14 (Thursday) - 15 (Friday) CST
Dallas Marriott Las Colinas
223 West Las Colinas Boulevard, Irving, TX 75039
HFMA Lone Star & DHG Healthcare
DHG Healthcare and HFMA’s Lone Star Chapter come together to lead an interactive workshop on revenue transformation, the expansion of healthcare payment [...]
DHG Healthcare and HFMA’s Lone Star Chapter come together to lead an interactive workshop on revenue transformation, the expansion of healthcare payment approaches, and Risk Capable models that help organizations effectively navigate the transition from Fee-For-Service (FFS) to risk-based payments. During this working session, a team of national thought leaders will lead participants through a series of presentations designed to assess organizational capabilities related to the design and implementation of alternative payment models. Participants will leave with a personalized workbook of action steps to support their organization in the next phase of their transition toward becoming Risk Capable. Each presentation will be led by DHG Healthcare’s national thought leaders who will share a state and local perspective on healthcare reform and dynamic responses to revenue transformation.
This session introduces the concept of Risk Capability and describes the foundational elements necessary for an organization to prepare, accept and manage risk-based payment models. We will present an overview of an effective governance structure for managing risk-based models, focusing specifically on bundled payment and episode-based models. Participants will be led through an exercise to begin evaluating their current governance structure.
As a Principal with DHG Healthcare, Bill currently serves as the Partner in Charge forthe Healthcare practice in the Southwest. His professional career spans over 30 years in the healthcare industry and he has held leadership roles with various firms and clients. Prior to joining DHG Healthcare, Bill served as a partner in the healthcare practice of an international professional services firm and served as the CFO for a fully integrated cardiovascular physician practice employing over 135 cardiologists.
At DHG Healthcare, he led the development of the Revenue Cycle and Compliance practice and was instrumental in developing the firm’s thought leadership and approach related to revenue transformation. Bill regularly assists his clients in navigating the challenging and difficult transition to alternative payment models and is a highly regarded and sought-after speaker on topics such as: “Revenue Portfolio Design for Healthcare Providers”; “Transparency in Healthcare Pricing”; “Operationalizing the Proposed MACRA Regulations”; as well as other topics related to the ongoing transformation in the industry. Through his expertise and industry experience, Bill continues to be actively engaged in leadership initiatives at DHG Healthcare.
During this session participants will hear a brief history of the evolution of bundled payments and gain an understanding of how CMS establishes bundled target pricing. We will share a case study example of how one health system is actively developing bundled products for the commercial market. We will also present and identify various clinical process levers to be considered as an organization considers whether to participate in a voluntary bundle. Additionally, participants will conduct a self-evaluation of their organization’s readiness to implement bundles.
Since joining the firm in 2010, Michael has become one of the firm’s go-to authorities on bundled/episodic payments, hospital merger transactions, physician-hospital alignment agreements, and health system strategic planning. These efforts have all been focused on helping physicians and hospitals develop win-win strategies and successful business models. During Michael’s tenure with DHG Healthcare, he has served as the Director of Bundled Payments (2012-2014) for a Bundled Payments for Care Improvement (BPCI) awardee. This position included leading care redesign efforts, aligning physician and hospital initiatives, creating economic win-win opportunities, and validating data to build the BPCI value proposition.
Michael’s other project work includes facilitating hospital-physician alignment relationships in orthopedics, radiology, spine services, sports medicine, oncology, cardiothoracic surgery, and general surgery. His experience in these hospital services includes co-management agreements, professional services arrangements, recruitment assistance contracts, bundled payments, and comprehensive clinical institutes. Client results from Michael’s work include increased physician engagement, decreased hospital costs for surgical implants, streamlined operating room efficiency, increased patient satisfaction, and stronger hospital-physician relationships. He has experience with acute-care hospital mergers, health insurance exchanges, and issues relating to academic medical centers. Michael has been sought for podium opportunities relating to bundled payments, hospital M&A, and healthcare strategic planning.
Dr. Kiskaddon, CMO of DHG Healthcare, will present new models for clinical collaboration between physicians and hospitals. The presentation will dive into important considerations for new collaboration models that are essential for the success of episode-based payments. Participants will be led through an exercise to evaluate their current physician and hospital partnership structure and identify opportunities for enhanced alignment.
Presented by Dr. Robert Kiskaddon, Chief Medical Officer, DHG Healthcare
As the Chief Medical Officer for DHG Healthcare, Dr. Kiskaddon brings over 20 years of clinical medical practice experience and over 30 years of combined healthcare administrative and medical staff leadership to Dixon Hughes Goodman’s national healthcare practice. He has worked with academic medical centers, integrated health systems, employed and private physician practices and has had key positions in strategic planning, quality/compliance, financial management, utilization review, recovery audit, information technology/clinical informatics, healthcare reform and clinical integration. He has guided clients through successful engagements to improve operational design, practice management, compensation models, clinical documentation, and economic alignment. In addition, he has served as medical school faculty focusing on residency development and clinical education at Stanford University Medical Center, Yale University School of Medicine and University of Illinois College of Medicine. Dr. Kiskaddon is a recognized expert in multidisciplinary collaboration, team building and communication.
A seasoned clinician, administrator, consultant and educator, his role as DHG Healthcare’s Chief Medical Officer involves helping to bridge the various gaps between clinical and non-clinical stakeholders, bringing common focus to the significant issues challenging medical practitioners and healthcare organizations, and further enhancing technical perspectives and solution sets related to the industry’s journey to risk capability
This sessions describes the importance of meaningful connections between physicians, hospitals, and other non-acute providers in a value based model of payment. We will present actionable strategies for designing clinical care processes to manage care under a bundled payment structure. Participants will learn the importance of linking risk stratification and care management design and will complete an evaluation of their organization’s clinical care management readiness.
Lisa is a Principal with DHG Healthcare and works with hospitals, health systems and post-acute care providers to develop and implement strategies to succeed as healthcare delivery evolves from fee-for-service (volume) to risk- and performance-based payment models (value). Lisa has more than 17 years of experience in the healthcare and senior living industry, providing strategic planning, operations assessment and performance improvement, market research, marketing, and other advisory services. Lisa has been involved in the development of numerous start-up communities, as well as expansion and repositioning projects. She is experienced in the preparation of market demand analyses for proposed and existing senior living and long-term care providers, including CCRCs, assisted living facilities, skilled nursing facilities and other retirement housing projects.
Session participants will gain an understanding that “correct” MS-DRG reimbursement does not have an impact on VBP/APM performance but that optimal performance depends on overall patient acuity mechanisms (Risk Adjustment, Hierarchical Condition Categories). We will present concepts that will allow participants to better understand that the appropriate portrayal of patient acuity requires a “purposeful” focus beyond CC/MCC capture and traditional financial performance metrics. Each participant will be led through an exercise to evaluate their organization’s CDI structure and the role it plays in value-based care models.
Wayne is a part of the DHG Healthcare CFO Advisory team with over 23 years of experience in healthcare finance assisting clients in such areas as revenue cycle financial and operational performance improvement, and reimbursement and compliance services. He has worked with large health systems, academic medical centers, regional hospitals, physician practices, post-acute care settings, home infusion and DME providers through the course of his career. He has focused on both financial improvement and clinical documentation improvement initiatives, fraudulent claims defenses and self-disclosures, representing clients in the capacity of the Independent Review Organization (IRO), identifying and quantifying impacts of billing edits and denials and assisting with managing broader operational improvement projects.
Prior to joining DHG in 2014, Wayne has served in leadership roles devoted to the healthcare industry with a Big Four professional services firm and another nationally recognized healthcare consulting firm. He began his career in public accounting performing financial statement audits and preparing Medicare and Medicaid cost reports for hospital and healthcare system clients.
Wayne is a CPA licensed in the State of Georgia and is currently engaged in various financial, reimbursement, and revenue cycle performance improvement initiatives leads the firm’s ICD-10 readiness assistance activities. Wayne is also a guest speaker/presenter for numerous healthcare industry forums and webcasts covering topics including ICD-10 preparedness, Revenue Cycle performance improvement, Bundled Payment initiatives, fraud and abuse and other compliance topics.
Value Based Payments and Commercial Contracting – This session allows participants to learn about concepts and see examples of value-based models for inclusion in commercial contracts. We will also present successful strategies for designing a future state revenue portfolio that includes more value-based and episode-based payment models.. We will also discuss suggestions for realizing the value-based bonuses available in your current commercial contracts. Participants will have the opportunity to develop a plan evaluating their readiness to transition to value-based contracts.
Beth Mullins is a Principal with DHG Healthcare, the national healthcare practice of Dixon Hughes Goodman, LLP. Beth has over 20 years of healthcare experience in various roles, including managed care contracting, pricing transparency, clinically integrated networks, and business development. Beth joined DHG Healthcare in January of 2017 to lead the managed care business consulting segment of DHG Healthcare’s National Strategy Practice. Beth’s experience includes international and domestic consulting experience with health systems, an in-depth knowledge of health plan and other payer systems, results-oriented managed care/provider pricing negotiations, strategic planning and product line analyses as well as building and broadening physician relationships.
Additionally, Beth works with hospitals and physician group clients in the development of networks (PHOs and IPAs) as a first step in the process of moving toward a clinically integrated network (CIN). This helps clients prepare for clinical integration, develop shared savings reimbursement models of payment, and identify quality metrics to drive changes in the delivery of healthcare. This continued focus on the strategic plan and its implementation has earned her recognition in the industry as a top performer.
This session will evaluate the various types of information and analytic capability required to manage bundled payment contracts. We will share case study examples of data informed program management and results. We will also discuss the expected CMS BPCI Open Enrollment and the typical data intelligence needed to make decisions on bundling, episodes and risk tracks. We will also share an example of ACO analytics – the “bundler on steroids.”
Chris serves as a Principal in our Enterprise Intelligence practice based out of Greenville, SC. He currently leads our Accountable Care Organization (ACO) analytics team, system and market access studies, product development and various dash-boarding initiatives. Chris previously spent 5 years as part of DHG Healthcare’s National Strategy Practice where he provided strategic planning and service line optimization in addition to leading extensive physician alignment initiatives such as clinical integration, co-management agreements, real estate joint ventures, employment strategies and directorships. Prior to joining Dixon Hughes Goodman, Chris served in various roles including Investments and Partnerships Specialist, Director of Physician Alignment and National Business Development Sales Manager. Chris has also served as past President for American College of Healthcare Executives (ACHE) of Northern Ohio.
Edward combines 25 years of healthcare consulting experience with seven years of corporate experience to provide realistic business thinking for our healthcare clients. Edward has acquired significant experience in the areas of enterprise analytics and business intelligence, strategic business planning, health system planning, growth strategies, service line feasibility, and market strategies. He has particular experience serving national accounts with custom strategic solutions. His business experience, coupled with his healthcare focus and years of hands on planning experience, ensures practical and manageable strategic solutions for our healthcare clients.
Edward currently serves as leader of the DHG Healthcare Analytic Solutions group, the enterprise intelligence practice area of the DHG Healthcare practice, with a specific emphasis in developing analytic solutions for risk capable organizations. In the past five years, Edward and his teams have conducted more than 500 planning engagements across a wide range of clients including for profit multi-location systems, not-for-profit systems, community hospitals, rural hospitals, specialty hospitals and health related companies. Edward is a frequent speaker on analytics and strategic planning.
Entering into value based payment arrangements, including payment bundles, creates significant risk for organizations. This risk often manifests itself in significant financial statement risk. This session will present the latest accounting guidance related to value-based payment models and will examine financial reporting implications.
Marie Castro, CPA, CHFP, is a partner with DHG Healthcare. With over 18 years of experience in public accounting, her background includes providing assurance and advisory services to clients within the healthcare industry and adding value throughout the audit process, specifically relating to complex accounting transactions, financial reporting, and internal controls.
Marie has spent her entire career working exclusively in health care. Her extensive healthcare experience includes auditing a wide range of not-for-profit and for-profit entities including health systems, hospitals, nursing homes, CCRC’s, academic practice plans, and physician practices. Marie is an active member of the Texas Society of Certified Public Accountants, Healthcare Financial Management Association, and the Texas Association of Healthcare Financial Administrators. Marie regularly makes presentations to board of directors and professional groups.