Officer’s Corner

By Hannah Lowe

While it still feels like the dead of winter as I sit writing this on yet another grey, cold, late February morning, in fact we are quickly speeding into spring, and with it, the end of HFMA’s educational year. Instead of gliding to the finish and calmly wrapping up the fi-nal presentations, writing speaker thank you notes and tallying survey results, the Mary-land Chapter’s Program Committee is hum-ming frenetically, pushing to execute and deliver timely topics of interest to a wide va-riety of audiences before summer vacations start taking our attention.

In reading the Chapter’s Monday morning email blast (sent from info@hfmamd.org so you can add it to your “safe” email list to avoid it getting spammed out), you have probably noticed that there is no lack of activity brew-ing here in Maryland. Just this week, the email advertises the LEAN process improve-ment roadshow, which is the first time that our Chapter has taken a topic and delivered the presentation three times: one each in Cen-tral, Western and Eastern parts of the State, as well as the Managed Care and Revenue Cycle Education Day (March 8), the CEO Breakfast Series (March 22) and the monthly free we-binar (March 7). Additionally, there is a save the date notice for the bi-annual “Exploring the Process of Healthcare” series (March 22).

Since by the time you read this, all those wonderful educational opportunities will have passed by, please allow me to shame-lessly plug some of the events you still have time to attend:

April 11&12 – Maryland will be sponsoring a joint program on Healthcare Reform with the Virginia/DC Chapter at the Gaylord National. An in-depth look at the different angles of and innovations driven by Healthcare Reform.

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Bay Linehesapeake

What’s Inside...Officer’s Corner 1

Leadership or Followership? One or Both? 2

Medicaid Expansion: Good or Bad? 3

Operations Requirements to EffectivelyManage Global Pricing Contracts 3

Beyond Medical Lockbox ProcessingTowards a Digital Revenue Cycle Solution 4

Panel Addresses Behavioral Health Reporting and Reimbursement ReformsFor Maryland Hospitals 6

Update on Certification Maintenance Requirements 7

Get to Know... 8

Provider Profile - Meritus Medical Center 9

Upcoming HFMA Maryland ChapterEducation Programs 10

KPMG Sponsorship Spotlight 11

Members Enjoy an Evening at Bin 604 12

MD Chapter Officers and Directors 13

Committees 15

Sponsors 16

CThe

By David P. CavellReprinted by permission from HFMA National

ALL SUCCESSFUL LEADERS NEED GOOD FOLLOWERS.

No matter how high a position we hold in an organization, we all are in a follower role to someone else. We need to be good, sup-portive followers for our leader to be suc-cessful.

I have been teaching a course in business leadership at Jackson Community College, Jackson, Mich. Three hours every Thursday night for 32 weeks (two semesters) accu-mulated to 96 hours of focused time on leadership. The education process included tests, research, discussion, presentations, and analysis on the subject of leadership. I have had the pleasure of working with em-ployed and enlightened students. Both of the class groups were large and especially eager to learn.

At the first class meeting of each semes-ter, I held an open discussion with the stu-dents to determine what they hope to gain from the class and learn about the subject. Special consideration is given to their cur-rent interests and immediate employment needs. The overwhelming response was that they desired to be good followers and to recognize the skills of great leaders. They felt that once they accomplished these goals, they could evolve into good leaders.I was pleased with the students’ approach to leadership training and adjusted the course material accordingly. They were smart, real-istic students. The primary emphasis of my classes is on students thinking and sharing their knowledge and thoughts. The goal is that the students retain for the long-term knowledge, tools, and ideals learned in class. One former student called me recent-ly to tell me about an experience in which she successfully used the knowledge and skills she learned in class to resolve a prob-lem. She used one of the quality decision tools she learned in a management class she took a few years ago to resolve a family problem related to distributing an estate. She was so successful in using the tool that she wanted to let me know. To an instruc-tor, that is better than a paycheck.

LESSONS LEARNEDWhen we addressed a big, theoretical is-sue such as leadership and followership in class, we did so with thought, research, analysis, and understanding. Some conclu-sions from teaching the class over the two

semesters highlight the important relationship between leadership and followership.

Desirable traits for successful leaders. Leaders have traits that make them leaders or improve the likelihood that they will become successful leaders. For example, former President Bill Clin-ton is a great communicator, and Bill Gates is a great visionary. The students reviewed the ac-complishments and leadership styles of many great leaders; studied text material, articles, and profiles; and completed projects that required them to interview local leaders. Then the stu-dents offered their perceptions of important leadership traits. They identified more than 30 diverse traits of leaders. No one trait stood out, indicating that we all perceive leadership dif-ferently and employ leadership skills according to our personal needs. To be a great leader, you need not only to be yourself, but also to identify your best leadership traits and make them stron-ger. For example, if you’re a good communicator, become a great communicator. If you’re good at setting goals, improve your skills at developing and sharing goals.

Desirable traits for successful followers. Although the students identified fewer traits for followers, they identified some standout desirable traits. Remember, being a good follower was the main class goal. The students identified 16 traits that are desirable for followers. Of the 16 traits, the one cited most frequently was supporting the leader’s decisions. The next most frequently men-tioned desirable trait was being a competent, dependable worker who can make suggestions. Because the students were interested in learn-ing how to be an excellent supporter to a good leader, we spent nearly as much time and effort on followership as we did on leadership.

Personal experience. The high value the students assigned to their personal experience with their leader was noteworthy. The students held per-sonal experience as highly important to judging leadership. Personal experience was important for them to relate to and understand the leader. They were looking for the personal touch, the personal impact.

Charisma. Charismatic leaders have a natural, in-tuitive gift for leading others. Charismatic lead-ers inspire people with their mere presence. Throughout history, just as we have recognized charismatic leaders who have had a positive impact, such as Franklin Roosevelt and Gandhi, we have seen those who have had a negative impact, such as Adolph Hitler, Jim Jones, and Charles Manson. Sheer personality, high energy, and passion drive charismatic leaders, but their ability to lead is determined by their followers. Charisma can be a gift or a threat. Society can benefit or suffer from their leader based on how

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Leadership or Followership? One or Both?

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By Lou Mazzulli, Jr., President, Hospital Support Services, Inc.

The answer, as in many questions, depends on who is doing the asking and who is receiving the benefits.

On December 10, 2010, Maryland’s Department of Health and Mental Hygiene (DHMH) and De-partment of Human Resources (DHR) jointly agreed upon issuing Action Transmittal #11-13 under the supposition that it would bring Maryland more in line with the Social Security Administration’s method of determining disabil-ity regarding persons applying for Social Secu-rity Disability Insurance (SSDI) and Supplemen-tal Security Income (SSI). While that may have been achieved, it turned out to be detrimental to healthcare providers and their patients, as the eligibility process wound up being slowed down even further, resulting in a lawsuit against the DHR on behalf of nearly 10,000 disabled adults (Baltimore Sun, Tuesday, January 28, 2013). We are currently operating under these regulations, and will likely continue to, until January 1, 2014, when the Affordable Care Act goes into full ef-fect in Maryland.

Under the next phase of Medicaid expan-sion, Maryland is mandated by the federal government to open Medicaid enrollment to adults between the ages of 21 and 65, who: 1) are not disabled, 2) are earning up to about $15,500 per year (approximately 138% of the Federal Poverty Guidelines), and 3) do not have more than $2,500 in sav-ings or checking accounts or other finan-cial instruments such as CD, 401K, etc.

This covers a lot of territory. Maryland Health Benefit Exchange, health-care navigators, will direct those earning more than the poverty guidelines to the various insurance programs available to them. (The Exchange will also be effective January 2014.) There is light at the end of the tunnel, but getting there is going to be an issue.

If you have questions how this might di-rectly affect your facility, please call or email Lou Mazzulli at 443-690-0075 or Lou@hssmd.com.

By Marty Brutscher

Trisha Frick RN, MS, Assistant Director of Managed Care Contracting and Marty Brutscher, McBee Associates Principal delivered a presentation at the March 8 Revenue Cycle meeting that focused on the contractual and operations requirements that hospitals must put in place to effectively managed bundled/global pricing contracts. Ms. Frick provided insight into Hopkins early entry into the bundled payment market and some of the challenges that were faced by the organiza-tion as they implemented these contracts. She discussed Hopkins more than 16 years of experi-ence and highlighted lessons they have learned as Hopkins has pursued this strategy.

Ms. Frick discussed how in the early stages the contracts they were negotiating were primar-ily in the cardiac service lines. She indicated in the early stages of Hopkins development of this service line, the hospital entered into these con-tracts to protect market share. Ms. Frick talked about how the service has evolved over time. The bundled arrangements have now matured to a point where 80% of the contract implementa-tion process is automated, approximately 50% of the bone marrow transplants are now in bundled arrangements, the Hospital is less risk averse and they are now exploring contracts that are direct-ly negotiated with employers for certain specific services.

Ms. Frick and Mr. Brutscher presented an overview of the key components of a bun-dled payment operations structure. Ms. Trick stressed the importance of having a strong physician as a leader of the clinical aspects of the operations. She indicated the physician leader can help address out-liers and other types of cases that can sig-nificantly impact high cost cases. She also discussed how more contracts, including the Medicare Bundling demonstration, are requiring significantly more quality report-ing and the importance of having a physi-cian assisting with those requirements.

Mr. Brutscher walked through the compo-nents that are key to managing the data re-quirements on a daily basis. He highlighted the importance of working with Patient Ac-cess and other parts of the operations to identify global patients at the time of ser-vice. He also talked about the importance of tightly defining how you will handle the payment of physician claims so as not to impact their participation in these types of contracts. He also discussed the impor-tance of setting up contract management capabilities in the systems that can handle multiple types of risk pools and withhold contracts and payment arrangements.

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Operations Requirements to Effectively Manage Global Pricing Contracts

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By Jay Brenner and Bruce NelsonMerkle Response Managment GroupHagerstown, MD

Medical billing has long been an issue for hospitals and other healthcare providers. The process is overly complex and requires a lot of paper work, filing and adjudication. Based on the type of insurance, or no insur-ance at all, certain procedures are allowed and others are not. There are partial pay-ments, credits and denials - which are typi-cally notated on an Explanation of Benefits (EOB) or the itemized bill. Since there are thousands of insurance carriers, the task of standardizing the transport and format of EOB’s and medical claims has proven to be problematic. In most cases Medicare, Medicaid, and Blue Cross/Blue Shield, as well as some of the larger carriers, transmit claims electronically through EDI. This ac-counts for approximately 75% of all claims processed. Much of the remaining 25% of claims are submitted in paper-based for-mat.

Healthcare organizations have dedicated staff for posting due to the vast differences in each payers specific EOB formats. The process is very tedious, error prone and the manual data keying is very time consum-ing. Due to these inconsistencies, studies show the U.S. heathcare system wastes up to 24 cents out of every dollar on adminis-trative and billing costs or in excess of $6 billion annually*.

As patient self pay and out-of-pocket healthcare spending continue to rise, and third party reimbursement trends promise to tighten margins even further, providers

must find more efficient ways of processing and reconciling paper-based and elecronic payments from both payers and patients with the original claims.

Problem for Medical Billers: Still Paper EOBs

Significant administrative costs and fees result from fragmented manual processes for posting and reconciling payments. The manual process-es behind a paper-based system, such as having employees key information off of paper docu-ments, is very inefficient and error-prone. Also, paper presents storage and retrieval challenges, forcing providers to research paper archives in order to manage their secondary claims. In addi-tion, without a central repository of data, provid-ers cannot properly analyze and research their payments, so they are not very effective at being able to handle their denial management.

Each payer has its own EOB formats and propri-etary claim-adjudication reason codes, which makes it difficult to post and reconcile payments. The sheer size of bulk paper remits presents its own challenges. Some facilities may recieve an EOB that could be as long as 300 pages, which takes several hours to post. There are also bal-ancing issues with paper remits. If you type $3.00 instead of $30.00, you have to check your whole batch to find the error. It’s near impossible to derive trends from managing paper documents because insurance companies have different re-mittance formats, limiting the ability to quickly identify potential problems with billing or ac-curate claims adjudication within a single payer or across service lines. Some payers may send checks directly to the bank and the paper remit-tance advice is processed or posted.

According to The McKinsey Quarterly, in about 60 percent of all claims payments, the payers print and mail checks to the providers, which manu-ally reconcile the claims and deposit the checks. The average system-wide cost per item is about $8. With an annual volume of 2.5 billion claims payments, the majority reimbursed by check, the system costs $15 billion to $20 billion a year in postage, item processing, and accounting. In-creasing the rate of electronic penetration to 90 percent, from the current 40 percent, would save $6 billion or more across the industry.

*According to the New England Journal of Medicine

“Productivity is about ensuring the right level of person is doing the right job in the right way, not

the total FTE count.

Technologies that facilitate process improvements to achieve

that goal are the key.”

HFMA’s Healthcare-Finance Outlook

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Beyond Medical Lockbox Processing Towards a Digital Revenue Cycle Solution

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Moving to a Digital Payment and Remittance Environment

Enhancing operations by enabling a transition from paper-based processes to digital payment and remittance processing has the potential to save providers as much as $35 billion and elimi-nate 2.5 billion pieces of paper annually by some estimates. By going digital, the challenge of handling the sheer size of paper payments and remits diminishes, along with the high error rate and high labor rates. Posting in a paper world is an all-day job for one person in comparison to posting digital forms that takes maybe an hour of someone’s time. Allowances on paper EOBs are not always accurate, nor is the amount of the patient’s responsibility. A digital environment provides the capability to more efficiently ad-dress these inaccuracies as well as track trends, which can help to identify overall billing prob-lems that can then be corrected.

The true benefits of a digital medical lockbox being able to balance the data by either index-ing the image and/or using the Electronic Remit-tance Advice (ERA) and Electronic Funds Transfer (EFT ) is not readily apparent to some providers. In fact, in a majority of instances where providers have taken the initiative to implement ERA and ERT in their billing life-cycle, they’ve realized numerous dividends they had not originally ac-counted for in their ROI calculation. There can be a 2-6 hours per day difference in processing time for a paper EOB versus an EDI Compliant 835 file (ERA). That being said, we must not forget that healthcare transactions in any form are far from perfect and so a mix of best practices and work-flow enhancement will enable a true end-to-end solution. The number of billing iterations for a single claim from primary claim submission to secondary claim payment can be numerous and each claim iteration, whether it is for denial, a request for medical records, or coordination of benefits information, multiplies the effect of the 2-to-6 hour per day improvement. Instead of waiting a few extra days to receive payment and remittance information, with an integrated electronic process you are able to balance, rec-oncile and re-associate all of your financial trans-actions with all of your healthcare claims by the next day.

Shift in Focus to Transaction Automation

The adoption rate towards digital automation must improve as the industry responds to costs

inherent in manual processing. Having ac-cess to EOB information in a digital and electronic format offers a faster, more ac-cruate method for processing the payment data that is integral to improving the pro-vider’s revenue cycle.

Medical Lockboxes play a vital role in the paper-to-electronic shift as they focus their attention on facilitating electronic transac-tions and cost reductions. Over the next several years, payers are expected to in-creasingly send e-remittances and e-pay-ments. Providers must have systems in place to ensure they have the ability to au-tomatically process and balance ERAs and patient payments for direct posting to their management systems.

Solution

There are many vendors that offer tools to address critical touch points in manag-ing healthcare payments and remittances. However, what is critical is the ability to weave together the processes, and most importantly, offer these tools through a single portal. These typically outsourced/partner based services allow providers to access data and solutions that make their business and lives run more efficiently with the elimination of waste and multiple touch points. What providers and others need is a way to connect those dots through an end-to-end solution capable of linking and managing every player and process in the medical claims and receivables process-ing transaction environment. This offers healthcare providers a clear and efficient pathway for integrated communications between payers, providers and other par-ties - regardless of their current data types, document formats and system capabilities.

Working directly with a lockbox partner that can provide a true medical lockbox, all elements of a healthcare transaction can be delivered in a single digital stream. Electronic remittances (835 files) are re-trieved from providers and clearinghouses; and as required, transform paper EOB’s to electronic 835 formats to enable truly pa-perless or “straight-through” processing. Key functions include a Single View pre-sentment of all EOB data, Denial and Ex-ception processing, Secondary Billing, rec-onciliation of payments and remittances,

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Towards a Digital Revenue Cycle Solution

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By Daniel Robbins, BRG

Effective July 1, 2013, the HSCRC reporting for a number of Psychiatric CPT codes will change, reimbursement has already en-countered significant reforms. On March 8, 2013, a panel consisting of Rachel Schaaf (Maryland Hospital Association), Lauren Rose (MedStar Health), and Marc Reiner (ValueOptions-Maryland), spoke to a num-ber of changes in psychiatric service codes and reporting, and how these reforms will potentially impact reimbursement for such services, as well as documentation for pur-poses of reimbursement from a clinical per-spective.

Mr. Reiner first spoke to specific changes between previous coding algorithms, the current model utilized to determine reim-bursement rates for clinicians, and poten-tial difficulties in transitioning towards the new coding and reporting design. Notably, the American Medical Association (AMA) will no longer utilize code 90862, phar-macologic management, for purposes of reimbursement. Rather, AMA has empha-sized specificity of the type of service, us-

ing evaluation and management (E & M) codes coupled with interactive complexity codes for purposes of reimbursement. Further, the revised model consists of two distinct categories, sepa-rating evaluation and management services from psychotherapy services. Clinicians will there-fore need to consider and record the amount of time spent within each of these categories while tracking the specific service type and case com-plexity.

Ms. Schaaf addressed how these changes will be considered from a regulatory perspective, updating the audience on a series of MHA task force meetings designed to understand the spe-cific layering of codes within the new algorithm, and ease the transition towards this new reim-bursement model. Ms. Rose joined Ms. Schaaf in speaking to certain ambiguities surrounding the transition towards the revised algorithm, and how psychiatric service reimbursement may dif-fer in regulated versus unregulated settings. At this point, however, nothing certain is known in terms of the financial impact of this transition. In the months leading to July, the Maryland Hospi-tal Association will continue to work alongside providers as more is understood regarding the specific implementation of the new algorithm.

Panel Addresses Behavioral Health Reporting and Reimbursement Reforms for Maryland Hospitals

Want to become a member or learn more about membership? Visit www.hfmamd.org or

contact Michelle Brandt at michelle.brandt@medstar.net.

and online at www.hfmamd.org

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Let Yourself Be Heard!

Attention all members, sponsors and friends of the HFMA Maryland Chapter.

Have something to say to the Maryland Chapter members?

Itching to share your thoughts with others?

Then write an article for the Chesapeake Bay Line.

Send your articles for consideration to Anne Hubbard, Newsletter Chair

at ahubbard@mhaonline.org

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Linker Mills, FHFMA

All of our certified members should have received an email in February outlining the new require-ments for certification maintenance as it per-tains to education hours. In short, the number of hours needed for certification maintenance over a three-year-period has decreased from 90 to 60 hours.

But with the drop in the number of hours need-ed, comes a tighter focus on the types of hours that are eligible for certification maintenance. All hours must relate to one of the following six functions: Revenue Cycle, Disbursement, Bud-geting/Forecasting, Internal Control, Financial Reporting, and Contract Management. These six areas match the six areas of the certification exam.

The good news is that if you have entered items that were previously counted, all those items attended or performed before January 1, 2013 still count toward your 60 total hours. Overall,

Update on Certification Maintenance Requirements

the same types of activities still count, but with a tighter focus on the six areas now eligible as education activities. The previ-ous requirement to have a minimum of 20 education hours per year is also no longer applicable.

Our certification committee will also be hosting a six session lunchtime webinar series starting on May 2nd for those who are interested in becoming certified. If your employer does not pay for the study guide or certification exam, your Mary-land HFMA chapter will reimburse you for them both once you become certified.

If you have any questions relating to the new requirements or reimbursement for your certification, please feel free to call me at 443-777-7949 or email me at linker.s.mills@medstar.net

Just Announced: Leadership Forum with Brian BillickApril �8: Sheppard Pratt Conference Center; �:�0 - 8:�0 pm EST

Faced with numerous financial, regulatory and clinical outcome challenges, today’s healthcare leader must possess the leadership skills to successfully and effectively manage. Join National Football League game analyst and former Baltimore Ravens head coach Brian Billick as he leads a discussion on leadership skills. In coach Billick’s words; “It ’s not about being a perfect leader. It ’s about being effective in the way you draw the best from yourself and your team.” Don’t miss this fun-filled evening and opportunity to learn

about crucial leadership skills. Registration details to follow shortly.

Get to Know... Beverly BlandV

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Interviewed by Jim Pisano, Asset Strategy Consultants

1. Where do you work? The Audit Group, Inc, Chesterfield, MO – On location at UMMS, Baltimore, MD. TAG is a leader in auditing large health systems around the country.

2. Why did you join HFMA? I wanted to increase my network of con-tacts in this region in my new position as Regional Director – Mid-Atlantic.

3. Have you joined a committee? I am currently on the membership commit-tee, working with Chuck Cronauer trying to increase membership in our chapter.

4. Are you going to work towards certifi-cation? Not at this time. The position I am in is new and demands quite a bit of time.

5. What do you want to get out of your HFMA experience? An opportunity to learn the needs of po-tential clients and develop tools and pro-cesses to meet those needs.

6. Who was the first member you met? The membership chair of the volunteer committee, Chuck Cronauer. He encour-aged me to get involved in a HFMA com-mittee.

7. Tell us about you… I am the Regional Director, Mid-Atlantic Opera-tions for The Audit Group. Our company audits large health systems across the country. We strive to strategically align our services with the goals and objectives of the Supply Chain management team. We work on special projects as well as re-covery auditing for the health system. TAG ar-rears of review include Pharmacy, Reference labs, Med/Surg contract pricing and Returned Goods. Our aim is to leave No Stone Unturned.

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Provider Profile - Meritus Medical Center

By Don Kohlhafer

Brief Overview of Meritus Medical Center

Meritus Medical Center opened its doors on De-cember 11, 2010. The new 272-bed community hospital is located on Medical Campus Road, just off of U.S. Route 40 in Hagerstown, MD. The new facility replaced Washington County Hospi-tal which was located on East Antietam Street in downtown Hagerstown. Ray Grahe, Chief Finan-cial Officer, recently commented, “The new hos-pital was the culmination of 33 months of con-struction and over five years of CON and permit hearings, design work, change orders and ongo-ing collaboration on the part of a planning team of approximately 300 individuals and more than 500 construction workers.”

Those teammates found themselves in regular meetings as they worked to design not only the hospital but its systems as well. Ray Grahe re-marks, “Our ongoing opportunity is to make cer-tain our new medical center and the surrounding campus, serve the needs of our staff and provid-ers in not only treating, but truly improving the health of our community.

Interview with Ray Grahe, CFO

1. As the CFO, what are the top issues that keep you up at night? A: This a time of significant change in our industry as we face uncertainty around fu-ture reimbursement levels. The Account-able Care Act, a potential new waiver test for Maryland, the sequester, and chang-ing levels of reimbursement for providers have brought new meaning to cost con-straint. These changes understandably raise some concerns among our senior leadership and physicians. We continue to operate under Total Patient Revenue (TPR) reimbursement methodology. Outside of

Maryland, some insurers and health systems are revising their contracts to decrease their inflation provisions. At this point, margins are our key focus and it becomes imperative that we continually reassess our care delivery systems to increase quality and lower costs. With projected reductions in re-imbursement, everyone is evaluating what cost cutting measures might be deployed. Many health systems, in-cluding ours, are evaluating the op-portunities available in alliances with

other health systems/hospitals in order to eliminate duplicative costs and maintain profitable operations. We have joined with other providers in the state of Maryland to project the financial impact of losing the Medicare waiver. We spend a lot of time evaluating how the health system can avoid readmissions, reduce length of stay, and negotiate more favorable terms with our

vendors. Compounding the problem is the difficultly demonstrating identi-fiable progress when every other com-petitor is evaluating each of these fac-tors at the same time. Like everyone else, I worry about cash, cash flow and access to capital dollars. ”Population health management” is the buzz word for the future; it is embedded in the Accountable Care Act; it is the focus of Patient Centered Medical Home initia-tives and it is believed by some to be the stabilizing agent to the significant increase in costs which will be gen-erated by the baby boomer genera-tion. But most importantly, population

health management needs to be the focus of care delivery in all of our institutions.

Right to Left: Carol Thomas, Melinda Cannon, Ray Grahe, Lee Shaver, Dale Bushey,

George Semko, Jake Dorst

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DATE TOPIC LOCATIONApril 11 & 12, 2013 Maryland & Virginia/DC

Spring Joint ConferenceGaylord Resort & Hotel,

National Harbor, MDApril 16, 2013 College Recruitment Day for

Local CollegesTowson University

April 26, 2013 Bill Mooney Education Series for new

HFMA Members

MHA

May 17, 2013 Legislative Update MHA

Certification Exam ReviewThursday 5/2/2013 Certification Exam Review -- Internal ControlsTuesday 5/7/2013 Certification Exam Review -- Contract ManagementThursday 5/9/2013 Certification Exam Review -- Budgeting / ForecastingTuesday 5/14/2013 Certification Exam Review -- Revenue CycleThursday 5/16/2013 Certification Exam Review -- Financial ReportingTuesday 5/21/2013 Certification Exam Review -- Disbursements

Check for updates on future programs on the Maryland Chapter Website, www.hfmamd.org.

Upcoming HFMA Maryland Chapter Education Programs

2. Can you talk a bit more about what it was like to oversee the construction of a replacement hospital? A: There was opposition to the replace-ment hospital initially and along the way. Ultimately the opposition turned out to be a small, albeit vocal, minority so we were able complete the project in spite of the conflicting opinions. We were challenged because the financing for the new build-ing closed just before the credit markets shut down in 2008. We also found ourselves dealing with a number of design changes and cost challenges based on the revised building codes. We even found ourselves initiating a whole new bid for certain prod-ucts, including steel, due to dramatic in-creases in commodity prices at that time. Gilbane Construction Company did a great job of reordering the project to address the hurdles that presented themselves. And the team here at the health system stayed the course and we all take great pride in the finished product.

3. What activities / committees have you or your team participated in as part of HFMA? A: With 33 years in the healthcare finance industry, I have held a number of

Provider Profile - Meritus Medical Center

positions with both HFMA and MHA. The major-ity of my committee involvement has been with MHA where I have served for many years on the finance committee and the various task forces. As an Advance Member and Fellow of HFMA, I have gained an appreciation for the value that HFMA brings to the membership.

4. Just how has being a part of HFMA helped you and your staff? A: I think HFMA has done an excellent job of pro-viding education for the membership. Together with the MHA, both organizations do a great job of keeping our team informed on the basic block-ing and tackling of hospital finance issues. The Maryland Chapter Annual Institute event each fall always proves to be a great source of infor-mation on an array of topics, as well as provides networking opportunities with peers and indus-try resources.

5. What would you like to see more of from the Maryland Chapter? A: The one area that I think HFMA could focus more attention is on population health. As I mentioned earlier, I truly believe this is where we can impact the cost of healthcare the most. It would be beneficial if this topic was elevated at both the Maryland Chapter and national levels.

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Don’t Miss...

April 11th & 12th: Maryland & Virginia/DC Spring Joint Conference

Gaylord Resort & Hotel; National Harbor, Maryland

Join us and our colleagues from the Northern Virginia/Washington D.C. Chapter of HFMA at the Gaylord Hotel as we discuss Consumer-Oriented Care and CMS Innovations on Population Health from local Community-Based Organizations. The conference includes numerous break-out sessions with CFO and CIO

panel discussions, as well as Regional and State Leaders providing the latest HFMA news. As always, there will be plently of opportunity to network with peers at this magnificent venue.

Vo

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ar 2013KPMG Sponsorship Spotlight

March 15, 2013

KPMG is proud to have a longstanding relation-ship with the Maryland Chapter of HFMA as a sponsor, partner and leader. KPMG is home to many Chapter members, including those serving in leadership positions across many committees, workgroups and educational seminars. The local office of KPMG has a rich tradition with the Mary-land Chapter, including members serving as past Chapter presidents (Bill Mooney and Mark Hig-don), a member serving as the current Chapter president (Mike Zito), and a member nominated to begin the officer track that will serve as a future Chapter president (Brett McCone). KPMG’s Advi-sory and Audit practices serve as trusted Advisors to Maryland Chapter provider members, with our relationships spanning multiple decades. Our lo-cal practice produces industry leaders, whether leading partners and professionals at KPMG, or professionals building their careers at KPMG and entering the market as financial and operational executives among healthcare providers and pay-ors.

Healthcare systems around world are facing un-precedented change. While healthcare is primar-ily organized within national geographies, the issues are truly global. Demographics, fiscal re-straint, new technologies and consumer expec-tations are creating significant challenges and opportunities.

Given these unprecedented challenges, leading a business requires insight and guidance from an adviser you trust. That is why leading companies turn to KPMG LLP’s Healthcare & Life Sciences practice. With more than 1,300 partners and pro-fessionals, we offer our clients a broad range of Audit, Tax, and Advisory services, grounded in deep industry experience, insight, and techni-cal skills. With deep industry experience, insight and technical support, KPMG firms are among

the leaders in delivering a broad range of audit, tax and advisory services to meet the unique needs of healthcare policy-makers, providers and payers. Our Advisory propo-sitions revolve around five core themes:

Care System Redesign: Working across regional health ecosystems to redesign patient pathways and shift the provision of care to more appropriate settings Strategy, Transactions and Financing: Ensuring value is delivered through mergers, acquisitions, divestments, joint ventures, shared services and out-sourcing arrangements Quality and Margin Improvement: Helping organizations to adopt best practice operational models, processes and cost management capabilities in order to enhance both service quality and value for money Health IT: Helping to leverage enabling technologies and enhance performance through systems selection, implemen-tation project management, controls assessments, business process im-provement, and change management services ‘Board Grip’: Helping to ensure Boards have the right skills, capabilities and in-formation to lead effectively, increase confidence in systems and processes, and improve data accuracy to stream-line the costs of regulation and compli-ance.

As a market leader in providing client based solutions, KPMG has, and always will, sup-port the Maryland Chapter of HFMA in its endeavors.

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Visit us online at

for upcoming events, industry news and more!

www.hfmamd.org

HFMA Members Enjoy an Evening out at Bin 604

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April 16 – Local hospitals, accounting and consulting firms will host a panel discussion at Towson University on healthcare careers aimed at interesting and recruiting graduat-ing college students.

April 26 – Maryland’s bi-annual “Bill Mooney Educational Series” will be held at MHA and will not only provide new healthcare profes-sionals with a basic understanding of health-care in Maryland, but will also explore some of the innovations and new ideas in the healthcare field.

April 26 – The morning will focus on physi-cian integration and the afternoon will focus on healthcare hot topics including an update on the modernization of the waiver.

As you may note, not all of these topics are geared toward every audience, and this tar-geted educational approach is something that the Maryland Chapter has improved upon year after year. If you are reading this news-letter, chances are you are already a member of HFMA, however some of these educational offerings are better suited for non-members. This is where we need your help!! We rely heavily on members to pass along great edu-cational opportunities to those non-members in their own organizations.

Mike Zito, Presidentmazito@kpmg.com, 410-949-8444

Chuck Zorn, President-Electczorn@mcbllc.com, 410-828-0534

Scott Furniss, Vice Presidentsfurniss@stagnes.org, 410-368-3130

Kelly Henneman, Secretarykhenneman@umm.edu, 410-328-1386

Hannah Lowe, Treasurerhlowe@mtb.com, 410-244-4836

Jennifer Maher, Past PresidentJennifer.m.maher@medstar.net, 410-772-6512

Traci La Valle, MHA LiaisonTla_valle@mhaonline.org, 410-379-6200

Joshua Campbell, Director (2011-2013)Joshua.campbell@medstar.net, 443-777-7356

Michael Myers, Director (2011-2013)mmyers@gbmc.org, 443-849-4328

Camille Bash, Director (2012-2014)cbash@dchweb.org, 240-460-6393

James Case, Director (2012-2014)jcase@kpmg.com, 410-949-8895

Charles Cronauer, Director (2012-2014)Ccronau1@jhmi.edu, 410-550-7185

Brian Sims, Associate Directorbsims@aahs.org, 443-481-5123

Maryland Chapter Officers & Directors2012 - 2013

Looking for interns or new hires? Think about attending the college recruit-ment event on April 16th. Already have new hires and need cost-effective ways to impart a basic un-derstanding of Maryland healthcare to them? Send them to the bi-annual “Bill Mooney Educational Series”, held each spring and fall (free for members). Want non-financial staff to learn how their work impacts the bottom line? Have them attend the bi-annual “Ex-ploring the Process of Healthcare” se-ries for a nominal fee.

Just as we’re charging ahead into spring, the field of healthcare is charg-ing ahead, always changing and always bringing new and exciting challenges. HFMA continues to be an excellent re-source in providing timely and relevant information and education. Addition-ally, if there are specific topics that in-terest you personally, I would encour-age you to reach out to the incoming Program Committee Chairperson, Kelly Henneman, so that they may be incor-porated into the coming year’s pro-gramming, whether through a seminar, workshop, webinar or road show. Happy learning!

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The presentation concluded with a number of questions from the audience. Their questions centered on the roles of the physician leader in addressing utilization issues, any concerns about reporting requirements with the Insurance Ad-ministration and data that is used to establish withhold and risk pool arrangements.

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charismatic leaders choose to use their special talents. Few healthcare leaders are born with the gift of charismatic leadership and seem destined to lead. Most learn to lead. Indeed, in health care, depending on charisma to help us lead is not realistic.WHAT’S YOUR LEADERSHIP/FOLLOWERSHIP IQ?

What are your leadership traits? What is your style of leadership? Are you a good follower to your leader? Do you provide the needed support to make your leader suc-cessful?

This article presents a lot of questions and not a long list of firm answers. You should be yourself and build on your strong traits. To be a good leader, recognize your strengths and improve them, but be sure to perceive what your followers want from you. To be a good follower, ask your leader what you can do to be more supportive. Your leader’s success means your success. David P. Cavell, CHFP, is business office di-rector, Chelsea Community Hospital, Chel-sea, Mich., and a member of HFMA’s Eastern Michigan Chapter (dcavell@cch.org).

Leadership or Followership? One or Both?

Beyond Medical Lockbox Processing Towards a Digital Revenue Cycle Solution

Operations Requirements to Effectively Manage

Global Pricing Contracts

and balancing and re-association of all of the financial transactions with the original healthcare claims.

The provider then has a process driven so-lution that will aid them with the recover of lost revenue, appeals and re-billing func-tions, and much more. Images are then indexed and keyed or the 835 file is auto-posted into providers’ billing systems. This architecture is flexible and allows for easy integration with multiple vendors. This cost effective transaction-based software-as-a-service (SaaS) eliminates the need for serv-ers and costly system maintenance while providing convenience, security and flex-ibility. This Web-driven approach can be reconfigured or scaled quickly and easily, allowing providers and other organizations to adapt readily changing care or business requirements.

Benefits of this integrated approach in-clude:

Conversion of EOB documents and images to HIPAA compliant 835 ERA transactionsA web-based document search and electronic archive tools allow you to search on any data field and imme-

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diately retrieve every matching transac-tion and associated imageTechnology for converting data to one single presentment format allowing pro-viders to post payments electronically re-gardless of IT platformInterfaces to Revenue Cycle Management, Billing Services or directly with Provider organizations to complete the transac-tion loop and tie critical data elements together for reconciliation and balancing of claim paymentGuaranteed turn-around-times and data quality SLA’sOne single data hub (portal) for access-ing and viewing status of transactions in processAn a la carte menu of services - Only use what is necessaryBuy versus build or acquire option saving time and money

“Good is the enemy of great” says the famous author Jim Collins and that is a key reason why so little becomes great. Heathcare providers can remain comfortable in the status quo or they can strive to achieve more - not by taking drastic measures or by blindly accepting risk, but by uti-lizing the proven tools that are available.

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The HFMA Maryland Chapter has many exciting committees that would welcome your participation. If you are interested, please contact one of the Committee Chairs below:

Committee Chairperson Email Address / Phone Number

Annual Institute Tim Brooks

Ellen Milles

timothy.brooks@baml.com410-547-4273milles@kennedykrieger.org443-923-1807

Certification Linker Mills linker.s.mills@medstar.net443-777-7949

Community Service Katie Wunderlich kwunderlich@mhaonline.org410-379-6200

Membership Michelle Brandt michelle.brandt@medstar.net410-933-3015

Newsletter Anne Hubbard ahubbard@mhaonline.org410-540-5081

Program (Chapter Education) Scott Furniss sfurniss@stagnes.org410-368-3130

Social Vanessa Smith vanessa.o.smith@baml.com410-547-4268

Sponsorship Craig Masters craig_masters@bshsi.org443-367-2206

Volunteers Chuck Cronauer ccronau1@jhmi.edu410-550-7185

Communications/Website Joshua Campbell joshua.campbell@medstar.net443-777-7356

Anne Hubbard(410) 540-5081ahubbard@mhaonline.org

George Bayless(443) 849-4311gbayless@gbmc.org

Joe Barndt(717) 756-2551jmbarndt@gmail.com

Michelle Brandt(410) 933-3015michelle.brandt@medstar.net

Tim Brooks(410) 547-4273timothy.brooks@baml.com

Michael Brozic(410) 949-8697mbrozic@kpmg.com

Nancy Creighton(410) 543-4759nancy.creighton@peninsula.org

Jeanette Cross(410) 660-9656jcross@brg-expert.com

Kathryn Crostic(410) 328-3864kcrostic@umm.edu

Dan Feeley(410) 933-2781daniel.m.feeley@medstar.net

Don Kohlhafer(410) 547-4278donald.kohlhafer@baml.com

Mitch Lomax(410) 368-2926mlomax@stagnes.org

Steven Luber(410) 659-3366steven.j.luber@us.pwc.com

Craig Masters(443) 367-2206craig_masters@bshsi.org

Scott Mitchell(410) 528-2013scott.mitchell@gt.com

Jim Pisano(410) 528-8282pisano@assetstrategy consul-tants.com

Newsletter Committee

Rachel Schaaf(410) 379-6200rschaaf@mhaonline.com

Brian Sims443-481-5123

bsims@aahs.org

Vanessa Smith(410) 547-4268vanessa.o.smith@baml.com

Liz Sweeney(212) 438-2102liz_sweeney@standardandpoors.com

Tom Trzcinski(410) 550-9645ttrzcin@jhmi.edu

HFMA Maryland Chapterc/o Laureen Nolker22 S. Greene St. - PP7Baltimore, MD 21201

Healthcare Financial Management Association

CThehesapeake Bay Line

Karen Weiss(301) 289-3598karen.weiss@windsorhce.com

Michael Wertz(410) 328-1723mwertz@umm.edu

Cathy Zito(410) 701-4439czito@lifebridgehealth.org

We are very grateful to our sponsors who help the HFMA Maryland Chapter provide high qual-ity education programs and events. If you would like to partner with us and join this group of business leaders please contact Craig Masters at 443-367-2206 or craig_masters@bshsi.org or visit our website at www.hfmamd.org to find out how. Thank you for your support.