Using Data Analytics to Reduce Potentially Avoidable Emergency Department Utilization

Oct 16, 2018 1:00pm ‐ Oct 16, 2018 2:30pm

Identification: ITuB2

Esperanza Health Centers is one of nine Chicago-area FQHCs and three health systems that owns the Medical Home Network (MHN), an accountable care organization with approximately 120,000 Medicaid members. MHN has a shared risk contractual arrangement for managing total cost of care. The health plan delegates complete care management responsibility to MHN which is performed by FQHC and other practice employed staff at the care team level. MHN care managers perform complete health risk assessments, create individualized care plans, and follow up on those care plans for moderate- and high-risk members, a subset of who are individuals who have made three or more emergency department (ED) visits in the previous six months. MHN receives admission, discharge, and transfer (ADT) alerts from 25 area hospitals so care managers are alerted as soon as their members register in the ED. MHN’s IT department combines those ADT alerts with complete medical and pharmacy claims data to create reports that can be used to provide insight and improve patient outcomes.

New Accounting Standards: Revenue Recognition and the Not-For-Profit Reporting Standards

Oct 16, 2018 1:00pm ‐ Oct 16, 2018 2:30pm

Identification: ITuA2

Two new accounting standards will begin affecting CHCs beginning with December 31, 2018 fiscal year-end. The first is a not-for-profit accounting standard for financial reporting which represents the largest change to not-for-profit financial reporting in 20 years. FASB’s goal is to improve the usefulness of information provided to not-for-profit financial statement users by eliminating diversity in practice, enhancing financial performance comparability, and increasing transparency around financial resource availability. BKD will examine the significant changes, tips to begin preparing, and example changes to the financial statements and footnotes. The second standard is a revenue recognition standard affecting all industries including CHCs. BKD will share the basic concepts of this new standard and provide an overview of how they will affect your CHC. Once you understand the basic elements of these new standards you will be better prepared to establish a plan to implement them.

Creating a Comprehensive Denial Management Program

Oct 16, 2018 1:00pm ‐ Oct 16, 2018 2:00pm

Identification: ITuD2

Claims denials are an integral part of the revenue cycle function, as insurance companies are financially motivated to scrutinize and deny our claims as often as possible. This presentation will demonstrate how to create a comprehensive denial management program that strengthens claims and limits the occurrence of denials. Participants will identify and discuss the elements of a comprehensive denial management program including tracking, categorizing, educating, and resolving. Participants will also learn techniques to educate practitioners and staff on these issues in order to gain buy-in at all levels across the practice.

Customer Service in Healthcare – The Impact of Work / Life Balance - SPECIAL EXHIBITOR SESSION SPONSORED BY CENTENE

Oct 16, 2018 1:00pm ‐ Oct 16, 2018 2:30pm

Identification: ITuE2

This presentation will discuss the importance of customer service in the healthcare setting, and examine some of the obstacles to delivering excellent customer service on a consistent basis…especially in the FQHC setting. We will also discuss the concept of work-life balance and its implications for the health center staff’s ability to deliver excellent customer service. This will be an interactive, entertaining and inspirational presentation that will motivate all health center staff to deliver better customer service and be aware of the concept of work-life balance.

Refreshment Break in EXPO Hall

Oct 16, 2018 2:30pm ‐ Oct 16, 2018 3:00pm

Identification: BRK3


Interoperability: The GPS to Better Patient Care

Oct 16, 2018 3:00pm ‐ Oct 16, 2018 4:30pm

Identification: ITuA3

Health care interoperability has been a hot topic for providers, policymakers, and patients for years. The public and private sectors are working throughout the industry to facilitate seamless health data exchange between a multitude of health IT systems to coordinate care across various health settings nationwide. Efforts around health care interoperability initiatives, health data exchange frameworks, and health IT standards have improved efforts; but there are several challenges still preventing stakeholders from achieving true interoperability for optimal care delivery and improved patient health outcomes. A panel of clinicians, HIE and EHR vendors, politicians, HIT staff, and patients will discuss the current and future effects of interoperability on patient care.

Maximizing Opportunities and Minimizing Challenges when Integrating a Newly Acquired Practice into Your Health Center

Oct 16, 2018 3:00pm ‐ Oct 16, 2018 4:30pm

Identification: ITuB3

The acquisition of a new practice is filled with opportunities and fraught with challenges. Extensive planning is required to integrate a new practice into your health center as seamlessly as possible. This includes identifying funding sources, facilities planning, human resource integration, and financial forecasting. In addition, operational planning to integrate EHRs, clinical staff, policies and procedures, and the model of care is required for a smooth crossover. A level of uniformity across sites, while identifying best practices of the new facility that can be integrated throughout the rest of your organization must be considered. An interdisciplinary leadership team that is able to communicate and act on clinical, operational, and financial issues as they arise is needed. Data needs to be used strategically to quickly pivot to ensure success and meet inevitable unanticipated challenges. In this session, presenters will share their recent experience integrating a large practice into their health center. They will review the overall project plan, strategies, and examples of key tools used to successfully execute site transition. This will include a discussion of clinical, operations, IT, HR, and finance components, and the dynamic interaction that impacted the overall trajectory of the implementation, as well as the roadblocks encountered.

Financial Management Reviews: Policy Considerations

Oct 16, 2018 3:00pm ‐ Oct 16, 2018 4:30pm

Identification: ITuC3

Session presenters will review the Financial Capacity Review document, currently being utilized by the Division of Financial Integrity (DFI) of HRSA, to analyze financial policies and procedures in place at health centers. This document contains 17 management control areas that HRSA believes will ensure grant recipients have policies in place that are compliant with the Uniform Grants Guidance and the Department of Health and Human Services (HHS) Grants Policy Statement. Special consideration will be made for findings most commonly disclosed in single audit reports, HHS Office of Inspector General reports, HRSA Operational Site Visit reports, and DFI grant reviews which are designed to ensure health centers have safeguards in place for the appropriate financial stewardship of federal funds.

The Journey to Improved Patient Access

Oct 16, 2018 3:00pm ‐ Oct 16, 2018 4:30pm

Identification: ITuD3

A patient’s first point of connection to your organization is often the call center. Erie Family Health Centers will share how it recently redesigned its call center, turning things around after a period of declining morale and performance. This session will outline an operational roadmap for increasing patient and staff satisfaction and incorporating patient access data into the organizational culture. Erie will provide examples of changes to staff training, retention efforts, staffing models, performance review procedures, and empanelment procedures that resulted in a highly functioning, proactive, sustainable Patient Access Center. Participants will leave the session better able to recognize insufficiencies that may contribute to patient dissatisfaction, outline strategies for improvement, and understand how to use data to support decision-making in patient access operations.

Enabling Services: A Technologically Integrated Approach

Oct 16, 2018 3:00pm ‐ Oct 16, 2018 4:30pm

Identification: ITuE3

Valley-Wide Health Systems, Inc. is a rural, frontier Federally Qualified Health Center composed of 12 primary care sites, 8 dental sites, 3 physical therapy sites, and 2 pharmacy sites. Over the last eight years, Valley-Wide has worked to develop and modernize its enabling services department. Starting with multiple spreadsheets, filing cabinets, and an access database, Valley-Wide began a journey to bring enabling services’ records into the EHR. With the state accountable care organization (ACO) creation, Valley-Wide was poised at a unique point to develop a comprehensive enabling services template set within their EHR. Starting with the cannibalization of their EHR's behavioral health system, the template set quickly morphed into a completely custom-built system. Today, with Phase Two of the state's ACO program starting, as well as the addition of financial eligibility, referrals, pre-auth staff and dental navigation; Valley-Wide's enabling services system must meet an ever-changing set of needs and an ever-expanding list of deliverables-- from ACO to UDS. As an owner/partner of the regional ACO delegate, Valley-Wide is challenged to set a new standard of enabling services in the region. Moving into the future, Valley-Wide's system is prepared to facilitate and lead an integrated enabling services delivery model.