EASTERN PENNSyLvANiA CHAPTER CASE MANAgEMENT CONFERENCE

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1 WWW. ACMAWe B.oR g/epa 1st Annual EASTERN PENNSyLvANiA CHAPTER CASE MANAgEMENT CONFERENCE Saturday, March 10, 2012 Dolce Valley Forge King of Prussia, PA

2 SeSSion descriptions KeyNote ADDReSS Roles & Responsibilities of a Physician Advisor: Observations & Experiences from the Field frank L. Urbano, MD, facp Medical Director of Care Management Albert Einstein Medical Center Philadelphia, PA SeSSioN ABStRACt: Physician advisors (PAs) are rapidly becoming essential members of the administrative team in hospitals and health care systems. The traditional role of the PA has involved acting in a denials management capacity; however, today s PA can have so much more to offer in terms of education and advocacy. This session will serve to introduce the concept of the PA in an expanded capacity, focusing on the critical role that the PA can play in improving hospital operations, documentation and reimbursement. 1. Compare and contrast the duties of traditional and expanded PA roles 2. Appreciate the role of the PA in education and advocacy 3. Develop a strategy for implementation of a physician advisor program SeSSioN 2 State and Federal Legislative and Regulatory Update: What s Hot in 2012 for Health Care? Pamela e. Clarke Vice President, Health Care Finance and Managed Care Delaware Valley Healthcare Council of HAP Harrisburg, PA SeSSioN ABStRACt: This presentation will highlight key pieces of legislation for which the Hospital & Healthsystem Association of Pennsylvania (HAP) is advocating including medical liability, hospital licensure and maintenance of Medical Assistance funding for hospitals. The speaker will provide an update on aspects of the Affordable Care Act (ACA) that impact care management services such as new federal requirements for external reviews of adverse benefit determinations; Medicare payment reductions for readmissions; establishment of an essential health benefits package for the health insurance exchange and changes in health care service delivery through the implementation of Accountable Care Organizations. Attendees will learn advocacy tools and strategies that can be used to support HAP s legislative and regulatory agenda for Recognize HAP s top three legislative priorities for Develop an outline of steps to file an external appeal in compliance with the federal government s requirements per the ACA 3. Determine an appropriate advocacy strategy to employ in support of HAP s legislative and regulatory agenda for 2012

SeSSioN 3: WoRKiNg LUNCH (SPonSored by AccreTive HeALTH) Observation and Extended Observation Steve Meyerson, MD Vice President, Physician Advisory Services Accretive Health, Inc.

3 SeSSioN 3: WoRKiNg LUNCH (SPonSored by AccreTive HeALTH) Observation and Extended Observation Steve Meyerson, MD Vice President, Physician Advisory Services Accretive Health, Inc. Chicago, IL SeSSioN ABStRACt: This session will cover a discussion of relative costs and benefits for inpatient admission from observation for the patient, physician and hospital. The speaker will demonstrate the effect of documenting medical necessity for inpatient admission to include Medicare compliance, provide examples of key words for physician documentation, clinical factors of InterQual criteria, and RAC review. Attendees will discuss options for two-day observation stays, with typical clinical scenarios from discharge to the PA s role. 1. Discuss relative costs and benefits for inpatient admission from observation 2. Demonstrate the effect of documenting medical necessity for inpatient admissions 3. identify options for two-day observation stays SeSSioN 4: SPeeD LeARNiNg SeSSioNS 4-1: Extended Acute Care Austin Reed, RN, BSN, MHA, CCM Clinical Nurse Manager, Department of Psychiatry Sacred Heart Hospital Allentown, PA SeSSioN ABStRACt: This session will provide an introduction and review of the Medical Health Recovery Model in an acute care hospital setting. Attendees will learn how this model provides an individualized patient approach with the goal of empowering consumers to manage their illness. 1. Understand the definition of Recovery Model 2. Strategize on the practical utilization of the model in an acute care setting 3. Evaluate services and programs offered by extended acute care 4-2: Care Transition Models tracey A. Wilds, MSN, RN, ANP-C, CRNP Homecare and Hospice Lehigh Valley Health Network Allentown, PA SeSSioN ABStRACt: As the inpatient length of stay has become shorter and hospitals will be financially responsible for readmissions within 30 days, many organizations are looking to bridge the gap between discharge and PCP follow-up. This session will discuss three care transition models, as well as the development and implementation process. 1. Review three prevalent transition of care models 2. identify patient population identified as being high risk for readmission 3. Discuss the programs development and implementation process

SeSSioN 5 Panel Discussion - Reduce Readmissions: Three Perspectives Karen fattore, SW Manager, Social Services Reading Hospital West Reading, PA Wendy Raifsnider, SW Director of Case Management,

4 SeSSioN 5 Panel Discussion - Reduce Readmissions: Three Perspectives Karen fattore, SW Manager, Social Services Reading Hospital West Reading, PA Wendy Raifsnider, SW Director of Case Management, Social Work Grandview Hospital Sellersville, PA Susan Standish-Wallace, RN, MS, Ne-Be, ACM, iqci Director, Care Management Lancaster General Health Lancaster, PA SeSSioN ABStRACt: This session will be a discussion by regional case management leaders on identifying, tracking, addressing and approaching readmissions within their facilities. The session will focus on barriers, best practices and future plans. 1. identify potential models that can be incorporated into other case management models 2. Review various interventions that can affect readmission 3. Recognize and describe potential barriers that influence the success of a readmission program CoNfeReNCe DAte: March 10, 2012 RegiSteR online: registration pricing early RegiStRAtioN AcMA must receive payment and registration by February 20, 2012 ACMA MeMBeR $65 NoN-MeMBeR $85 MeMBeRSHiP PACKAge* $215 LAte RegiStRAtioN ACMA MeMBeR $80 NoN-MeMBeR $100 MeMBeRSHiP PACKAge* $230 * includes 1-year AcMA & chapter Membership, membership application required. ConferenCe registration We make registering easy! Simply decide which method is best for you. For a hard copy registration form, complete online registration and print to mail. Online: Mail: West 36th Street Little Rock, Arkansas Fax:

ConferenCe SChedule 7:15 am 8:15 am Registration Networking Breakfast with Sponsors & Exhibitors 8:15 am 8:30 am Welcome Announcements & Chapter Business Meeting 8:30 am 10:00 am Keynote Address:

5 ConferenCe SChedule 7:15 am 8:15 am Registration Networking Breakfast with Sponsors & Exhibitors 8:15 am 8:30 am Welcome Announcements & Chapter Business Meeting 8:30 am 10:00 am Keynote Address: Roles & Responsibilities of a Physician Advisor: Observations & Experiences from the Field 10:00 am 10:30 am Networking Break with Sponsors & Exhibitors 10:30 am 11:45 am Session 2: State and Federal Legislative and Regulatory Update: What s Hot in 2012 for Health Care? 11:45 am 1:15 pm Working Lunch Session: Observation and Extended Observation (Sponsored by Accretive Health) 1:15 pm 1:45 pm Networking Break with Sponsors & Exhibitors 1:45 pm 3:00 pm Session 4: Speed Learning Sessions 4-1: Extended Acute Care 4-2: Care Transition Models 3:00 pm 3:15 pm Transition Break 3:15 pm 4:30 pm Session 5: Panel Discussion: Reduce Readmissions: Three Perspectives 4:30 pm Closing Remarks Chapter Board of directors & ConferenCe planning Committee President Laura Benner, RN, BSN, ACM Patient Access Coordinator Case Management Sacred Heart Hospital Allentown, PA President-elect Maureen Sawyer, LSW Director, Case Management Lehigh Valley Health Network Bethlehem, PA Treasurer Jim Matula, LCSW Director, Social Work Sacred Heart Hospital Allentown, PA Members-at-Large: Pamela Miles, ACNS-BC Director of Clinical Services Nursing Administration St. Luke s Hospital Allentown, PA Continuing education CE Certificates will be awarded upon completion of the conference. Participants may earn up to 8.7 Nursing Contact Hours (based on 50-min hour) and up to 7.25 Social Work Contact Hours. CE credits can be applied toward ACM Certification renewal. important dates HoteL DeADLiNe February 10, 2012 early RegiStRAtioN DeADLiNe February 20, 2012 LAte PRiCiNg BegiNS February 21, 2012 CoNfeReNCe DAte March 10, 2012

6 1st Annual EASTERN PENNSyLvANiA CHAPTER CASE MANAgEMENT CONFERENCE Saturday, March 10, 2012 Dolce Valley Forge King of Prussia, PA ConferenCe location Dolce Valley forge 301 West DeKalb Pike King of Prussia, PA The Dolce valley Forge is offering a limited number of guest rooms to conference attendees at a rate of $129.00/night. To receive this rate, you must make your reservation by February 10. To place a reservation, call the hotel directly at and reference American Case Management Conference group Rate. parking information Parking is complimentary West 36th Street Little Rock, AR FIRST-CLASS PRSRT U.S. POSTAGE PAID LITTLE ROCK, AR PERMIT #1105

WESTERN PENNSyLVANIA CHAPTER CASE MANAGEMENT CoNFERENCE

WWW. ACMAWe B.oR g/wpa 7th Annual WESTERN PENNSyLVANIA CHAPTER CASE MANAGEMENT CoNFERENCE September 24, 2011 Four Points by Sheraton Pittsburgh North Mars, PA SeSSion descriptions KeYNoTe AddReSS Why am