Kentucky Primary Care Association

Transcription

1 Kentucky Primary Care Association 2011 Annual Meeting October 17th and 18th, 2011 Embassy Suites 1801 Newtown Pike Lexington, Kentucky The KyPCA is offering full-day training for the following tracks: Billing & Coding CEUs offered through PHIA for certified coders Board Training Clinical Quality CME applied for through AAFP Corporate Compliance for Clinic Staff Managed Care Management Daily Schedule Don t forget the Keeneland Out- Outing, Sunday, October 16, sponsored by: Remember that ticket availability is limited, and request your tickets early! 7:00-8:00 am 8:00-9:30 am 9:30-10:00 am 10:00-11:30 am 11:30-12:30 12:30-1:30 pm 1:30-3:00 pm 3:00-3:30 pm 3:30-5:00 pm Registration Learning Session Break Learning Session Lunch Plenary Session Learning Session Break Learning Session 1

2 Kentucky Primary Care Association 2011 Annual Meeting October 17th and 18th, 2011 Embassy Suites 1801 Newtown Pike Lexington, Kentucky Medicaid Managed Care Plenaries Monday 12:30-1:30 pm Plenary Session: Medicaid Update Federal Perspective Dan Hawkins, NACHC Tuesday 12:30-1:30 pm Plenary Session: Medicaid Update State Perspective Secretary Janie Miller, Cabinet for Health & Family Services Monday Evening Sessions Invited Monday Evening (a working dinner will be served) 5:00-7:00 pm Quality Session To Be Determined Medicaid Advocacy Planning Lynn Williams, NACHC The Medicaid program is undergoing significant change in Kentucky even as the future of federal support for the program is being challenged. Because Medicaid is critical to the primary care safety net, the KyPCA will hold an evening session on Monday, October 17 th with Lynn Williams from NA- CHC to assist organizations in developing their Medicaid advocacy plans. Preserving Medicaid will take a long, sustained effort from all stakeholders. Please take advantage of this session to learn how to step up your advocacy efforts. Billing & Coding Track CEUs will be offered through PHIA for certified coders. E/M Auditing Sherry Thomas, CCP, CCP-AS, Medical Staff SOS, Inc.-PHIA In this session, you will strengthen your auditing skills by reviewing all aspects of E/M documentation and discuss the three key components: History, Examination, and Medical Decision Making. Hands on exercises will be provided and discussed as group. Making the Transition from ICD-9 to ICD-10 Coding Sherry Thomas, CCP, CCP-AS, Medical Staff SOS, Inc.-PHIA This presentation will provide an overview regarding the new ICD-10-CM code set as well as the guidelines, structure of this new coding system, documentation issues and auditing. Hands on exercises will be provided. You will either need to bring an ICD-10 draft coding book OR purchase one for $94.00, including tax and shipping & handling (add the cost of the book to your registration fee). Please let us know at least three weeks before the meeting if you will need to purchase a book to make sure there are enough. Audits, Audits Everywhere Sherry Thomas, CCP, CCP-AS, Medical Staff SOS, Inc.-PHIA This session will provide you with an overview of the different Healthcare audits occurring today and why so many are being performed. Discussion of what to do after an audit and how to take a more proactive approach to prepare for the next audit within your practice will also be part of this session ICD-9-CM Updates Sherry Thomas, CCP-CCP-AS, Medical Staff SOS, Inc.-PHIA This session will provide the attendee with a listing of the deleted, added and revised ICD-9 codes that will be incorporated as the next to last version of this code set. This version will be appropriate to use between October 1, 2011 October 1, ICD-10 codes will take affect October 1,

3 Board Training Track Corporate Compliance for Board Members Marcie Zakheim, Esq, Feldesman Tucker Leifer Fidell LLP Health Center Board members are vested with numerous legal responsibilities, establishing health center priorities & ensuring organizational compliance with applicable laws, regulations and policies. The Health Reform Bill includes enhanced corporate accountability measures and fraud enforcement activities, and mandates corporate compliance programs, thus magnifying the importance of these duties. Now more than ever, effective corporate governance requires Board members to develop a clear understanding of their legal roles and responsibilities and, in particular, their corporate responsibility duties. Strategic Planning Pamela Byrnes, NACHC Clinical Quality Track Models for Patient-Centered Care: The Need for Improving Chronic Care Management Dr. E. Mark Watts, Carilion Clinic, Roanoke, VA Dr. Watts will present evidence of the need to improve the quality of care for patients with chronic medical conditions, introduce the Chronic Care Model (CCM) and how it supports high-quality chronic care management within the Patient- Centered Medical Home, and describe how chronic care model relates to other patient-centered care models (Patient -Centered Medical Home). Quality Session To Be Determined Documentation in the Electronic Age Tammy Geltmaker, HealthCare Excel Partnering to Best Serve Your Community Joy Hoskins, Kentucky Breast & Cervical Cancer Program Ellen Schroeder & Shirley Reed, American Cancer Society Ruth Woolum, Rotary Free Program Tuesday 8:00 am-5:00 pm Motivational Interviewing Mary Clare Champion, Cherokee Acquire skills necessary to coach patients in self-management and behavioral change. Tobacco Cessation: The 5 A s Program Mary Clare Champion, Cherokee Learn to use the evidence-based 5 A s program to assist tobacco users in their quit attempts. What the Heck is Health Literacy? Emily Beauregard, Family Health Centers Mary Beth Wright, Kosair Children s Hospital The KHIE Connection: Partnering to Improve Patient Health Outcomes Polly Mullins Bentley, Deputy Director, GOEHI The Commonwealth of Kentucky strives to be a leader in our nation s journey to advance health information technology to transform paper health records into electronic health records. With initiatives underway to enhance the quality, safety, and efficiency of health care for all Kentuckians, the Commonwealth is at the forefront of Health information Technology. The Kentucky Health Information Exchange offers the Commonwealth an unparalleled opportunity to support our health care system in adopting and using health information technology. This will not only encourage but enable the health care provider to participate in a secure Health Information Exchange (HIE), where valuable health information will be available when and where it is needed to achieve the best positive patient outcomes. Because other industries have already embraced information technology, our health care system can capitalize on advances already made to ensure the privacy and security of shared health information. This presentation will provide history and an update on the Kentucky Health Information Exchange including the impact of ARRA legislation and HITECH funding on the Commonwealth of Kentucky. Corporate Compliance Track Tuesday 8:00 am-5:00 pm Corporate Compliance for Clinic Staff Adam Falk, Feldesman Tucker Leifer Fidell LLP In addition to making significant changes to the health care system, the Patient Protection and Affordable Care Act grants new authority to enforcement agencies, increases potential financial penalties, and establishes new government audit programs. Now, for the first time, compliance programs will also become mandatory conditions of enrollment in Medicare, Medicaid, and CHIP. Undoubtedly, these changes create significant risks for clinics that lack an effective corporate compliance program to maintain compliance with the myriad legal, regulatory, and financial requirements. This compliance training will provide your clinic with information, tools, and tips to implement your compliance program and to maintain compliance with applicable laws and regulations. 3

4 In the one-day training program, the morning sessions will identify action steps for implementing your compliance program and describe emerging enforcement trends. The afternoon sessions will delve into financial and legal requirements for key clinic risk areas. Managed Care Track Preparing for Managed Care: Key Considerations for Primary Care Clinics and Health Centers Adam J. Falk, Feldesman Tucker Leifer Fidell LLP As a result of the Patient Protection and Affordable Care Act, managed care is likely to account for an increasing amount of revenues for primary care clinics and health centers that serve medically underserved populations. State trends indicate that Medicaid programs will turn to managed care to controls costs as Medicaid eligibility expands. Furthermore, many patients who were previously uninsured will purchase subsidized coverage from managed care organizations (MCOs) operating in the State health benefit exchanges. To thrive in this new environment, clinics and health centers need to understand the financial, clinical and operational implications of managed care and take steps now to prepare and strategize. Goals: Participants will recognize internal business processes that may need to be adjusted or adopted to maximize revenue under managed care Participants will identify what training and hiring investments in administrative and clinical staff may be necessary to fulfill their duties as a primary care provider (PCP) in managed care Participants will know what legal provisions should be included in their managed care contracts to minimize potential financial and legal exposures Text: Managed Care Handbook (forthcoming NACHC publication expected for release in early Fall 2011) ments, having team competencies is critical to organizational success. In this training, you will learn strategies and skills for building, evaluating and maintaining team competencies including: Goal-setting Building trust and mutual respect Determining roles and responsibilities and holding members accountable Decision-making Running effective team meetings Resolving conflicts Evaluating and improving team effectiveness over time. Tuesday 8:00 am-5:00 pm Practical Coaching Skills for Managers Sue Brundege, Integrated Work Strategies Improve employee performance, deal with difficult situations, and make your work-life easier by learning how to coach while you manage. Coaching is valuable in the workplace because it lays the foundation for significant performance improvements based on mutual respect, collaboration, and accountability between manager and employee. In this training you will increase your confidence and skill as a coach by learning: The difference between coaching and managing, and when each is most effective How to recognize a coachable moment Methods to increase the power of your observation and listening How to raise difficult issues without damaging relationships When and how to apply coaching concepts in daily work. Management Track Teams are essential to Patient-Centered Medical Homes. Join these sessions to gain critical competencies for effective teams. Building Team Competencies Sue Brundege, Integrated Work Strategies This training focuses on the critical skills necessary to build and lead strong teams. In complex, dynamic and diverse environ- 4

5 Kentucky Primary Care Association 2011 Annual Meeting Polly Mullins Bentley, RN, RHIT, CPHQ is the Deputy Executive Director of the Governor s Office of Electronic Health Information (GOEHI). Ms. Bentley has thirty-five years of healthcare experience including clinical nursing (emergency department), health information management, quality & performance improvement, case management, regulatory compliance (including HIPAA Privacy & Security), and clinical information technology. Polly s current post is in the newly established Governor s Of- Office of Electronic Health Information in the Cabinet for Health & Family Services, with a primary focus on the statewide initiative for health information exchange (Kentucky Health Information Exchange/KHIE). She is working to facilitate the KHIE Strategic & Operational Plan, which is focused on connecting all providers across the state of Kentucky to the health information exchange over the next year. The Kentucky Health Information Exchange will enable point-of-care access for the provider to comprehensive patient health information encounters, medication history, lab, radiology and other reports. Access to this level of patient information has already been proven to improve quality and safety of patient care and reduce healthcare costs. KHIE currently is working with 200+ healthcare organizations across Kentucky (hospitals, labs, clinics and physician practices), all of which are at some point along the path of connectivity. Prior to this Polly spent the past ten years as Director of Clinical Information Systems for Appalachian Regional Healthcare, where she was responsible for the implementations of a number of clinical systems including a physician portal, documentimaging/emr, PACS, physician practice EHR, and Emergency Department EHR (both including CPOE). She also served in the capacity of the organization s HIPAA Security Officer. Sue Brundege is an Organizational Learning Facilitator at Integrated Work, providing facilitation and coaching to clients in the areas of leadership, communication, peer learning, and teambuilding. She is also the Project Director for the HRSA-funded Peer-to-Peer Learning Group contract for PCAs and FQHCs. As a certified coach, Sue provided organizational development consulting for a major healthcare system, including leadership coaching and communication skills training. She has owned her own company, coaching and mentoring entrepreneurs as they grow their businesses. Presenter Bios She holds a Bachelor s degree in Speech Communication with an emphasis in organizational management, and is currently in a Psychology and Organizational Consulting graduate program. Pamela Byrnes, PhD, is the Director of the Health Center Growth and Development Program at the National Association of Community Health Centers. This program provides technical assistance, training, and support to communities developing new health centers, organizations interested in applying for 330 funding, and newly funded grantees. She also serves as administrative policy liaison between NACHC and the Bureau of Primary Health Care. Dr. Byrnes has a Doctorate in Sociology of Health Care Systems from the University of Connecticut and a Masters degree in research methods and applied statistics. Prior to joining NACHC she served as a consultant to health centers and primary care associations for over twenty years. Dr. Byrnes served on the Connecticut Legislative Commission on the Uninsured and has provided extensive legislative testimony on health care policy and legislation. She is an Assistant Clinical Professor in the Department of Community Medicine at the University of Connecticut Health Center. Adam Falk is a partner in the health law, non-profit and corporate law, and federal grants law practice groups. Mr. Falk assists health care providers, provider networks, and managed care organizations with regulatory, transactional, and compliance matters. In addition, Mr. Falk advises non-profit charitable organizations, trade, and professional associations on incorporation, tax-exemption, and antitrust matters. In his health care practice, Mr. Falk counsels publicly-funded health care entities such as community health centers, Medicare and Medicaid HMOs, and PACE organizations on contracting, regulatory compliance, fraud and abuse, and reimbursement matters. He provides specialized guidance on the complex interaction between federal programs created under the Public Health Service Act (e.g., Federally Qualified Health Center and 340B Drug Discount Programs) and the Medicare and Medicaid health insurance programs created under the Social Security Act. Prior to joining the law firm, Mr. Falk served as Program and Policy Counsel at the Alliance of Community Health Plans, a national association of non-profit and provider-owned health 5

6 plans. Mr. Falk began his legal career as a trial attorney in the Antitrust Division's Health Care Task Force at the U.S. Department of Justice. In that position, he led and participated in civil antitrust investigations and litigation of anticompetitive activity by physicians, health plans, and other entities. Cynthia Prorok Senior Consultant, Management Solutions Consulting Group HRSA Consultant Ms. Cynthia Prorok has 30 years of experience in providing financial management and executive leadership for governmental units and community based non-profit organizations. She is an expert in improving financial management and outcome measurement systems for health and human service organizations. Her special interests are in financial management, maintaining financial stability, financial recovery planning, rate setting and cost reimbursement systems, unit cost reporting, auditing, managed care, strategic planning, policy formulation, program evaluation, and outcomes based management. More specifically, she has a comprehensive understanding of financial accounting, cost accounting, and financial reporting systems, allowing her to properly assess financial conditions, to project the fiscal impact of policy decisions, and to maintain sound financial management practices. She has experience in designing streamlined fiscal operating policies, based on her knowledge of financial regulations and reporting requirements of numerous governmental programs. She has also conducted numerous evaluations of cost systems of public and private insurance systems, governmental programs, and other health and social services. In particular, she has worked with financially troubled community-based health and social service programs, resulting in financial turnarounds, improved financial stability, improved revenue management, and establishment of sound accounting and internal control systems. She has provided technical assistance and compliance review services for the Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration, Center for Disease Control, and Tri-Care Management Activity for Military Health. Her experience includes a variety of financial, administrative, and practice management services for the Bureau of Primary Health Care, Bureau of Clinician Recruitment and Service, HIV/ AIDS Bureau, Office of Quality and Data, and HRSA Office Performance Review (now Office of Regional Operations). She has worked closely with BPHC Officials and Community Health Centers, including new access points, experiencing financial instability, to identify underlying problems and develop financial recovery plans to stabilize operations and restore financial health. Presenter Bios Sherry Thomas brings over 30 years experience in the healthcare industry including office management, billing, collections, ICD-9-CM, CPT-4 and HCPCS coding. She has assisted in minor surgical office procedures as well as performed front desk, laboratory, x-ray and medical assistant duties. She developed, authored and teaches the Certified Coding Professional (CCP) curriculum, the certification exam and the study guide to the certification exam. She also provides one-on-one professional assistance to physicians and their staff for all specialties; related to ICD-9, CPT and HCPCS coding and documentation. Ms. Thomas has also been called upon to provide expert witness in legal matters related to Fraud and Abuse. E. Mark Watts, MD is a practicing Family Physician with the Carilion Clinic in Roanoke, VA with a strong interest in practice redesign. His Family Medicine office became the 1st NCQA Level 3 PCMH in the state of Virginia in Since that time, Carilion Clinic has expanded our medical homes to include 31 practices and 157 providers serving 220,000 p a t i e n t s i n s o u t h w e s t e r n V i r g i n i a. Dr. Watts has served as President of the Virginia Academy of Family Physicians, Medical Society of Virginia Foundation, Project Access of the Roanoke Valley and my local medical society. He has also served as director on the Medical Society of Virginia Board of Directors. On a national level, Dr. Watts serves on the AAFP Commission for Quality and Practice. Mary Beth Wright is currently a Patient/Family/Community Nurse Clinician at Kosair Children s Hospital in Louisville, Kentucky, and has worked as a nurse for over 25 years in a variety of roles, including tracheostomy clinician for Patient s and Family s and Chair of System Patient Education Matrix. She has taken care of critically ill infants and educated patients and families on a variety of health-related issues. She has also developed and implemented medical play sessions to decrease children s anxiety in preparation for medical procedures. Ms. Wright has developed and implemented policies, procedures, and plans of care for interdisciplinary patient and family education. She has also created educational programs on patient and family education for staff. Over the years, Ms. Wright, a graduate of Spalding University with a BSN degree, has won several awards, the latest being the 2010 KCH Nursing Achievement Award for Educational Achievement. She is also the Norton Healthcare Representative on the Kentucky Health Literacy Coalition Committee. 6

7 Marcie Zakheim is a partner at the law firm of Feldesman Tucker Leifer Fidell LLP, specializing in health care law, particularly in the areas of Federal grants and grant-related requirements for health care services (including Section 330 of the Public Health Service Act); health care provider networks and affiliations; non-profit corporation law, including governance; corporate compliance programs for health care providers; federal health care fraud and abuse law; and managed care contracting. Ms. Zakheim s work includes providing advice on governance, administration and operation of health care providers (in particular, community health centers) and provider consortia; reviewing, developing and providing advice regarding federal grant applications; review and analysis of, and drafting legislative proposals for, statutory and regulatory programs affecting the health care industry; and assisting providers and providerbased consortia in maintaining compliance with legal requirements. Ms. Zakheim s firm is counsel to the National Association of Community Health Centers and she provides technical assistance services and advice to health care providers and provider-based consortia, national and state associations and public agencies across the country. Ms. Zakheim also conducts training programs, presents seminars and webinars, and has written various issues briefs, information bulletins, advisories, manuals and articles on a wide array of health care-related issues. Ms. Zakheim earned her law degree from the George Washington University Law School and is a member of the District of Columbia Bar and the California Bar. Presenter Bios 7

8 Kentucky Primary Care Association 2011 Annual Meeting October 17th and 18th, 2011 Embassy Suites 1801 Newtown Pike Lexington, Kentucky Registration Fees: Payment Received KPCA Members Non-Members Before September 9th $350 (1 day $200) $400 (1 day $250) After September 9th $400 per person (1 day $225) $450 per person (1 day $275) KPCA Cancellation Policy: Notice of cancellation must be received in writing by the KPCA at least 5 business days prior to the event in order to be eligible for a refund. Send notices to saram@kypaca.net on or before October 10 th. Please send registration form and fees to: Kentucky Primary Care Association PO Box 751 Frankfort, KY Overnight Accommodations (not included in registration fees): Room Reservations are eligible for the KPCA group rate of $145 per night until September 9 th. Please call the Embassy Suites at EMBASSY and refer to the KPCA Annual Meeting. Questions? Please contact Sara McClain via , saram@kypca.net, or phone,