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Delta RHPI Project 2009 Conference Session Descriptions
Thursday, September 17, 2009
12:30pm – 1:00pm Accountability: Up and Down Rural Style! Mark Chustz, ABD, MSW, Administrator Southern University, Baton Rouge, Louisiana Nelson Mandela School of Public Policy
Healthcare executives walk a fine line between recklessness and courage. “Just hold them accountable and get rid of them if they don’t shape up.” Sounds great! Except, she is one of the only three nurses living in town and her brother is the mayor. He is a politically appointed board member with 20 years of board service and is planning to stay on your board until he is 90. He hates you and he is only 75. In this session, we will discuss the unique challenge administrators face in small town settings and review some strategies for survival.
1:15pm – 3:00pm Breakout Session I (Sessions #1 and #2)
1. From Customer Service Training to Leadership Development and Community Engagement: An On-going Process Improvement for Rural Hospitals
Engaging Local Assets to Build Market Share: Taking Customer Service Excellence and Community Engagement to a Powerful New Level Richard Manning, Chief Executive Officer, Montfort Jones Memorial Hospital, Kosciusko, Mississippi Charlotte Englund, Chief Executive Officer, The Solutions Group, Brookhaven, Mississippi
Customer Service Excellence has found its way to the forefront of a hospital’s business plan as a necessary tool for survival and growth. With the competitive nature of today’s market, hospitals can only compete to a certain extent, and survival (or growth) can be challenging, especially for rural hospitals. While there are many strategies that can be employed, Customer Service Excellence can be “The Difference Maker” in whether a person chooses one provider over another.
Customer Service Training through Leadership Development Wes Murray, Chief Executive Officer, Texas County Memorial Hospital, Houston, Missouri Steve Nyquist, Principal and Co-founder, Salient Health Ventures, Cullman, Alabama
Contagious and focused Customer Service is a hospital imperative. Motivating an entire organization to embrace this directive is more, though, than writing it into a Strategic Plan. Hospital executives, senior leaders and department directors play the most significant role in modeling, coaching and encouraging Customer Service attitudes and attributes. The Texas County Memorial Hospital story chronicles a shift in hospital culture that began with its commitment to equip and engage the Leadership Team.
2. Improving Quality by Transforming Processes into Strategy Planned Actions
A Holistic Approach to Quality Improvement Paula Lang, Chief Executive Officer, Patient’s Choice Medical Center, Belzoni, Mississippi Sally Harrison, Chief Executive Officer, Rural Health Strategies, Edwards, Mississippi
This session focuses on an example of building and implementing effective processes, and changing “this is how we have always done it” culture to improve quality and outcomes at one rural hospital. By targeting process improvement and changing culture, hospitals can improve quality and overall performance
The Role of Quality in Creating Long Term Strategic Success
Linda Deville, Chief Executive Officer, Bunkie General
Hospital, Bunkie, Louisiana
Hospitals that rely on traditional approaches to quality may not be strategically positioned to survive the era of intolerance that is emerging in today's healthcare environment. In this presentation, we will discuss one hospital's experience in making their quality program a critical piece of their strategic future
3:15pm – 5:00pm Breakout Session II (Sessions #3 and #4)
3. PPS Hospitals & Financial Performance Improvement
Key Issues in Revenue Cycle Efficiency Robert Schile, CPA, Principal, LarsonAllen LLP, Minneapolis, Minnesota
This session will focus in on the top reasons revenue cycles become inefficient, and ultimately extend the time of cash collections. In addition to the key reasons, attendees will receive practical management ideas to more effectively manage their revenue cycles, and will also hear some case studies.
Medicare Payment Challenges for PPS Hospitals: Transfer DRG, Medicare Bad Debts, & Medicare Disproportionate Share (DSH) Tommy Barnhart, CPA, Principal, Dixon Hughes PLLC, Winston Salem, North Carolina
The session will include information on the reduction in Medicare DRG payments created by the discharge to a post-acute care setting, and will explain how to identify the incorrect reductions to recover the amounts. There has been much confusion about the amount of unpaid Medicare deductibles and coinsurance that can be claimed on the cost report. The session will discuss the current interpretation of the bad debt rules. The amount of DSH payment a hospital receives is determined by a complex formula, and each hospital’s DSH percentage. One of the components in determining the hospital’s percentage is the amount of patient days for which Medicaid is the primary payor. The session will describe problems with identifying the number of Medicaid days and actions the hospital can take to get an accurate count.
Business Office Employee Productivity: Teaching Old and New Dogs New Tricks! Walter Edwards, CCHE, Founder, CEO, Medical Accounts Receivable Systems, Paducah, Kentucky
Seasoned Business Office (BO) staff bring much needed experience to your facility. Unfortunately, your veteran staff may very well be the biggest part of your revenue cycle management problem. Seasoned staff often operate "old school" and are highly reluctant to change. New hires in your business office are energetic and ready to learn but often times your veterans are doing the on the job training so the ingrained ideas of how to make things happen are passed on. Today's healthcare environment constantly demands more for less from all staff involved in the revenue cycle management process. In this session, you will learn 5 ways to: 1) motivate BO staff and maximum productivity, 2) receive "Best Facility" benchmarks for BO roles and assignments, 3) hear how "Quality and Quantity" of staff efforts impact your days outstanding, 4) laugh at 10 funniest reasons from BO staff as to why revenues are not flowing; 5) learn how to bring on new staff and make them productive from day one.
4. CAH & Financial Performance Improvement
Using Measures to Improve CAH Performance Eric Shell, MBA, CPA, Principal, Stroudwater Associates, Portland, Maine
This presentation will provide an overview of how performance measures are critical to driving improved accountability, ownership, and ultimately performance into rural hospitals. A number of case studies will be presented highlighting best practice rural hospital adoption of important measures leading to bottom line improvement in areas such as revenue cycle functions, emergency room operations, patient safety goals, and departmental accountability.
The Impact of Charge Description Master Coding on CAH Medicare Cost Report Settlement Greg Britt, CEO, J. Greg Britt, Consultant, Inc., Louisville, Kentucky
This session will focus on Charge Description Master Coding and the Medicare revenue cycle, and the presentation will include a brief explanation of Medicare cost report settlement fundamentals that frames an explanation of how Critical Access Hospital charge description master coding impacts properly matching revenue with the correct Medicare cost center. Specific examples of common problems and related compliance issues will be discussed.
CAH – It’s Time for a Reality Check! Cynthia Dupree, CPA, CCS, FHFMA, Partner, Draffin & Tucker, LLP, Albany, Georgia
It’s time to face the reality that many of the nation’s Critical Access Hospitals cannot survive much longer. Due to increasing unemployment and poverty, the depletion of cash reserves, and the inability to attract physicians and paying patients, the CAH’s financial position is dire. The Medicare and Medicaid programs were never designed to insure the financial survival of these hospitals. Only county support and supplemental funding have kept many of CAHs open. If the goal is to sustain the CAH, we must get the message out - the CAHs are in trouble!
Friday September 18, 2009
8:15am Improving Emergency Department Performance & It’s Affect on the Hospital Daryl Weaver, Chief Executive Officer King's Daughters Hospital, Yazoo City, Mississippi
This session will focus how to measure and track Emergency Department performance to improve both quality of services and the overall financial performance of the hospital.
9:15am – 11:00am Breakout Session III (Sessions #5 and #6)
5. Lean Thinking & Balance Scorecard: Putting Strategic Planning into Action for Continuous Improvement and on-going Strategy Focused Management
Lean Thinking & Value Stream Mapping at
Evergreen Medical Center
The objective of the Evergreen Lean Process Planning Project was to create a current and future state value stream maps for the Operating Room, Emergency Department, Radiology, and Registration (Direct Admit), and to address CMS documentation problems. The Evergreen team used lean thinking to standardize processes and identify ways to provide immediate, short-term and long-term solutions to relieve congestion in a major area of the hospital. Through lean process planning, the hospital improved patient flow, increased CMS measurement reporting compliance, reduced ED patient length of stay, reduced waits and delays within direct admit process, and more.
Building and Implementing a Balanced Scorecard & Strategy Map at Ripley County Memorial Hospital Bob Garrison, Chief Executive Officer, Ripley County Memorial Hospital, Doniphan, Missouri Scott Goodspeed, DHA, FACHE, Principal, Performance Management Institute, Portland, Maine
The Balanced Scorecard is a framework that helps hospitals translate strategy into operational objectives that drive both behavior and results. While the Balanced Scorecard was originally developed for business and industry, it has proven to be a valuable performance improvement tool for small rural hospitals that need to better communicate strategy; make strategy everyone’s job; create organizational alignment and positively move the performance needle. This session will highlight the Balanced Scorecard implementation process and the development of a strategy map at Ripley County Memorial Hospital.
6. Master Site Planning and Operations Assessment: Developing Future Opportunities and Improving Performance
Improving Operations through Physician Commitment and Targeted Care Management Barry S. Cochran, Chief Executive Officer, Fayette Medical Center, Fayette, Alabama Clinton MacKinney, MD, MS, Senior Consultant, Stroudwater Associates, Portland, Maine
This project identified obstacles to timely hospital discharge, and discovered opportunities for improvement strategies that affect both current and future operations. Discharge data was presented to the Medical Staff in a format that encouraged practice comparison. The goal was to improve the care management process, which in turn, further progresses hospital operations by improving clinical quality and efficiency, reducing opportunity for medical error, and increasing hospital financial stability by reducing ALOS. This presentation will highlight an operational assessment that concentrated on revitalizing physician commitment.
Preparing for the Future Opportunities through the Development of a Master Site Plan Michael Layfield, Chief Executive Officer, Drew Memorial Hospital, Monticello, Arkansas Joseph P. Pyatek, AIA NCARB, Pyatek Architect, LLC, Manchester, Missouri
A master site plan is a comprehensive guidance for future planning that supports the business plan, and should be part of the overall strategic plan. It should focus on physical plant structure and systems, and be flexible and adaptable to sustain the hospital for long-term planning. This session will discuss how to use master site planning as a strategic planning tool to prepare for future financial and operational opportunities, and to strengthen your competitive position.
11:15am Federal Legislative and Policy Impacts on Daily Hospital Management Brock Slabach, MPH, FACHE Senior
Vice-President for NRHA Member Services,
Kansas City, Former
Administrator, Field
Memorial
Community
Hospital,
This session is an overview of key factors from our national legislative and policy makers that are influencing the performance of Hospitals in the Mississippi Delta region of our country. Understanding the forces behind these factors will in turn assist Administrators in managing their facilities for success. From the management of Quality, HIT and reimbursement, the Federal impact will be covered.
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