Director of Revenue Cycle MAP, includes many examples of how hospitals have used this process and the practices that HFMA research has shown are associated with high performance. Also learn more about HFMA’s MAP initiative for revenue cycle excellence, including HFMA’s MAP Keys (key performance indicators) and the MAP Award.

Learning Objectives: After this presentation, you will be able to (1) Identify how healthcare reform will affect the revenue cycle; (2) Select key performance indicators to measure revenue cycle performance; (3) Use a comparative approach to identify improvement opportunities; (4) Identify successful practices associated with revenue cycle excellence in key areas, including culture, people, processes, and technology.

Target Audience: CFOs, VPs of finance, VPs and directors of revenue cycle, managers of patient financial services, and others who lead and manage revenue cycle performance in health systems, hospitals, and large physician practices

Cynthia A. Gray - Vice President Finance, Valley Baptist Medical Center - Harlingen, Texas | Mrs. Gray has been worked in the Texas healthcare market since 1998 and has been with the Valley Baptist Health System since 2008. Prior to serving in her current Health System role, Mrs. Gray was the Chief Financial Officer at Valley Baptist Medical Center-Harlingen. Valley Baptist Health System is one of the largest health systems in South Texas with more than 800 beds. Valley Baptist is a not for profit, faith based health system. Mrs. Gray is actively involved in community leadership roles and has previously served with the YWCA, United Way, and Junior Achievement. She is currently serving on several committees of the Rio Grande Valley Livestock Show, Mercedes, TX and, with her husband, as a Director of the Algodon Club, Harlingen, TX. Mrs. Gray is currently serving as a board member of the South Texas HFMA Chapter.

3:05 - 3:15 pm Refreshment Break

3:15 - 5:20 pm (concurrent sessions)

HFMA Certification Coaching Course (Part II)

Course: 1105-03 | CPE Credits: 2.5 | Level: Basic | Prerequisites: None.

Course Description: This course is a continuation of Part I held at 1:00-3:05.

Learning Objectives: See Objectives above

Brenda Cox, FHFMA, CPC - Practice Manager, Pathology Resource Consultants

George K. Hill, CHFP, CPA - V.P. Health Plan Contracting/Reimbursements - Community Hospital Corporation

3:15 - 4:55 pm (concurrent sessions)

"CMS - That Money is Mine!"... Value Based Holdback and How to Keep More of It

Course: 1105-04 | CPE Credits: 2.0 | Level: Intermediate| Prerequisites: An understanding of your HCAHPS and Core Measures reporting to CMS

Course Description: In this session, Mr. Swift will discuss new rules from CMS on Value Based Purchasing and how you can avoid a big surprise. We will outline all factors that go into successfully understanding rules and proposed changes in 2012-2015. You will have the opportunity to sign up for a free evaluation of your hospital current VBP score and how many dollars are at risk. This will be at no charge. We will review HCAHPS and Core Measure data and how it relates to this new CMS rule.

Learning Objectives: After this session, attendees will be able to understand and interpret the VBP rules, laws, new changes and how to obtain your hospitals VBP score and how many dollars are at risk for holdback from CMS.

Target Audience: CEO/COO/CFO/VP or Dir Finance/VP of Quality or Service Excellence

Randy Swift - Regional Manager, Central Strategic Consulting & Education, Press Ganey Assoicates, Inc | In this role, Randy Swift is responsible for achieving the overall strategic, growth, profit and client service goals of the division. The Strategic Consulting & Education Services Division delivers innovative solutions and educational programs to healthcare executives, managers, physicians and staff to improve their individual and organizational performance outcomes through effective planning, leadership and leveraging the human and relationship capital of their healthcare organization. Randy is an accomplished leader, with more than 20 years’ experience in Healthcare Management and developing client centric solutions. He has held IT and Consulting Executive positions as Principal for SwiftThink Consulting, Vice President of IT Outsourcing for Perot Systems/A Dell Company, Regional Mgr. for Draeger Medical, A Siemens Company, Commercial Leader for Provider Solutions at GE Healthcare and Automation Consultant for McKesson Automation. In this role, Randy is responsible for leading Press Ganey’s healthcare improvement practice, including research and development, technology innovation, marketing, and client relationship management. Randy lead operations in providing healthcare clients with business solutions based on the company’s extensive research and empirical data.

Martin D. Wright - Manager, Improvement services, Press Ganey Associates, Inc. | As Manager, Improvement Services with Press Ganey Associates, Inc., Martin Wright is responsible for managing all aspects of a Client Improvement Manager Team which includes employee hiring, coaching and development, project coordination, quality improvement efforts, client retention, and departmental planning. In his previous life as a consultant with Press Ganey, Martin partnered with countless hospitals in their patient satisfaction quality improvement efforts to create and manage change. Since joining Press Ganey Associates in 2002 he has been a featured speaker at a variety of healthcare conferences, and has co-authored articles in important healthcare publications all while mentoring and training other consultants for quality improvement. With a background in hospitality and hotel management, Martin focuses on the needs of his team's customers and their unique experiences to create a long-lasting partnership in improvement. Martin is a certified Lean Six Sigma Yellow Belt and graduated from Purdue University in West Lafayette, IN.

4:55 - 5:45 pm (concurrent sessions)

Electronic Health Record Implementation Risk Management

Course: 1105-05 | CPE Credits: 1.0 | Level: Intermediate| Prerequisites: Basic knowledge of electronic health records and health information technology

Course Description: These are challenging but exciting times for the healthcare industry and change is coming at a pace perhaps more rapid than ever before experienced. The influx of EHR implementation efforts has begun. In this session, learn how you can help play a key role in effectively managing your organization’s implementation efforts throughout this journey and how to identify and minimize the impact of the many risks you will undoubtedly face along the way. Whether performing point-in-time assessments, or designing an end-to-end checkpoint assessment approach, there is no wrong time to be involved in these critical efforts.

Learning Objectives: After this session, attendees will be able to (1) understand how to assist with planning, execution, and risk management efforts ranging from software selection and PMO support / project risk management to revenue cycle enhancement; (2) take away ideas for operational assessment approaches to help evaluate organizational readiness, assess control design effectiveness of processes supporting key revenue cycle processes, and assess the utilization of key application-based configurable controls; and (3) leave with ideas for technical assessment approaches to help evaluate IT general control practices supporting the implementation, evaluate security mechanisms, and asses testing strategies.

Target Audience: Revenue cycle specialists, Internal Audit, Compliance, IT, and others with a role in project/risk management for these implementations.

Richard Williams - Managing Director, Protiviti I Richard is a Director in Protiviti’s Dallas office and a key leader in Protiviti’s Healthcare Revenue Risk Solutions practice. Richard has more than 11 years professional experience providing operational, financial, and regulatory consulting and internal audit services to the healthcare industry. Prior to joining Protiviti, Richard was a Project Manager at Arthur Andersen focusing on healthcare internal audit and risk consulting.

Matt Jackson - Associative Director, Protiviti | Matt is an Associate Director in Protiviti’s Dallas office with more than 11 years experience providing professional services to the healthcare industry. He is a key member of Protiviti’s national Healthcare Practice and serves as Protiviti’s National Electronic Health Records Solutions Lead. He is a frequent speaker on, and has published various articles related to, internal audit, compliance, and information technology improvement initiatives.

5:30 - 7:00 pm Welcome Reception

Friday, May 27

7:00 am Registration | Breakfast

7:30 - 8:00 am

HFMA 101: South Texas Chapter

Course Description: This session will provide a brief description of the benefits/value of a HFMA membership. In addition, an overview of how HFMA/Chapter is utilizing today’s social media: LinkedIn, Facebook and Twitter to bring forth additional education portals to today’s healthcare providers to gain immediate access to the latest topics, trends and issues in healthcare.

Learning Objectives: You will leave having gained valuable insight on how to leverage your HFMA membership and gain a clear understanding of how to utilize today’s social media to stay current with breaking news within healthcare.

Target Audience: C-Suite, Revenue Cycle, PFS, Patient Access

Christopher A. Snyder - Regional Account Executive, Avadyne Health | Chris was in the financial services sector working for firms such as Morgan Stanley, Van Kampen Investments, The Hartford and New York Life prior to transitioning into healthcare finance. He is currently the Regional Account Executive for Avadyne Health, a revenue cycle management firm. Chris is active within both the Healthcare Financial Management Association (HFMA) and the American Association for Healthcare Administrative Management (AAHAM). He is a board member and the Communications Chair for the South Texas Chapter of HFMA.

8:00 - 8:50 am

The 2011 Legislative Session: How Bad Will It Be?

Course: 1105-06 | CPE Credits: 1.0 | Level: Intermediate| Prerequisites: Basic understanding of the legislative process.

Course Description: A projected $10 to $15 billion budget shortfall, redistricting, another attempt to pass the Sunset bill for the Texas Department of Insurance, implementation of federal health care reform….when the Texas Legislature convenes in January 2011, they will have no shortage of difficult issues to keep them busy. Hospitals will need to be at the table as federal health reform begins to roll out and state leaders work to balance the budget. Cuts to providers will likely be on the table and there promises to be many implementation issues as we try to expand coverage to the more than 6.1 million uninsured in the state. Other key issues that will be considered include trauma funding, workforce, advance directives and the corporate practice of medicine. Hawkins will share what to expect how you can become informed and use your influence to ensure the interests of your hospital are well-served during the upcoming legislative session.

Learning Objectives: Participants will gain an understanding of the Political environment leading up to the next session, the issues that will likely be discussed next session, and Ways to effectively advocate for your hospital.

Target Audience: Hospital Executives

John Hawkins - Senior V.P., Government Relations, Texas Hospital Association | John Hawkins is responsible for managing all aspects of THA’s state andfederal advocacy efforts before the Legislature and regulatory agencies. Before joining THA, Hawkins served as a senior policy analyst for the Texas Sunset Commission, where he managed the performance reviews of state agencies. Hawkins also served as a legislative aide in the House of Representatives for two legislative sessions and worked as legislative liaison for the Texas Department of Information Resources for three sessions.

8:50 - 10:15 am

ACO's and Healthcare Collaborative - The tide is high, are you holding on?

Course: 1105-07 | CPE Credits: 1.5 | Level: Overview| Prerequisites: Basic knowledge of reimbursement models

Course Description: The Texas Senate passed a bill to establish a Texas Institute of Health care Quality and Efficiency. SB 8 seeks to improve health care quality, accountability and cost containment in Texas by encouraging health care provider collaboration, effective health care delivery models, and coordination of health care services. The bill also gives HHSC the authority to develop performance based demonstration programs, through reimbursement alternatives like bundled or quality based payments.

Learning Objectives: After this session, attendees will be able to understand the development of SB 8 and the requirements of participation in a health care collaborative.

Target Audience: Hospital Administrators, Healthcare Executives, Chief Financial Officers and Revenue Cycle Directors

10:15 - 10:30 am Refreshment Break

10:30 - 11:45 am

Quality Tie-In to Reimbursement - Study Presentation

Course: 1105-08 | CPE Credits: 1.5 | Level: Basic| Prerequisites: None

Course Description: What is quality in the hospital setting? This is one of several questions Dr. Conner will answer in her presentation on quality improvement initiatives in the hospital setting.

Learning Objectives: After this session, the attendee will be able to (1) identify what is quality care; (2) identify the current mandates for public reporting; (3) identify how hospitals have demonstrated quality care and how their demonstration will change in the future; (4) recognize what quality improvement initiatives the Texas Center for Quality & Patient Safety offers THA-member hospitals.

Target Audience: Hospital Administrators, Healthcare Executives, Chief Financial Officers and healthcare financial leaders

Terese "Terri" Conner, Ph.D. - Vice President, Texas Center for Quality & Patient Safety, Texas Hospital Association | Therese ‘Terri’ Conner, PhD, serves as Vice President of the Texas Center for Quality & Patient Safety at the Texas Hospital Association. She has over twenty years of experience in health care research and
quality improvement initiatives in academic, private and public community-based health care delivery organizations, and managed care systems. She holds a Master of Science and a Doctorate of Philosophy from the University of Texas at Austin College of Pharmacy, specializing in Pharmacy and Health Economics.

11:45 am - 12:45 pm Lunch and Annual Meeting | Installation of Officers | Medal of Honor Awards

12:45 - 2:00 pm

The High Tech Act (Meaningful Use)

Course: 1105-09 | CPE Credits: 1.5 | Level: Basic| Prerequisites: None

Course Description: This session will provide an executive perspective of the Hi-tech Act and the challenges and success with preparing for the Meaningful Use criteria. It will look at this from the Hospital and Physician perspective.

Learning Objectives: After this session, attendees will be able to (1) understand Meaningful use criteria and timelines; (2) obtain knowledge from what other facilities are doing to prepare; (3) understand the reimbursement mechanisms for Medicare and Medicaid.

Target Audience: CFOs, CIO’s, Finance Directors, Revenue Cycle Managers and other healthcare financial leaders

Wesley Fountain - CFO, St. David's South Austin Medical Center | Mr. Fountain has over 20 years of health care finance experience in multiple HCA facilities and has served as Chief Financial Officer for the past fifteen years. Presently, Wes oversees the financial operations of St. David’s South Austin Medical Center, a 252-bed acute care hospital and one of the busiest emergency departments in the city. Under Wes’s financial leadership, the facility is currently undergoing a $72 million expansion. Additionally, Wes has been integral in several strategic initiatives, such as establishing the area’s first free standing emergency department, and expanding access through the establishment of two hospital-based urgent care centers. Wes serves on the Board of the South Texas Chapter of HFMA, participates on the Membership Committee, and was recently appointed to the Region 9 LINK Committee. His community service roles include serving on the Board of Directors of Anchorage Children’s Home when he worked in Panama City, FL. Since coming to Texas in 2006, Wes and his wife, Melinda, have become involved in the State’s foster care system through Arrow Child and Family Ministries.

Rosie Mendiola - Assistant Administrator IS/HIM, Privacy Officer, South Texas Health System | Rosie Mendiola currently serves as Assistant Administrator over the Information Services and Health Information Management departments for South Texas Health System, a subsidiary of UHS. She also serves as the role of Privacy Officer for the system. Rosie has been with UHS for over 20 years serving in different capacities throughout her years of service. Her role has included providing leadership role in the opening of a new facility in Laredo and the structuring of the technology department and service excellence program and restructuring operations and services as needed.

Fausto Meza, M.D. M.P.A. - Chief Medical Information Officer, Doctors Hospital at Reniassance | Fausto S. Meza, M.D. M.P.A. is the Chief Medical Officer and Chief Medical Information Officer at Doctors Hospital at Renaissance in Edinburg, Texas. He holds a clinical appointment as clinical assistant professor at the UTHSCSA – Regional Academic Health Science Center and with adjunct appointments as Assistant Professor of Medicine at Weill Medical College of Cornell University and adjunct assistant professor in the department of health policy and management at Texas A&M’s School of Rural Public Health. At Cornell’s New York Presbyterian Hospital, he completed fellowship training in Geriatric medicine and residency in internal medicine. Dr. Meza earned a Masters of Public Policy and Administration (M.P.A.) at Columbia University’s School of International & Public Affairs in 2007. As Chief Medical Information Officer at Doctors Hospital at Renaissance, he worked as a member of the physician team that successfully implemented a new electronic medical record system within a year. Doctors Hospital at Renaissance is now moving to leverage the system to improve the quality and efficiency of care while meeting the federal requirements of meaningful use.

Becky Englehardt, Moderator - | Becky is a Health Care Consultant in the Nashville, TN office of HORNE. She has operational knowledge of regulatory and compliance requirements for ambulatory surgery centers, acute care, and physician practices, as well as government and private payer reimbursement requirements including Medicare Part A, Part B, and Part D. As a consultant to a broad range of health care organizations, she serves as a valuable resource for quality monitoring, process improvements, contract negotiations, the development of new programs including the establishment and monitoring of compliance programs. She has over 32 years of diverse operational experience within the health care industry having held various senior management roles within for-profit and not-for-profit hospital systems, a nursing home, a home health agency, and a large physician practice.

2:00 - 2:15 pm Refreshment Break

2:15 - 3:05 pm

HIPAA 5010: Preparing for the Future

Course: 1105-10 | CPE Credits: 1.0 | Level: Basic| Prerequisites: None

Course Description: This session provides an overview of the changes required for moving to version 5010 for the HIPAA-mandated transactions, and impact that may occur to provider systems and processes.

Learning Objectives: After this session, attendees will be able to gain an understanding of the changes required for the 5010 updates, both to software and systems processing the transactions, but also to overall business office processes that need to change based upon the new requirements.

Target Audience: business office managers, directors of patient accounts

Pam Grozse - VP Healthcare Operations Payer Services, PNC | Pam Grosze is the Vice President of Payer Services for PNC Bank’s Healthcare Division, which provides financial and revenue cycle management solutions for hospitals, healthcare providers, and other healthcare organizations.Pam has spent 20 years in healthcare environments, implementing and supporting healthcare EDI transactions for leading companies, including PNC Bank and RelayHealth. She has worked with numerous healthcare EDI transaction types, including claims, remittances, claim status, eligibility, and acknowledgements, with particular expertise with X12 837 Claims and X12 835 ERAs. She has extensive knowledge and expertise in clearinghouse operations, revenue cycle management, remittance posting products, and payer processing. Pam has been directly involved in industry committees and organizations, including X12, WEDI, CAQH CORE, and HFMA. In addition to attendance at these regular meetings, she has presented on multiple occasions on a variety of topics, including EFT, HIPAA, NPI, 5010, and ICD-10, and currently co-chairs WEDI’s subworkgroup on EFT.

3:05 - 3:55 pm

Medicaid Update

Course: 1105-11 | CPE Credits: 1.0 | Level: Overview| Prerequisites: Basic knowledge of Medicare Reimbursement

Course Description: To provide the latest information on changes being proposed in the Texas Legislature related to Medicaid. Included will be discussion on the SDA rate. Managed care expansion, DSH and UPL.

Learning Objectives: After this session, attendees will be able to understand and estimate impacts on Medicaid reimbursement from proposed State budget cuts to Medicaid programs.

Target Audience: CFO, Controller, Reimbursement and Budget staff

Peggy Deming -Executive Vice President and Chief Financial Officer, University Health System| Ms. Deming has over thirty years of health care experience in health care finance, Federal and State reimbursement, budgeting, cost accounting, decision support, managed care, business plan development and physician services. She has worked in public accounting with two of the National accounting firms and worked for the Christus Healthcare System prior to joining University Health System. In her current position as Executive Vice President/Chief Financial Officer for the University Health System, she is directly responsible for the fiscal affairs of the Health System and the reporting thereof to the Health System’s governing board and County Commissioners. In addition, Ms. Deming serves as the Chair on the Hospital Payment Advisory Committee, member of the Medical Care Advisory Committee and a Hospital Reimbursement Advisory Workgroup for the Texas Health and Human Services Commission, and is the past Chair of the Board of Examiners of the Healthcare Financial Management Association. She currently serves on the Texas Hospital Association Policy Committees for Hospital Reimbursement Issues and Hospital Billing and Charges.