Volume 67 | Issue 1 Summer 2014
heartbeat H E A LT H C A R E F I N A N C I A L M A N A G E M E N T A S S O C I AT I O N S E R V I N G T H E K A N S A S C I T Y C H A P T E R Programming .............................2 Webinars ....................................2 Membership Directory ................2 President’s Corner ......................3 Summer Institute........................4
Officers and Directors.................8 Corporate Sponsors ....................8 MMIC Spotlight...........................8 Annual Awards & Officers.....9&10
Region 8...................................11 BKD Spotlight ...........................12 Virtual Conference ....................12 MHA Update .............................13
LTC 2014..................................14 New Members ..........................15 Committee Chairs/Co-Chairs.....16 ANI 2014 ..................................17 HOA Mini LTC............................18 Golf Registration.......................19
Changes in Employer-Sponsored Insurance Could Dramatically Alter Hospital Business Fundamentals Kenneth Kaufman, Chair, and Mark E. Grube, Managing Director Transformation in employer-sponsored health plans has the potential to drive more of what happens to the business fundamentals of hospitals and health systems going forward than other forces currently at work in the healthcare industry, including the Affordable Care Act.
Kenneth Kaufman
Mark E. Grube
Healthcare executive teams and boards must be paying close attention to three critical changes in the private employer insurance market: - The movement from defined-benefit health plans with no or low deductibles to defined-contribution health plans with high deductibles - The transfer of employees from employer-sponsored insurance to plans offered through private exchanges - The emergence of narrow-network insurance products
The financial performance of the nation’s hospitals and health systems will be challenged by these changes. The major impact may be lower revenue from the commercially insured population, which historically has been the best-reimbursing portion of a hospital’s payment mix. Commercial revenue has enabled many organizations to maintain positive margins over the past decades. Article continues on page 5
mark your calendars National Webinars
Heart of America Programming
Learn about timely healthcare finance topics and earn CPEs. Most live webinars are free for HFMA members and $99 for non-members, unless otherwise noted.
The topics listed are subject to change and will be more clearly defined as the program year progresses:
July 30
Using Analytics to Work Smarter in a Healthcare Setting
July 31
Building Unique Relationships to Boost the Bottom Line
August 12
Using New Business Models to Reduce Hip and Knee Implant Expenses
August 14 August 21
October 16
Linking Payment with Quality: Reducing Rehospitalizations Understanding How Predictive Tools Help Expedite Value Analysis Controlling Costly Physician Preference Items
SEPTEMBER 18, 2014
Chapter Favorite! Regulatory Update from MHA and KHA and Political Landscape for Health Policy Lunch 9:00 am - 4:00 pm $75 | Location: Ritz Charles
NOVEMBER 20, 2014
Chapter Favorite! CEO/CFO Panel Lunch 12:00 - 4:30 pm $65 | Location: Ritz Charles
JANUARY 21, 2015
New Program! Managed Care Forum: Payors and Providers Discuss Managed Care Landscape Lunch 12:00 - 4:30 pm $45 | Location: North Kansas City Hospital
FEBRUARY 19, 2015
Back by popular demand! Healthcare 101 Lunch 8:30 am – 4:30 pm $65 | Location: Shawnee Mission Medical Center
HOA Membership Directory has been placed in the Membership section of the new and improved website at www.hoahfma.org
MARCH 26, 2015
First Annual! Women in Healthcare Luncheon Location: TBD $25
APRIL 23, 2015
Leadership/Organizational Skills & Awards Banquet Lunch 12:00 – 4:30 pm $65 | Location: Ritz Charles
View all upcoming on-demand webinars HFMA provides webinars available one calendar year following the live webinar date and year. Most on-demand webinars are free for HFMA members and $99 for non-members, unless otherwise noted. Go to http://www.hfma.org/Templates/OnDemandWebinars.aspx?id=6730 to view all available on-demand webinars with topics that include: - Accounting & Financial Reporting - Finance & Business Strategy - Payment, Reimbursement, & Managed Care - Revenue Cycle - Technology - And others – page 2 –
Jim Mozena, President
Dear Heart of America HFMA Members After four years of preparation, I am excited to now be serving as chapter President. My year started out great by attending HFMA’s National Leadership Training Conference in April and the Annual National Institute in June. LTC provided a great opportunity for our officers to work together in planning for this year and networking with chapters from across the country to understand best practices. ANI provided great insight to the future of health care and gave us ideas for future programs for the chapter.
Many thanks to our officers for their commitment to serve this year: President Elect Paul Knudtson Vice President Michelle Narayan Secretary Todd Kenney Treasurer Matt Robertson Also, many thanks to the board of directors and committee members for taking on leadership roles in the chapter.
Our HFMA 2014-2015 National Chair, Kari Cornicelli announced this year’s HFMA theme, “Leading the Change” – encouraging healthcare finance professionals at all levels to take a lead role in making a difference in their organizations and keeping hospitals and health systems strong. With its numerous educational programs and networking opportunities to help keep current on healthcare trends and legislative changes impacting your operations, HFMA can be a part of keeping your organization strong.
Lastly, but importantly, I would like to thank the sponsors of our chapter; their support contributes to our education and networking events that are the basis of the Heart of America Chapter.
The Heart of America Chapter won awards for membership and education at ANI. Without you, the members, these awards would not have been possible. I encourage all members to get involved in the chapter, either by attending educational or networking events, serving on a committee, and/or sponsoring a new member.
Thanks,
I look forward to working with all of you over the next year as we navigate through changes within the healthcare industry. If you have any questions about the chapter or if you have recommendations for improvements or programming, please be sure to contact me.
Jim Mozena, President
The Heart of America Chapter is making changes in the upcoming year to facilitate better communication and options for educational events. We have kicked off this year with a redesigned website — please check it out at www.hoahfma.org. We encourage your recommendations for further improvements to the site. We will also be changing the way we communicate through email and program registration. We will be providing more information in the near future. I am excited to be working with the officers, the board of directors and committee members over the next year to continue to provide our membership with valuable resources and tools and also to encourage all to take that leading role in keeping their healthcare organizations strong.
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Changes in Employer-Sponsored Insurance, continued...
Statistical evidence of the three private insurance market changes is noteworthy, indicating that fundamental movement is occurring at a rapid pace and much quicker than in public Medicare and Medicaid programs. A close look at the data for each trend follows.
From Defined-Benefit to Defined-Contribution Plans America’s corporations are moving their employee health plans from defined-benefit to defined-contribution structures. This mirrors what companies did with their pension plans after the Internal Revenue Service published rules in November 1981 on how 401K plans would work. Most businesses started offering employees only 401K plans, to which the companies contribute a fixed dollar amount (defined contribution) toward each employee’s retirement plan rather than a defined benefit on retirement. Once 401K rules were in place, defined-benefit plans “flat-lined.” Within 11 years, 401Ks were the most prevalent retirement savings vehicle in the U.S. (see Figure 1). The defined-benefit plans that still remain are legacy plans. In the healthcare arena, corporate America is likely to take far fewer than 11 years to similarly de-risk itself, thereby limiting exposure to unpredictable and rising healthcare costs. The employer-sponsored insurance (ESI) market is huge. One hundred and fifty-nine million Americans were enrolled in ESI in the most recently reported year.1 Fifty-seven percent of small firms with three to 199 workers and 99 percent of firms with 200 or more workers offer health benefits.2 Sidebar 1 (included in the full-length article) provides more details. Figure 1. Number of Participants in Pension Plans, By Type of Plan, 1975-2011 (in millions)
Up to this point, commercial health insurance has been dominated by employer-sponsored, defined-benefit health plans. Under such plans, employers identify the benefits to be offered to their employees and the expected costs employees would cover (proportion of premium, deductibles, and copayments). Insurance rates are negotiated between employers and insurers, with insurers bearing the risk for unknown levels of healthcare utilization and costs. Employers bear the risk of significantly higher future premiums if costs are out of line. Employees also bear some such risk based on the extent to which employers pass along the higher premiums. Self-funded employers are fully exposed to the risk of higher-than-expected utilization and cost. Increasingly unwilling to shoulder risk for rising costs, many employers are now shifting their employees into defined-contribution plans by using a private exchange benefits administration model. Under such plans, an employer contributes a fixed amount toward each employee’s health insurance. Each employee determines how and where to spend the money for their healthcare coverage. Individuals generally select their insurance plan and its provider network from an array of options offered through the exchange. Recent product innovation in the insurance market includes consumer-directed health plans (CDHPs) and high-deductible health plans (HDHPs) paired with a tax-advantaged savings option in the form of a health savings account (HSA). Such defined-contribution health plans will dominate the U.S. employer private insurance market in the near future. The proportion of workers enrolled in HDHPs with savings options has increased from 4 percent in 2006 to 20 percent in 2013 (Figure 2).3 More than 26 million individuals with private insurance—representing about 15 percent of that market—were either in a CDHP or an HDHP with an HSA in 2013.4 And recent surveys indicate that HDHPs are poised to “go mainstream” in 2014. Forty-four percent of employers are considering offering an HDHP as employees’ only option in 2014, up from 17 percent in 2013.5 Figure 2. Percent of Workers Enrolled in High-Deductible Health Plan with Savings Option
Note: The black dots indicate when the IRS first published rules on 401K plans in 1981, and when the number of such plans surpassed defined-benefit plans 11 years later; the 2005 shifts are due to changes in the definitions of total participant and active participant. Source: U.S. Dept. of Labor, Employee Benefits Security Administration: Private Pension Plan Bulletin Historical Tables and Graphs, June 2013.
Source: Kaiser Family Foundation and Health Research & Educational Trust: Employer Health Benefits—2013 Annual Survey. Aug. 20, 2013.
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Article continues on next page
Changes in Employer-Sponsored Insurance, continued...
These numbers are significant because consumers behave dramatically differently under benefit structures with high deductibles and copayments than they do under traditional plans, where they have “first-dollar” or “low-dollar” coverage. According to a recent study,6 adults in a CDHP or an HDHP were much more likely than those in a traditional plan to exhibit cost-conscious behaviors. The new cost-sharing structures incentivize employees to be active consumers, making purchasing decisions for healthcare like they would for other goods and services.
Transfer of Employees from ESI to the Private Exchanges The transfer of employees from ESI into the public exchanges is garnering recent attention, but the movement of employees into private exchanges is likely to have greater impact in many areas of the country. As described in a recent article,7 private exchanges involve arrangements between employers and private exchange sponsors, which may be insurance companies or benefits management/consulting companies. In addition to decision-enrollment support and defined-contribution administration, private exchanges typically offer employees a variety of insurance plans and a broader scope of services than offered in the public exchanges. Private exchanges also will offer high-deductible plans, in addition to Health Maintenance Organization and Preferred Provider Organization plans. HDHPs are expected to capture the lion’s share of near-term enrollment, with migration to narrow-network plans (as described next) occurring over time as the provider networks mature. Enrollment in private exchanges is expected to grow rapidly to a projected 40 million individuals by 2018 (enrollment in public exchanges is expected to be about 31 million).8 Sidebar 2 (included in the full-length article) describes drivers that could increase the shift from ESI plans to private exchange plans. The effect of less generous employee health benefits and providers’ exclusion from networks (more on this next) will be less generous and less frequent reimbursement for many doctors and hospitals. Hospital leaders should be taking steps to gain knowledge about changes occurring in their specific service areas. Markets are transforming at different speeds. Private exchanges likely will be attractive to employers of all sizes. Commercial exchange companies are forging partnerships with national brokers to offer exchange plans to smalland mid-size employers.9 Surveys indicate that nearly 30 percent of employers anticipate moving to private exchanges during the next three to five years.10 The presence of employers already involved in or interested in private exchanges can quickly alter payer mix for providers in communities nationwide.
The Emergence of Narrow-Network Insurance Products Insurance products offered through both public and private exchanges typically limit the number of providers in the network, narrowing patients’ choice of hospitals and physicians to those that offer what the plan administrators define to be quality services at lower costs. “Carriers are adapting to affordability imperatives by actively excluding some higher cost hospitals while collaborating more closely with those hospitals willing to accept lower reimbursement rates,” notes McKinsey & Company in its recent study of a sample of networks.11 The study indicated that 70 percent of hospital networks offered predominantly through public exchange products are “narrow” or “ultra-narrow” (Figure 3). By definition, broad networks exclude less than 30 percent of the largest hospitals in the area, narrow networks exclude 30 to 69 percent, and ultra-narrow networks exclude 70 percent or more.12 The Department of Health and Human Services requires qualified health plans sold through the public exchanges (“marketplaces”) to maintain networks that are sufficient in number and types of providers to assure that all services will be accessible to enrollees without unreasonable delay. The Centers for Medicare & Medicaid Services cites hospital systems, oncology providers, mental health and substance use disorder services, and primary care providers as areas of particular focus due to past network adequacy concerns.13 But now and over the next five or 10 years, organizations may find themselves with or without the option of inclusion in the exchangebased networks that cover patients in their region. Hospitals that can compete along the required quality/cost dimensions may sign on to narrow networks, accepting sometimes significant revenue discounts with the hope of increased volume. Hospitals not willing to take steep discounts—perhaps due to the precedent the discount would set (and the challenge of ever recovering from that discount)—may opt out of network participation. Hospitals not able to meet quality and cost requirements, or hospitals not moving quickly enough to beat an aggressive competitor to the network, may find themselves excluded from network participation. Figure 3. Distribution of Networks by Network Breadth
Source: McKinsey Center for U.S. Health System Reform: “Hospital Networks: Configurations on the Exchanges and Their Impact on Premiums.” Dec. 14, 2013.
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Article continues on next page
Changes in Employer-Sponsored Insurance, continued...
With increasing numbers of patients covered by exchange plans and their narrow-network offerings in coming years, network exclusion could have a significant negative impact on hospital performance. Organizations should try to maintain market share through participation in the “right” networks, with the “right” discounts, and at the “right” time. Hospitals can use a framework to evaluate narrownetwork contract opportunities going forward. Both direct financial considerations and strategic contract effects (often indirect) should be considered. Sidebar 3 (included in the full-length article) outlines key considerations covered in a financial evaluation. This evaluation enables a hospital to identify a range of possible effects of network participation on inpatient admissions, outpatient visits, and total contribution margin by scenario. The strategic evaluation considers such issues as opportunities that may result by not participating in year one of a plan offering. This might include the ability to negotiate greater exclusivity and/or reimbursement in year two and beyond. Factors such as the “spillover effect” of narrow network rates onto other commercial contracts and “lockout risk” (the risk that a provider will be excluded from a network for an extended period of time or prevented from joining future networks) also should be considered in the strategic evaluation.
References 1 Sonier, J., Fried, B., Au-Yeung, C., and Auringer, B.: State Level Trends in Employer-Sponsored Health Insurance. Princeton, N.J.: Robert Wood Johnson Foundation, April 2013. 2
Kaiser Family Foundation and Health Research & Educational Trust: Employer Health Benefits—2013 Annual Survey. Aug. 20, 2013.
3
Kaiser Family Foundation and Health Research & Educational Trust (Aug. 20, 2013).
4
Fronstin, P.: Findings from the 2013 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey. EBRI Issue Brief No. 393, Dec. 2013.
5
PwC Health Research Institute: Medical Cost Trend: Behind the Numbers 2014. June 2013.
6
Fronstin, P. (Dec. 2013).
7
Cohen, A.S., Kim, C., O’Riordan, J., and Pizzo, J.J.: “Health Insurance Exchanges: What’s Your Strategy?” Kaufman Hall Report, Fall 2013.
8
Accenture: “Are You Ready? Private Health Insurance Exchanges Are Looming.” May 17, 2013.
Concluding Comments The three changes to the private employer insurance market described here likely will affect all hospitals and health systems. The rapid growth of defined-contribution plans with high deductibles is creating a consumer population that will approach health and healthcare decisions differently than in the past. Rapid enrollment of employees in private exchanges and narrow-network insurance products could transform a hospital’s or health system’s role in its community. Business fundamentals, including patient population, service lines, payer mix, revenue, margins, and other metrics, could change for the better or worse, based on how the organization responds. It is critical for healthcare executives to be studying these trends, and proactively assessing their impact on the organization.
Deloitte Center for Health Solutions: “2012 Survey of U.S. Employers: Opinions About the U.S. Health Care System and Plans for Employee Health Benefits.” July 2012; Aon Hewitt: “Aon Hewitt Survey Reveals Growing Shift in How Employers Intend to Offer Health Care Benefits in the Future.” Press Release, Feb. 28, 2013.
The variables are many, but rigorous evaluation of trends and consideration of appropriate responses are essential at this time.
12
9
Shutan, B.: “BAN Partners with Liazon, Traction May Take Time.” Health Insurance Exchange News, Sept. 17, 2013.
10
11
McKinsey Center for U.S. Health System Reform: “Hospital Networks: Configurations on the Exchanges and Their Impact on Premiums.” Dec. 14, 2013. The study sample had a bias toward big cities, in which it typically is easier to form hyper-narrow networks.
Your comments are welcome. Kenneth Kaufman (
[email protected]) and Mark Grube (
[email protected]) can be reached at 847.441.8780.
13
Centers for Medicare & Medicaid Services’ Center for Consumer Information and Insurance Oversight: “Draft 2015 Letter to Issuers in the Federally-facilitated Marketplaces.” Feb. 4, 2014.
Excerpted from Changes in Employer-Sponsored Insurance Could Dramatically Alter Hospital Business Fundamentals https://www.kaufmanhall.com/SitePages/DocumentDetails.aspx?did=458049e5-58db-490f-835f-ea90d776bb15. Used with permission.
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Officers and Directors 2014 HEART OF AMERICA CHAPTER OFFICERS
BOARD OF DIRECTORS 2013-2015
President President-Elect Vice President Secretary Founders/DCMS Treasurer
Mea Austin Heath Leuck Cathy Kindle Karrie Pence Mary Knollmeyer
Jim Mozena Paul Knudtson Michelle Narayan Todd Kenney Todd Kenney Matt Robertson
2014 PUBLICATION COMMITTEE
2014-2016 Jessica Baird Damara Harper Esteban Ponce
Jessica Baird, Co Chair Cathy Kindle, Co Chair
816-407-2041 816-691-2010
Deadline for submission of articles for the next newsletter is September 18, 2014.
Keely Roach
2014 Corporate Sponsorship PLATINUM
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BKD, LLP Bank of America Merrill Lynch Haase & Long Human Arc McGladrey LLP Mercer MMIC
Bank of Kansas City
Sincere appreciation is extended to our corporate sponsors for 2014. Your support of our Chapter significantly improves our ability to offer quality programs to our members. Please consider joining our fantastic group of sponsoring organizations.
SILVER Cardon Outreach Country Club Bank HRS Erase
If you are a service provider, please contact: Mea Austin 785-842-0726 Mary Knollmeyer 913-791-3500 x 4018
Summer Sponsor Spotlight: MMIC
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HOA Annual Awards & Officers
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The annual awards and officers installation was held on April 24, 2014 at the Ritz Charles in Overland Park, Kansas. Award recipients are as follows: - Follmer Gold Merit Award: Jim Mozena - Outstanding Contribution Award, Education: John Travis - Outstanding Contribution Award, Networking: Todd Kenney - Outstanding Contribution Award, Newsletter: Cathy Kindle and Jessica Baird - President’s Award: Mea Austin - Reeves Silver Merit Award: Mea Austin, John Maschger and Andrea Lindsay The afternoon also included special presentations from Bill Beerman, Executive Vice President of Cordon Outreach, and nationally known speaker Jerry Traylor.
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Andrea Lindsay, HOA Chapter President 2013-14 Dan Williams with Jim Mozena, Incoming HOA Chapter President, and Paul Knudtson, President-Elect, presided over the installation ceremony. Jim Mozena presents the President’s Plaque to outgoing President, Andrea Lindsay. 2014-15 HOA Leadership: Jim Mozena, President; Paul Knudtson, President-Elect; Michelle Narayan, Vice President; Todd Kenney, Secretary; Matt Robertson, Treasurer; Board Members – Mary Knollmeyer, Cathy Kindle, Heath Leuck, Karrie Pence, Mea Austin, Jessica Baird, Keeley Roach, and Esteban Ponce Andrea Lindsay, recipient of the Reeves Silver Merit Award and Mea Austin, recipient of the President’s Award. – page 9 –
Awards & Officers, cont.
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Andrea Lindsay with Jessica Baird and Cathy Kindle, recipients of the Outstanding Contribution Award for the Newsletter. Andrea Lindsay with Todd Kenny, recipient of the Outstanding Contribution Award for Networking. Speaker Bill Beerman presents “What is the Color Code?”. Andrea Lindsay with John Travis, recipient of the Outstanding Contribution Award for Education. Board Members Karrie Pence and Mary Knollmeyer take an opportunity to network with Natalie Lee. Speaker Jerry Traylor presents “Improve the Business of CARING”.
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Tracy Packingham, Region 8 Executive
HFMA Greetings! My name is Tracy Packingham, and I am honored to introduce myself as your Region 8 Regional Executive for the 2014-15 chapter year. I am a member of the Greater St. Louis Chapter as well as your representative on the HFMA Regional Executive Council. The primary responsibilities of the Regional Executives, from the eleven regions, are: - To serve as the primary volunteer and policy liaison between the chapters and HFMA National;
national meetings or volunteering for a committee. Based on my experience, you will get 10x more out of what you put in. That is only one of the many outstanding things about HFMA. This year’s Chairman’s Theme is “Leading the Change”. I have had the privilege of working with each of your chapter Presidents over the past year and have already seen them incorporating this theme. Each chapter in our region has exceptional leaders and I have no doubt that Region 8 will have another phenomenal year. Thank you for the opportunity to serve Region 8, by far the best region in HFMA! I look forward to working alongside your dedicated chapter leaders and meeting many of you throughout the year.
- To assist chapter leaders in serving members; - To foster dialogue and effective communications between national HFMA and the individual chapters; - To represent the needs and interests of chapter leaders to the HFMA Board and management, and
My telephone number is 314-570-3580 and my email address is
[email protected]. Please feel free to contact me with questions or comments any time!
- To encourage chapters to collaborate and help other chapters. I would like to extend a sincere thank you to my predecessor, Randy Hoffman. He definitely raised the bar to a new level of excellence in 2013-14. Randy has been a fabulous mentor and has set the stage for our continued success. And for those that know Randy – we have some big shoes to fill. Thanks again Randy for a robust year. Stephanie Hultman from the Iowa Chapter is the Regional ExecutiveElect for Region 8. I am thrilled to be working with her again. Stephanie has already started working with your President Elects and has been very involved in the planning for our upcoming Fall Presidents Meeting. During the week of April 27, 2014, your chapter leaders attended the Leadership Training Conference (LTC) in National Harbor, Maryland. LTC is held each year to allow your elected leaders and various committee chairs to receive the training needed to fulfill their responsibilities. LTC is very rewarding and sets the tone for the upcoming year. I would encourage each of you to support your leaders in reaching the goals set for the June 2014 through May 2015 chapter year. It takes a team to reach the goals set at each chapter and believe it or not each of our members is part of our chapter’s team. Getting involved can be as simple as attending chapter meetings, attending
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Andrew B. Wheeler, Vice President of Federal Finance, Missouri Hospital Association
Federal Legislation and CMS Proposed Rule Updates The Centers for Medicare & Medicaid Services has once again been working hard to issue proposed rules, updating each Medicare payment mechanism for 2015. This year’s update includes the continuation of changes and expansion of quality incentives/disincentives, changes to the base rates, changes to the labor market areas used to determine wage index and much more.
Inpatient prospective payment system The proposed IPPS updates will increase the payments to Missouri’s hospitals by approximately 1 percent. This payment increase does not take into account the 2 percent reduction caused by sequestration. Hospital financial leaders should be aware of the following items and technical errors in the proposed rules. - On Page 28,325 of the Federal Register, the labor portion of the operating payment for hospitals with a wage index less than or equal to 1.0 that submitted quality data was $3,384.94. CMS has since corrected the error and stated that the rate should have been $3,348.94. - Table 5 within the proposed rules, which is a listing of all DRGs and their weights, has been updated, decreasing many proposed weights by approximately 0.26 percent. The IPPS updates also include revisions to the Medicare disproportionate share distributions, documentation and coding adjustments, quality reimbursement programs and labor market areas. In addition, the IPPS updates remind and provide limited guidance about providing price transparency as required by the Affordable Care Act and asks hospitals for input about an alternative payment approach for short hospital stays. The Missouri Hospital Association submitted comments about many of the proposed changes.
Long-term hospital prospective payment system The long-term hospital PPS also will realize a relatively modest rate increase of 0.6 percent on a revenue basis of $83 million. This rate change does not take into account the 2 percent sequestration adjustment. The updates included changes to the labor market areas, marketbasket updates and expansion of the interrupted stay policy.
Inpatient rehabilitation facilities Payment rates for inpatient rehabilitation facilities will increase in aggregate by 1.8 percent on a revenue base of $152 million. This rate change does not take into account the 2 percent sequestration adjustment. This year’s proposed rule updated the case mix group weights and quality reporting program updates. MHA submitted
comments about the 60 percent presumptive compliance standards and the quality reporting program.
Inpatient Psychiatric facilities IPFs should expect to receive on average a 1.8 percent increase in payments as compared to 2014. This rate change does not take into account the 2 percent sequestration adjustment. Unlike other prospective payment systems, CMS is not proposing to use the new labor market adjustments. MHA submitted comments about the proposed quality reporting program requirements. For additional information, MHA has released issue briefs for the IPPS and LTCH, federally qualified health and rural health centers, skilled nursing facility, IRF, inpatient psychiatric facility, and hospice payment systems.
Rural floor area wage index adjustment MHA also has released a supplemental issue brief describing the effects of the rural floor area wage index adjustment. This adjustment is a direct result of a provision within the Affordable Care Act, which significantly increased payments to most hospitals in Massachusetts. While Massachusetts continues to receive a significant windfall of cash, amounting to a 4.9 percent payment adjustment, California now leads the nation in the total amount of cash received as a result of the provision. Within the FY 2015 IPPS updates, CMS illustrated the effect of this policy for each state. Some of the highlights include the following. State California Massachusetts Nevada New York Texas Illinois Missouri
Payment Adjustment $196.3m $157.8m $10.9m ($48.9m) ($31.9m) ($28.5m) ($11.7m)
Percent Adjustment 2.0% 4.9% 1.6% -0.6% -0.5% -0.6% -0.5%
These estimates include only those for the IPPS, however the effect of the adjustment is also realized in any payment system that uses the wage index in the base rates. MHA continues to advocate for the repeal of this provision. Missouri’s U.S. Senator McCaskill has sponsored a bill (S.183) to repeal the provision and Senator Blunt is a co-sponsor. Another bill (H.R. 2053) has been introduced in the U.S. House of Representatives and Rep. Graves, Long, Luetkemeyer and Wagner have co-sponsored this bill. MHA thanks the members of Congress who support this effort.
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Power comes from being understood.SM When you trust the advice you’re getting, you know your next move is the right move. That’s what you can expect from McGladrey. That’s the power of being understood. For more information, contact Natalie Lee at 816.753.3000. Experience the power. Go to www.mcgladrey.com/healthcare
© 2013 McGladrey LLP. All Rights Reserved.
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Heart of America Chapter Leaders attended the annual Leadership Training Conference, April 27-29, in National Harbor, Maryland. Standing L to R: Michelle Narayan, Matt Robertson, Paul Knudtson, and Todd Kenney; Seated: Jim Mozena Paul Knudtson practicing to be the next President.
Welcome New Members! Janelle Allnutt, Senior Accountant Lafayette Reg Health Center Work Phone: (660) 259-7318 Email: janelle.allnutt@ hcamidwest.com
Leslie R Lapsley, Sr Compliance/Quality Specialist Cerner Corporation Work Phone: (816) 201-0731 Email:
[email protected]
Ryan Bradley, Patient Financial Services Rep Heartland Health Work Phone: (816) 271-7626 Email: ryan.bradley@ heartland-health.com
Patricia Madson, Sr Manager, PFS The Children’s Mercy Hospital Work Phone: (816) 701-5175 Email:
[email protected]
Kiley Brooks, Vice President of Healthcare Accounting Tutera Senior Living & Health Care Work Phone: (816) 444-0900 Email:
[email protected] Andrew Crotty, Account Executive Medix Work Phone: (913) 529-8764 Email:
[email protected] David Dickey Cerner Corporation Work Phone: (816) 221-1024 Email:
[email protected] Kim A. Fuller, Revenue Cycle Executive Cerner Corporation Email:
[email protected] Stacey R Holle, Sr Business Systems Analyst North Kansas City Hospital Work Phone: (816) 691-5143 Email:
[email protected] Brittney C James, Manager BKD, LLP Work Phone: (816) 221-6300 Email:
[email protected]
Bruce A. Matter, Hospitals & Large Practices GE Healthcare IT & Performance Solutions Work Phone: (913) 579-3156 Email:
[email protected]
Joanne Phillips, Admin Director Corp Compliance & Risk Shawnee Mission Medical Center Work Phone: (913) 676-2160 Email: joanne.phillips@ shawneemission.org Jamie L Smith, Business Office Manager Harrison County Community Hospital Work Phone: (660) 373-0532 Email:
[email protected] T Rolen The Children’s Mercy Hospital Email:
[email protected]
Cassie McMillen, Revenue Cycle Analyst Northwest Medical Center Work Phone: (816) 726-3941 Email: cassie.mcmillen@ northwestmedicalcenter.net James Nation, SVP, Healthcare Banking, Div Mgr Commerce Bank Work Phone: (816) 234-1897 Email: james.nation@ commercebank.com Tami Nugent, Product Manager Commerce Bank Work Phone: (816) 234-1897 Email: Tami.Nugent@ commercebank.com Jena Parker, Government Programs Manager The Children’s Mercy Hospital Work Phone: (913) 669-5766 Email:
[email protected]
– page 15 –
2014-15 Committee Chairs/Co-Chairs: Audit Committee Keeley Roach 816-474-4253 x21507
Website Matt Michalak, Chair 817-308-7338
Certification Damara Harper, Chair 816-781-7200
Link Committee Frankie Forbes, Chair 913-341-8600
By-Laws Committee Mary Knollmeyer, Chair 913-791-3500 x4018
Fall Workshop Committee Paul Knudtson, Chair 816-932-0336
Come Join Us!
Sponsorship Committee Mea Austin, Co-Chair 785-842-0726 Mary Knollmeyer, Co-Chair 913-791-3500 x4018
Social Media/Networking Committee Heath Leuck, Co-Chair 816-347-2859 Kalinda Tenborg, Co-Chair 913-234-6654
Publications Committee Cathy Kindle, Co-Chair 816-691-2010 Jessica Baird, Co-Chair 816-407-2041
Membership Committee Todd Kenney, Chair 816-701-0266
Directory Robert Fowle, Chair 913-319-6209
Programs Committee Michelle Narayan, Co-Chair 913-791-4260 Nominating Committee Andrea Lindsay, Chair 816-502-7033
HFMA volunteers receive opportunities for professional development, information, networking, and advocacy and earn Founders points when they participate in a chapter committee.
dŽŽƉƟŵŝnjĞLJŽƵƌĐĂƐŚŇŽǁandŚĞĂůƚŚĐĂƌĞƌĞĨŽƌŵ ƐƵĐĐĞƐƐ͕LJŽƵŶĞĞĚĞdžƉĞƌŝĞŶĐĞ͘͘͘ǁŝƚŚinsight͘ Experience.&ŽƌƚŚƌĞĞ ĚĞĐĂĚĞƐ͕,ƵŵĂŶƌĐŚĂƐ ŚĞůƉĞĚŚĞĂůƚŚĐĂƌĞƉƌŽǀŝĚĞƌƐ ĮŶĚƐŽůƵƟŽŶƐƚŽĐĂƐŚŇŽǁ ŝƐƐƵĞƐ͘EŽƐƵƌƉƌŝƐĞƚŚĂƚǁĞ ĂƌĞƚŚĞďĞƐƚͲƉƌĂĐƟĐĞůĞĂĚĞƌƐ ŝŶƌĞǀĞŶƵĞƌĞĐŽǀĞƌLJĂĐƌŽƐƐ ŽƵƌŝŶĚƵƐƚƌLJ͘
Insight. tĞĂƌĞĐŽŶƐƚĂŶƚůLJ ŝŶŶŽǀĂƟŶŐƚŽƉƌŽŵŽƚĞLJŽƵƌ ĮƐĐĂůŚĞĂůƚŚĂŶĚŚĞůƉLJŽƵ ŵĂŶĂŐĞƚŚĞĐŚĂůůĞŶŐĞƐŽĨ ŚĞĂůƚŚĐĂƌĞƌĞĨŽƌŵ͘ J ůŝŐŝďŝůŝƚLJĞŶƌŽůůŵĞŶƚ JKƵƚͲŽĨͲƐƚĂƚĞDĞĚŝĐĂŝĚ JĞŶŝĂůĂƉƉĞĂůƐ J>ĞŐĂĐLJƐLJƐƚĞŵĂĐĐŽƵŶƚƐ J^,ƐĞƌǀŝĐĞƐ JƵĚŝƚƌĞƐƉŽŶƐĞƐĞƌǀŝĐĞƐ
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– page 16 –
ANI 2014 - Las Vegas, June 22-25 2
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ANI’s theme this year was “This is BIG”, and the conference delivered with a big payoff (great networking opportunities), a big gathering (over 4,000 attendees), big takeaways (excellent programming), and a big destination (Las Vegas)! During Monday night’s award ceremony, the Heart of America Chapter received two National HFMA Awards: - Henry Hottum Award for Educational Performance Improvement - Gold Award of Excellence for Membership Growth and Retention
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Programming was focused around eight BIG themes with sessions that explored the issues in depth. Keynote speaker, Atul Gawande, MD, presented Leading the Change: Healthcare in Transition and offered a unique perspective about the shift from independent practices to team-based delivery in highly integrated systems of care.
The ANI 2014 exhibit hall featured more than 400 companies offering ideas and solutions for healthcare organizations.
Jim Mozena, Heart of America Chapter President, attended many educational sessions and represented our chapter at the annual awards banquet. As the new National Chair of HFMA, Kari S. Cornicelli presented the motto for the upcoming year, “Leading the Change”. Joseph Fifer, President and CEO of HFMA, invited attendees to a BIG celebration on the last night of the conference. – page 17 –
Heart of America Mini LTC 2
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HOA Officers, Board Members and Committee Members attended the Mini Leadership Training Conference on June 13, 2014 at the Kansas City Culinary Institute in Overland Park, Kansas. The meeting included a strategic planning session and the culinary center’s “mystery box” teambuilding experience, in which team members cook from mystery ingredients without recipes. It was a fun and educational experience for all who attended!
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HOA leadership participated in a strategic planning session prior to teambuilding.
Team members Esteban Ponce, Matt Robertson and Mary Knollmeyer work on a mystery dessert dish.
Michelle Narayan and Jim Mozena create side dishes for the group.
Keeley Roach stirs up a side dish.
Jerry Plagge and Paul Knudtson work hard at the stove.
Mary Knollmeyer and Matt Robertson apply the finishing touch to dessert.
Team members enjoy the fruits of their labor! – page 18 –
2014
HFMA Golf Tournament
Platinum Sponsor:
Player Registration Monday, August 25 @ 10am
Thank you to our Sponsors! Gold:
$80 Entry Fee Includes: Green fee & cart Range balls Hole prizes
Breakfast, lunch & drinks Tournament giveaways
Silver:
Name:___________________________________________ Email:___________________________________________ Company:________________________________________ Phone:_________________ HFMA Member? Y __ N __ Name:___________________________________________ Email:___________________________________________ Company:________________________________________ Phone:_________________ HFMA Member? Y __ N __ Name:___________________________________________ Email:___________________________________________ Company:________________________________________
Staley Farms Golf Course 10310 N. Olive Avenue Kansas City, MO 64155 Breakfast, Registration: 8:00 – 9:45 am
Phone:_________________ HFMA Member? Y __ N __
Rules & Announcements: 9:45 am
Name:___________________________________________
Shotgun Start: 10:00 am
Email:___________________________________________ Company:________________________________________
Lunch: 12:00 p.m.
Phone:_________________ HFMA Member? Y __ N __ I am interested in: A Hole Sponsorship: Yes ___ No ___
Send payment to: Make checks payable to: HFMA Heart of America Chapter Todd Kenney, BKD CPAs & Advisors 1201 Walnut Street, Ste 1700 • Kansas City, MO 64106
[email protected] Fax: 816.221.6380
Questions? Contact Kalinda Marfisi at 913.234.6654 or
[email protected].
