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H E A L T H C A R E F I N A N C I A L M A N A G E M E N T A S S O C I A T I O N S E R V I N G T H E K A N S A S C I T Y C H A P T E R

Programming .............................2

Webinars ....................................2

President’s Corner ......................3

New Board Members ..................7

ANI Conference...........................8

Officers and Directors.................9

Corporate Sponsors ....................9

Managed Care Forum ...............10

Healthcare 101.........................11

Region 8...................................12

Sponsor Spotlight .....................12

CHFP Ad ...................................13

MHA Update .............................14

High Deductible Plans...............15

New Members ..........................16

Women in Healthcare ...............17

CHFP Certification.....................18

HFMA Anniversaries..................19

heartbeat

Volume 67 | Issue 4Spring 2015

Every year B. E. Smith analyzes its surveys of more than 300 health-care executives, partners with AHA on a thorough environmental scanand reflects upon the most crucial trends expected to impact health-care leaders throughout 2015 and beyond. Some trends are prevailingfrom recent years, showing their long-run persistence. Others areemerging and gaining momentum. The following nine trends deservetop-of-mind attention in executive decision-making and strategicleadership throughout 2015.

Cost Savings vs. Quality CareDebate continues about whether, after years of attention to cost-cut-ting in all aspects of healthcare, a pivot to heavy concentration onquality is needed. Are the two demands at odds?

There is little abatement in aggressive cost cutbacks. As the AHA Environmental Scan notes: “Providers will be under tremendous pres-sure due to lowered reimbursement rates and increased patient volumes from health insurance exchanges and expanding Medicaidrolls. Some health systems are approaching the challenge by trying to

reduce costs by 20-30% overall.”1 The fundamental alteration of thehealthcare business model will continue to drive such reductions.

Yet care quality is equally demanded, and healthcare leaders recog-nize they must focus rigorously on both cost and quality, with the onlyway to bridge the two being devotion to value. This term is being defined as “delivering the best possible outcomes at a given level ofcost. We call this competing on outcomes.” 2 Such competitionmoves away from simply seeking the lowest cost or market pricingpower.

Increasing Volume, Variety and Complexityof AffiliationsOrganizations pursue the value equation within a changing and oftenunclear healthcare environment. The uncertainty is borne out by arecent B. E. Smith executive survey that revealed a split between the44% Confident or Very Confident in outlook for the year and the 47%who hold an Uncertain or Very Uncertain outlook. 3

Healthcare Trends 2015 By Doug Smith, MBA, MHAChristine Ricci, MBA, RN

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mark your calendarsNational WebinarsLive WebinarsApril 29 Moody's Not-for-Profit Healthcare

Industry Outlook and Credit Perspective

April 30 Current Trends in Healthcare Consumer Payments and Their Impact on Providers

May 11 Understanding HFMA's Newly Redesigned Certified Healthcare Financial Professional (CHFP) Program

May 12 Balancing Clinical and Financial Concerns: Insights on CMO-CFO Collaboration

May 13 Reigning in Labor Costs Using Predictive Analytics and Data Transparency

May 14 Fostering Provider-Payer Collaboration to Improve Chronic Care Management in Accountable Care Organizations

View all upcoming live webinars If you are interested in presenting a webinar, please contact Kurt Belisle at kbelisle@hfma.org.

View all upcoming on-demand webinarsHFMA provides webinars available one calendar year following the live webinar date and year. Most on-demand webinars are free for HFMA members and $99 for non-members, unless otherwise noted.

Go to http://www.hfma.org/Templates/OnDemandWebinars.aspx?id=6730 to view all available on-demand webinars with topics that include:- Accounting & Financial Reporting- Finance & Business Strategy- Payment, Reimbursement, & Managed Care- Revenue Cycle- Technology- And others

ATTENTION: OFFICERS, BOARD OF DIRECTORS, AND CHAIRS/CO-CHAIRS

JUNE 12, 2015Heart of America Leadership TrainingMark Your Calendars!!!

National WebinarsWebinars available for one year...HFMA provides webinars available one calendar year following the live webinar dateand year. Most on-demand webinars are free for HFMA members and $99 for non-members, unless otherwise noted.

Available until October 13, 2015Six Strategies to Keep Your Hospital Out of the Pricing Headlines

Available until December 2, 2015CFO Action Steps: Leading Practices for Revenue and Outcomes Reporting Improve-ment – Panel Discussion

Available until December 9, 2015Personalizing the Patient Experience: The Ultimate Objective of Population Health

Available until December 24, 2015Building the Right Infrastructure to Succeed in Higher-Risk Value-Based ContractsView all on-demand webinars

Heart of America Programming

– page 3 –

Jim Mozena, President

Dear Heart of America HFMA MembersWow, that was a quick four years as an HFMA officer! Cappingoff the experience over this past year as president has beengreat, and I would encourage others to take on the challenge. I will miss the opportunity to network with people from all overthe US and share the success stories of the Heart of AmericaChapter. With minimal ongoing HFMA responsibilities, I’vestarted to figure out how I will be spending some of my newfound free time. For starters, I’ve joined a softball team again…after a 20-year hiatus. It will be an interesting summer!

I’m happy to be able to report some successes and positivechanges to the chapter over the past year. First, the programswere modified during the year to feature different types of offer-ings, including a political update and the “Women in HealthcareLuncheon”. The website redesign received an overwhelminglypositive response.

The payment process was modified by utilizing PayPal to offer members and sponsors more flexibility in making payments.Modifications were also made to the registration and e-mailcommunication process. The chapter now uses Constant Contact, which gives us greater flexibility in registering and communicating with members. These improvements impactedthe chapter’s performance with a 66% overall high satisfactionrating, an increase of 3% from the prior year. The rating is basedon program topics, coverage of issues, the newsletter, network-ing opportunities, the website, and an overall rating.

I would like to recognize the continued support of our corporate sponsors. Their engagement through sponsorships and volun-teering allows us to provide quality educational and networkingopportunities for our membership.

Paul Knutson has been working diligently in planning the 2015-2016 year. He has a great team in place to lead our chapterthrough the next year. The team includes Michelle Narayan,President-Elect, Todd Kenney, Vice-President, Matt Robertson,Secretary, and Damara Harper, Treasurer. We have implementedmany changes to the chapter’s operations in the past year, andthese leaders will continue to make improvements over the coming years.

Thank you to our membership, board members, officers, and committeechairs who all contributed to making this a successful year for the Heartof America Chapter. Your continued support is appreciated and is crucialto the ongoing success of the chapter.

– page 4 –

Healthcare Trends 2015, cont.Healthcare leaders are responding with stepped-up pursuit of a widerange of alignments that include horizontal scale increases via hospitalmergers and acquisitions (M&A) and vertical integration of physicianpractices, ambulatory centers, post-acute providers and others. Someare undertaking even more transformative moves that may be harbin-gers of the future: Embracing risk-shifting by becoming payers as wellas providers. PricewaterhouseCoopers estimates that 50% of healthsystems have applied or intend to apply for an insurance license. 4

All of this realignment can create ever more complex organizations,which leaders must work to simplify. Noted management consultantAdrian Slywotzky has called healthcare delivery “hassle map heaven,”warning the industry to adapt and be truly customer-centric.

Migration of Care Outside the Hospital is AcceleratingA parallel movement to value and realignment is a shift to caregivingoutside the four walls of the hospital into various ambulatory entitiessuch as urgent care centers and stand-alone EDs, as well as greaterreliance on post- acute settings such as home care and long-termacute care providers. More surgeries are now performed outpatientthan inpatient, and hospital ownership of free- standing ambulatorycare centers has grown 27%.5 Brian Silverstein, M.D., of researchfirm Sg2, observes that the hospital profit base 10 years ago was 64%inpatient and 35% outpatient. “Today, that’s flipped,” he says. 6

Driven by the emerging population health movement, telemedicine isalso booming. Video consultations are projected to grow from 5.7 million in 2014 to 130 million by 2018.7 Geisinger has found that telemonitoring of patients “improved the efficiency of care managersand delivered a 3.3 times return on Geisinger’s investment.” 8

This migration does not represent simply tinkering with the care delivery model. It is a response to far more disruptive forces. Non-traditional healthcare clinics are growing due to accessibility andconvenience. Urgent care centers have become a $13 billion market9

and the rise of retail clinics in drugstores and other locations has beendramatic, doubling between 2012 and 2015. The recent rebranding of CVS to CVS Health sends a clear directional message from this self-described “new entrant.”

Healthcare Consumerism has ArrivedMost of the trends described are fueled by - and require - far moreactive consumer participation in the process than has traditionallybeen the case. While the rise of consumer power has been predictedfor many years, it now appears to be here in force. Newly insured individuals and the spread of high-deductible plans are driving morecustomer awareness of healthcare delivery options, further fueled bygreater market price transparency. 10

Additionally, aging “baby boomers” are healthier, better educated andmore accountable for their well-being. This important population willinsist on being involved in their own care and their patient rights.

Altarum confirms the trend: “Similar to prior years, this survey findsstrong evidence that consumers want a seat at the table in decisionsabout their health. Nine out of 10 consumers prefer to be in control ofmedical decisions, while 64% take steps to learn about their healthcondition instead of relying solely on the doctor for information.” 11

Population Health Driving Communities of ServiceBeyond the move to outpatient care, alignments and partnerships areextending to very non-traditional delivery settings such as soupkitchens, Red Cross facilities and non-governmental organizations.

These innovative approaches are being driven by the substantial inter-est in population health. They are motivated by the recognition thatstronger preventative medicine and wellness programs are neededand will succeed if they meet individuals at their locations and statesof readiness.

This emergent trend is creating true “communities of service” designed to keep patients out of the hospital and leverage post-

article continues on next page...

When you trust the advice you’re getting, you know your next move is the right

move. That’s what you can expect from McGladrey. That’s the power of being

understood. For more information, contact Karrie Pence at 816.751.1831.

Experience the power. Go to www.mcgladrey.com/healthcare

© 2014 McGladrey LLP. All Rights Reserved. MCG-1214KV

Power comes from being understood.®

– page 5 –

Healthcare Trends 2015, cont.acute care management. It is a model that optimizes what an observer described as the essence of population health: “Customizedcoordinated care.” 12

Changing Environment Creating New Leadership Competencies and CompensationLeadership is being heavily impacted by the altering landscape, creating new success requirements. A particularly notable trend isthat CEO turnover is on the rise, reaching its highest level in 2013:20%.13 Retirements, hospital M&A and the pressures of change are all contributing factors.

B. E. Smith’s research suggests the consequences of CEO turnovercan be far-reaching in many organizations. When asked which executives are likely to leave after a CEO departure and which initia-tives are most affected, respondents indicated below.14

Executive compensation is adapting to the new leadership realities aswell, albeit somewhat slowly. B. E. Smith continuously monitors thecompensation landscape. Over the past year, pay raises in the execu-tive suite ranged between 2% to 3%, with CEO increases slightlyhigher. Consensus forecasts average 2% for 2015.15

There is clear movement to alignment of compensation with the performance-based care model. Despite progress, though, 43% ofsurveyed executives say their organization has yet to match incentivesto key values such as cost containment, patient engagement and clinical outcomes.16 Such changes will accelerate in 2015 and beyond. Experimentation with compensation typical in other industries is also occurring. Examples include stay bonuses to promote project completion or complete merger transitions and flexible, metrics-based bonuses to motivate individual goals.

Organizations Focusing on SuccessionPlanning and Emerging LeadersGiven the C-level turnover and the urgency to promote the skills necessary to thrive, healthcare organizations are increasingly trainingtheir sights on two interrelated initiatives: Succession planning anddevelopment of emerging leaders. The former is overdue, as 64% ofexecutives still report no succession program in place.17 With at least40% of CEO hires resulting from internal promotion,18 the need for amore formal succession approach is desirable. Some hospitals areturning to outside advisors to help build customized programs.

Leadership development is about more than identifying the next-in-line. Strategic organizations are devoting attention to younger andemerging leaders, realizing the need to build a strong bench in the

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Healthcare Trends 2015, cont.face of an aging workforce and a younger generation that may neednew incentives to seek leadership roles.

Recommended education and emerging-talent development efforts include:• Executive coaching and one-on-one real-time mentoring• Leadership development programs tailored to an organization’s specific needs

• Regular competency assessment

Physician Leadership a Clear PriorityTwo data points are compelling when it comes to the role of physi-cians in the leadership equation. First, physicians continue at a rapidpace to become employees rather than independent practitioners.Forecasts suggest over 75% of physicians could be employed in hospitals and systems by 2020.19 Second, physicians are underrep-resented in senior leadership, representing just 14% of C-suite hires in a recent study. 20

This situation is changing rapidly as organizations seek closer integra-tion of the clinical and administrative. Doctors are being recruited fornew positions such as Vice President of Clinical Transformation or Informatics as well lending their voice as part of management dyadsor triads with other leaders.21 Roles span the operational, strategicand even cultural. As the AHA Environmental Scan observes, thephysician leader must drive a culture of accountability, commitment tocare excellence and continuous performance improvement. Determin-ing the right skill sets, identifying physicians with the best cultural fitand providing strong training are all becoming paramount.

Workforce Engagement Remains a Key Ingredient in Achieving QualityThe shift to value-based care is increasing the emphasis on patientsatisfaction and employee engagement at every level of the organiza-tion. Yet achieving such engagement continues to be very challenging.A recent B. E. Smith survey found executives completely divided:22

Given the attention to this topic over the years, one would expectgreater progress toward positive engagement, suggesting furtherprioritization needed. B. E. Smith frequently advises organizations onenhancing workforce engagement.

Recommendations include:• Foster a truly collaborative culture that sees individuals as partners who can bring ideas to the table.

• Promote the right competitive environment that motivates rather than stifles change.

• Gain leadership exposure to people outside healthcare for fresh perspectives.

• Be attentive and work hard to overcome cultural and social norms that inhibit engagement. For example, women comprise 80% of the healthcare workforce but only 18% of leadership.

The trends discussed here span a range of factors impacting institu-tional structures, competitive forces, patient demands, populationhealth and workforce development and engagement. Clearly 2015presents many challenges, but healthcare leaders should recognizethat successfully navigating the changes presents exceptional oppor-tunities to make significant progress towards transforming not onlytheir organizations, but the industry as a whole.

Doug Smith, MBA, MHA, has served aspresident and chief executive officer at B. E.Smith since 1996. A seasoned professionalwith more than 30 years of experience inhealthcare search and recruitment, Smithprovided leadership to B. E. Smith during aperiod in which the firm grew from two consultants to a staff of over 200.

Christine Ricci, MBA, RN, is chief communi-cations officer at B. E. Smith. Ricci is recognized for assessing market conditions,building strategy and brands and deliveringwith executional excellence.

For more information visit BESmith.com orcall 855.254.8261

1 “American Hospital Association Environmental Scan 2015,” Hospitals & Health Networks, September 2014.2 Boston Consulting Group, quoted in AHA Environmental Scan.3 B. E. Smith Executive Survey, September 2014.4 Gary Ahlquist, Minoo Javanmardian, Phil Lathrop, and Amika Porwal, “Several hundred health networks will

become payors,” Strategy&, June 20, 2014.5 Modern Healthcare, June 23, 2014. See also a study by Kaufman Hall finding that “inpatient utilization rates per

1,000 declined across all age groups, averaging a 5 percent across-the-board drop.” R. York, K. Kaufman, M. Grube, “Where have all the inpatients gone?” Health Blog, January 6th, 2014.

6 Kara Olson, “Outpatient Outlook,” HealthLeaders online magazine, 2014.7 Parks Associates forecast quoted in mHealthNews, August 26, 2014. 8 Christine Kern, “Telemonitoring Provides 3 to 1 ROI,” HealthIT Outcomes, Oct. 14, 2014.9 IBIS World Urgent Care Centers report, 2012.10 AHA Environmental Scan cites growth in percentage of workers with HDPs from 4% in 2006 to 20% in 2013.11 Altarum Institute, 2014 Survey of Consumer Health Care Opinions12 Jenkins and Neuwirth, Carolinas Health System, presentation at American Society for Healthcare Human

Resource Administrators (ASHRAA) convention, 2014. 13 ACHE data quoted in AHA Environmental Scan.14 B. E. Smith executive surveys, 201415 Charles Kim, quoted in Karen Wagner, “Core Competencies for a Changing Healthcare Environment,”

HFM Web August 01, 2014.16 B. E. Smith survey, 201417 B. E. Smith survey, 201418 “Who are you hiring for your C-suite?” Becker’s Hospital Review, August 25, 2014.19 AHA Environmental Scan20 “Who are you hiring for your C-suite?” Becker’s Hospital Review, August 25, 2014.21 Health Research & Educational Trust, Building a leadership team for the health care organization of the future,

April 2014.22 B. E. Smith survey, 2014

– page 7 –

To our newly elected board members: Sue BrammerMichelle DeckerDonna FindleyKalinda MarfisiTammy Shepard

Officers for the 2015-16 term are as follows:President Paul KnudtsonPresident-Elect Michelle NarayanVice President Todd KenneySecretary Matt RobertsonFounders/DCMS Contact Matt RobertsonTreasurer Damara Harper

Stay tuned! In the next issue, learn more about our new board members and officers, and how they plan toimpact the 2015-16 HFMA year.

Medical Claim Insurance Recoveryi I miaailCCllaalccaiddieed

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voccoeRecnarusnIm yrryeervve

2015-16 Officers from L to R: Damara Harper, Matt Robertson, Todd Kenney,Michelle Narayan, and Paul Knudtson

2015-17 Board Members from L to R: Donna Findley,Sue Brammer, Tammy Shepard, and Michelle Decker

– page 8 –

Connecting industry expertise with

customized solutions is how healthcare

systems and patients grow stronger. Matthew Michalak

816.292.4258

matthew.michalak@baml.com

baml.com/healthcare

The power of global connectionsTM

– page 9 –

PLATINUMBKD, LLPBank of America Merrill LynchHaase & LongHuman ArcMcGladrey LLPParrish Shaw

GOLDBank of Kansas CityCommerce Bank

SILVERCardon OutreachCountry Club BankMercer

2015 Corporate SponsorshipSincere appreciation is extended to our corporate sponsors for2014. Your support of our Chapter significantly improves our ability to offer quality programs to our members. Please considerjoining our fantastic group of sponsoring organizations.

If you are a service provider, please contact:Mea Austin 785-842-0726Mary Knollmeyer 913-791-3500 x 4018

2015 HEART OF AMERICA CHAPTER OFFICERSPresident Jim MozenaPresident-Elect Paul Knudtson

Vice President Michelle Narayan

Secretary Todd KenneyFounders/DCMS Todd Kenney

Treasurer Matt Robertson

BOARD OF DIRECTORS2013-2015Mea Austin Heath LeuckCathy Kindle Karrie PenceMary Knollmeyer

2014-2016Jessica Baird Esteban PonceDamara Harper Keely Roach

2015 PUBLICATION COMMITTEEJessica Baird, Co Chair 816-407-2041Cathy Kindle, Co Chair 816-691-2010Tammy Shepherd 913-945-5596Pablo Marquez 816-218-1699

Deadline for submission of articles for thenext newsletter is June 15, 2015.

Officers and Directors

Audit CommitteeKeeley Roach 816-474-4253 x21507

By-Laws CommitteeMary Knollmeyer, Chair 913-791-3500 x4018

Sponsorship CommitteeMea Austin, Co-Chair 785-842-0726Mary Knollmeyer, Co-Chair913-791-3500 x4018

Membership CommitteeTodd Kenney, Chair 816-701-0266

WebsiteMatt Michalak, Chair 817-308-7338

Fall Workshop CommitteePaul Knudtson, Chair 816-932-0336

Social Media/Networking CommitteeHeath Leuck, Co-Chair 816-347-2859Kalinda Tenborg, Co-Chair 913-234-6654

DirectoryRobert Fowle, Chair 913-319-6209

CertificationDamara Harper, Chair 816-781-7200

Publications CommitteeCathy Kindle, Co-Chair 816-691-2010Jessica Baird, Co-Chair 816-407-2041

Programs CommitteeMichelle Narayan, Co-Chair 913-791-4260

Nominating CommitteeAndrea Lindsay, Chair 816-502-7033

Link CommitteeFrankie Forbes, Chair 913-341-8600

Come join us!HFMA volunteers receive opportunities for professional development, information, networking, and advocacy and earn Founders points when theyparticipate in a chapter committee. The 2014-15 committee chairs and co-chairs are as follows:

– page 10 –

Managed Care Forum & UpdatesThe program held at North Kansas City Hospital on January 21st focused on the current state of Managed Care, as well as updates from localpayors. The half-day session included presentations by Mark Whiting, Principal of Employee Health and Benefits at Mercer and Bob Finuf, VicePresident of Payor Relations and PCN Executive Director at Children’s Mercy and Children’s Mercy Pediatric Care Network. Representatives fromBlue Cross and Blue Shield of Kansas City and Coventry Health Care of Kansas were also on hand to discuss payor updates.

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Mark Whiting presents “How We Got Here and Where We Are Going”.

Brenda Cook, Manager of Provider Services, Coventry Health Care of Kansas

Jason Spacek, Department Vice President, Channel Marketing, Blue Cross and Blue Shield of Kansas City

Bob Finuf discusses Children’s Mercy’s transition from volume to value.

The Healthcare 101 program was again a big success! Hosted by St. Joseph Medical Center in Kansas City, the all-day eventwas held on February 19 and included over 70 attendees. Topics of discussion were comprised of ACA impacts, patient finan-cial engagement, management of the EHR, productivity and labor management, Stark/Anti-Kickback concerns, and more. Localexperts presenting at the event included:

Cari Benshoof and Sean Callahan, HRS EraseDan Kutchel, CarePaymentMea Austin, Haase & LongMark Whiting, MercerMary Mirabelli, 2014-2015 HFMA National Secretary/TreasurerMark Hakim, ProAssuranceDavid Pursell and David Solberg, Husch BlackwellStephanie Dorwart, Altius Healthcare Consulting Group

Mea Austin defined next steps related to the 501(r) IRS Final Regulation

David Pursell and David Solberg presented Stark law and Anti-Kickback Hot Topics for 2015

Healthcare 101

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Tracy Packingham, Region 8 Executive

Your complete self-pay reimbursement solution, right here in Kansas City.

In 2014, we celebrated our 30th year of providing comprehensive solutions to address self-pay reimbursement challenges.

Experience: An extensive range of solutions including Medicaid anddisability program eligibility enrollment, screening and enrollment forsubsidized Marketplace insurance, out-of-state Medicaid billing andfollow-up, and denial management and appeals.

Compassion: A patient-first approach achieved through genuine caring, concern and respect for everyone we serve, optimizing theirhealth care experiences while improving your fiscal health.

Results: Improved access to health care and quality-of-life benefits delivered to over a million people each year, and billions in incrementalrevenue secured for clients nationwide.

Through a combination of technology and innovation, we can providethe solution you need to secure more revenue—from complete out-sourcing of self-pay patient account management to leading-edgesoftware that makes in-sourcing more accurate and efficient.

800.828.6453 or 816.363.8989Fax: 816.363.3535 | www.humanarc.com

Spring Sponsor Spotlight: Human Arc

Wow, it’s hard to believe this is my final Regional Executive message and another HFMA year is almost complete. I would like to take this opportu-nity to say “Thank You” to all of the Region 8 Presidents – Darren, Amy, Troy, Rita, Tim, Sarah, Jon, Becky and Jim. It has been a privilege to workwith and get to know all of you. It has been a phenomenal year to say the least. All the chapters in the region have met or exceeded goals andwill be presented with National Awards at ANI this year in Orlando. It takes a TEAM to make this happen and we have an amazing group of dedi-cated individuals. CONGRATULATIONS to each of you!

Stephanie Hultman and her TEAM have been working hard to bring yet another fantastic year in 2015/2016. Thank you Steph for all your supportthrough this year; the region is in very good hands with you and Bill Fenske. Thank you for the continued support of all of our officers, directors,volunteers and members. Our chapters are truly exceptional. Region 8 ROCKS!!! Get involved and make this next chapter year even better.

Thanks for the opportunity to serve as your Region 8 Regional Executive. This was truly a fabulous experience and look forward to working withthe new leadership.

Lastly, I would like to thank all of the chapter leaders who have made the Region 8 Mid America Summer Institutes a success. Don’t miss theconference this year, August 26-28 in Minneapolis, MN. Hope to see everyone there.

My telephone number is 314-570-3580 and my email address is tracyp@triageconsulting.com. I welcome your questions and comments at anytime!!!

– page 13 –

– page 14 –

Andrew B. Wheeler, Vice President of Federal Finance, Missouri Hospital Association

Why is the King v. Burwell Case Important to Missouri?Since the passage of the Affordable Care Act, opponents have workedto repeal and question its constitutionality. While the Supreme Courtof the United States previously ruled that the ACA may require nearlyall Americans to secure insurance, it ruled that states cannot be forcedto expand Medicaid eligibility standards to 138 percent of federalpoverty level. Since that time, 28 states and the District of Columbiahave increased the eligibility standards to meet the ACA requirement.To date, Missouri has yet to expand Medicaid eligibility, leaving morepopulation without insurance than those states who have expandedcoverage.

The ACA contains provisions to assist individuals without affordablecoverage through Medicaid eligibility expansion and through thehealth insurance marketplace. Since Medicaid eligibility has not beenexpanded in Missouri, the only other ACA option is to purchase insur-ance through the health insurance marketplace.

The Supreme Court is once again hearing a case which could havenegative implications for those in Missouri who are now coveredunder the marketplace. The challengers are arguing that the text ofthe ACA only allows tax credits to be provided in state facilitated marketplaces. If the challengers are successful, this will leave thosewho have enrolled in a federally facilitated marketplace without taxcredits, allowing them to purchase affordable insurance. Since Missouri is a federally facilitated marketplace state, the loss of taxcredits could result in many individuals forfeiting coverage.

What is known is that more than 253,000 individuals in Missouri haveenrolled in the marketplace. Of the enrollees, 88 percent are a receiv-ing tax credits averaging $3,408 per year. Without these tax credits,Missouri’s marketplace enrollees would see their average monthlypremium payment increase by 4.3 times their current payment. Theloss of these tax credits would force Missouri’s marketplace enrolleesto collectively incur a $761 million increase in premiums for 2015. Ifthe challengers succeed, all providers in the state of Missouri will seean increase in the patients who are uninsured.

All FFM MO AR IL IA KS NE OK TNStates

Percent Enrollee’s with Premium Assistance 87% 88% 88% 78% 85% 80% 88% 79% 82%

Average Yearly Premium $4,488 $4,440 $4,764 $4,116 $4,560 $3,684 $4,260 $3,624 $3,852

Average Yearly Tax Credit $3,216 $3,408 $3,444 $2,520 $3,156 $2,568 $2,940 $2,496 $2,532

Average Premium after Tax Credit $1,260 $1,032 $1,320 $1,596 $1,404 $1,128 $1,320 $1,140 $1,320

Percent Premium Reduction due to Tax Credit 71.7% 76.8% 72.3% 61.2% 69.2% 69.7% 69.0% 68.9% 65.7%

– page 15 –

As more consumers enroll in high-deductible health plans (HDHP),they must quickly become reasonably fluent in the language of healthinsurance and benefits. Patients who were previously covered underHMO, PPO, and POS plans were able to get by with a basic under-standing of a referral and primary care doctor. Now, these same consumers struggle to understand the difference between a copay,coinsurance, and deductible, let alone a basic idea of what their treatment will actually cost them. Hospitals can leverage this con-sumer education gap to their advantage through patient and physicianeducational outreach.

According to a PwC survey1, 67% of employers offered their employ-ees HDHPs in 2014, up from 62% in 2013. Additionally, 56% of employers are considering increasing employee contributions, and26% of employers selected HDHP as the plan with the largest enroll-ment, compared to 21% in 2013. Under these HDHPs, sometimes referred to as consumer-directed plans, patients typically must pay atleast the first $1,000 before their insurance company covers anytreatment. Oftentimes, patients do not fully grasp the importance ofselecting a plan fit for their lifestyle until they are faced with a largehealthcare bill.

By proactively educating consumers about HDHPs, health savings accounts, and price transparency, hospitals can help patients makebetter informed decisions, build goodwill with the community, andprovide entry to their organization for potential patients. These goalscan be reached through consumer outreach at events such as healthfairs, community gatherings, local non-profit organizations, and company meetings.

Most hospitals already support community outreach for wellnesschecks, cancer screenings, and vaccination drives at communityevents. Adding basic education about health insurance information tothese events can bolster success around the goal of overall wellness.For example, instead of encouraging patients to sign up for traditionalscreenings such as colonoscopies at these events, also provide themwith information on how to pay for such services. Send Patient Finan-cial Services specialists to meet with local religious groups or civic organizations such as Rotary International and the Junior League.Offer to speak about the changing dynamic of health insurance andprovide educational material to members that they can, in turn, sharewith others. As providers work to educate consumers, they should beprepared to address patient concerns about the reality of having aHDHP and paying higher out-of-pocket amounts for coinsurances and copayments, particularly with respect to middle-to-low incomeconsumers. According to a report published by The Commonwealth

Fund in November 2014, consumers are increasingly concerned aboutaffording their deductibles.2 Forty-three percent (43%) of privatelyinsured adults surveyed reported that their deductible was somewhat,very difficult, or impossible to afford. Of the group surveyed, 40%

even reported delaying/avoiding a doctor visit due to the unaffordabil-ity of their deductible.2 In allaying these concerns while providing education around basic health insurance information, these consumeroutreach events can be an excellent venue to spotlight any pricetransparency efforts your hospital has put into place. Encourage andempower your patients to manage their healthcare costs and direct them to your financial counselors.

By helping consumers understand their health benefits before theyneed them, your hospital will see many benefits. For one, these discussions are a key marketing opportunity for your organization. Insurance education outreach differentiates your hospital from thestandard community outreach, while still supporting the local commu-nity. Outreach also provides an opportunity to exhibit quality and favorable price metrics. Armed with basic knowledge of their healthplan, a consumer is more likely to not only understand, but to payhis/her bill in a timely fashion, or seek financial counseling prior toservice. As consumers adjust to the most recent major changes inhealth insurance, you and your patients can benefit by being ahead of the curve on revenue cycle patient education.

Take Advantage of Regular Enrollment PeriodsScheduling meetings during regular enrollment time could be particu-larly helpful to consumers who are making decisions about their future healthcare needs. If a large local employer has recently startedoffering a HDHP as an option, or has moved all employees to a HDHP,reach out to their Human Resources office and arrange a lunch-and-learn on how the plan impacts its consumers. Make sure that all representatives from your hospital have a solid understanding of insurance terms and are prepared to answer consumer questions. Inaddition, coaching patients and addressing their concerns withhigher deductibles, copayments and coinsurances will help themthrough this transition.

© 2014 PricewaterhouseCoopers LLP, a Delaware limited liability partnership. All rights reserved.

PwC refers to the U.S. member firm, and may sometimes refer to the PwC network.

Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details.

This content is for general information purposes only, and should not be used as a substitute for consultation with professional advisors.

1 http://www.pwc.com/en_US/us/hr-management/publications/assets/pwc-touchstone-survey-results-june-2014.pdf

2 Collins, S.R.; Rasmussen, P.W.; Doty, M.M.; Beutel, S. “Too High a Price: Out-of-PocketHealth Care Costs in the United States”. Tracking Trends in Health System Perform-ance. Commonwealth Fund pub. 1784 Vol. 29. November 2014. < http://www.com-monwealthfund.org/~/media/files/publications/issue-brief/2014/nov/1784_collins_too_high_a_price_out_of_pocket_tb_v2.pdf>

High-Deductible Plans: Consumer Education for SuccessfulReimbursement By Emily Anne Nolte and Stacey Lee

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Welcome New Members!Adrian Calderon, Sr Account ManagerSagacious ConsultantsWork Phone: (816) 914-7572Email: adriancalderon@ sagaciousconsultants.com

Lesley Delaney, Accounting ManagerHedrick Medical CenterWork Phone: (660) 214-8124Email: ldelaney@saint-lukes.org

Nevin FolinoCerner CorporationWork Phone: (816) 645-4714Email: nevin.folino@cerner.com

Jean Garten, PrincipalJG ConsultingWork Phone: (913) 884-6789Email: ejgarten@embarqmail.com

Sarah Howard, Sr Financial AnalystSaint Luke's Hospital of Kansas CityWork: (816) 932-1522Email: sehoward@saint-lukes.org

Tim Lambing, Senior AssociateMercerWork Phone: (816) 556-4808Email: timothy.lambing@mercer.com

Sharum Newberry, Treasury Sales AnalystBank of America Merrill LynchWork Phone: (816) 292-4233Email: sharum.newberry@baml.com

Venkata Rao, Dir of Staff Development & TrainingOsawatomie State HospitalWork Phone: (913) 755-7173Email: venrrao@outlook.com

Chris SandovalKansas City Pulmonology PracticeWork Phone: (816) 333-1919Email: chris.sandoval@hcahealthcare.com

Debora SummersDLS ConsultingWork Phone: (816) 305-4308Email: deborasummers@dlsconsulting.org

Augustin Sylvester, Associate AdministratorTruman Medical CentersWork Phone: (816) 404-6351Email: augustin.sylvester@tmcmed.org

Matthew Toyne, Operations Revenue Cycle MgrOptum RXWork Phone: (913) 217-3537Email: Mtoyne@hotmail.com

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Women in Healthcare

The Women in Healthcare Luncheon was held on March 26 at North Kansas City Hospital. Speakers included Sandy Brown with The Employer’sResource, Becky Fisk, Vice President, Revenue and Business Development at North Kansas City Hospital, and Joanne Burns, Senior Vice Presidentand Chief Strategy Officer at Cerner.

Sandy Brown discusses the importance of having fun at work.

Joanne Burns talks about her personal journey to becoming the Senior Vice President and Chief Strategy Officer for Cerner.

Attendees enjoy the lunch and learn program.

Women in Healthcare speakers Joanne Burns and Becky Fisk.

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Women in Healthcare Luncheon

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HFMA’s strategic vision characterizes the current healthcare businessenvironment as the transformation of care to achieve value. Providers,physicians, and payers are all confronted with new business chal-lenges. The nature of the business environment and its impact on industry stakeholders supply both the demand for and elements of anew approach to the CHFP.

New CHFP program features- A learning program designed to build comprehensive industry understanding and sharpen business skills;

- Two-module structure: 1) Achieving Strategy: the Business of Healthcare 2) Operational Excellence: Healthcare Industry Stakeholder’s Business Challenges;

- CHFP designation earned by successful completion of both modules;

- Online study materials created specifically to assist in mastering the business content.

Why is the certification program changing?The healthcare reform environment has caused the industry’s keystakeholders—providers, payers and physicians—to fundamentallyrethink existing business models. Care transformation is businesstransformation. The necessary success factor for finance professionalstoday: Change-oriented business acumen. The existing certificationprogram focuses narrowly on applied finance and financial reportingand does not address the business environment.

CHFP Program Important Dates:- April 30, 2015 - Current CHFP exam registration ends You may register for the current CHFP exam prior to April 30. You have one year from the date of registration to schedule your exam. For example; if you register in March 2015 you will have until March 2016 to schedule your exam. Also, if you need to retake the exam, the current exam will be available to you for as long as you need (based on current registration, scheduling, and retake policy).

- May 1, 2015 - New CHFP program pre-registration availablePre-registration allows interested members to email HFMA. HFMA will email members as soon as the link to purchase and more information about the new program is available.

- June, 2015 - New CHFP program registration available.

CHFP Program - Transition GroupsFor members who are currently pursuing certification and havebegun actively preparing for the exam, or have been through a chaptercertification webinar series or practicum study group, HFMA encour-ages continuing with the current process.

Current CHFP candidates can choose, at no additional cost, either tocontinue the traditional CHFP program or to wait until June 2015 to

pursue the revised certification. These options are open to those whohave: - Purchased the self-study course since January 2014, whether they have completed it or not.

- Registered and paid for the CHFP exam via Castle since February2014 (but not yet scheduled).

- Registered, paid for, and scheduled the CHFP exam via Castle since February 2014 (but not yet taken).

Note: Members who may have been unsuccessful and are waiting toretake the current CHFP examination are not eligible.

Candidates must choose one of these options by April 30, 2015 andnotify Career Services at careerservices@hfma.org. HFMA will provide the complete revised CHFP program (Modules 1 and 2) at nocost to all those who have purchased the CHFP self-study courseand/or registered for the exam, as outlined above.

For members interested in certification who have not yet begunpreparing, HFMA encourages that they wait and use the new materials available in summer 2015 to prepare for the new CHFP.

Questions? Please contact careerservices@hfma.org or call (800)252-4362 and ask for career services.

Changes to HFMA’s CHFP Certification Program

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5 YEARS 25 YEARSJamie Ackerman - Wisconsin Physician Services Terri Bradley - Western Missouri Medical CenterJessica Baird - Liberty Hospital Allen ClarkCathy Berube - Western Missouri Medical Center Janet Gordon - Saint Luke's Surgicenter/Nueterra HlthcareDwight Carvell - Heartland Regional Medical Ctr Cathy Kindle - North Kansas City HospitalKari Casady - St Francis Hospital And Health Services Terry Weathers - Sunflower State Health PlanMitchell Clark - Cerner CorporationMichelle Frederick - Esolutions, Inc. 30 PLUS YEARSRhonda Harrelson - Enterprise Bank & Trust Larry Todd - Netsmart TechnologiesScott Hendrickson - Allscripts Mary Knollmeyer - Olathe Medical CenterCynthia Hicks - Clinical Reference Laboratory, Inc. Jocelyn Skidmore - St. Francis Hospital & Health ServicesSteven Hunt - Love Funding Linda Cole - Country Club BankLinda Lemons - North Kansas City Hospital Michael Herrick - Catholic Health InitiativesKristine Marsh - Davita Healthcare Partners Kathy Janvrin - Carondelet HealthKarrie Pence - Mcgladrey LLP Joyce Keck - Carondelet HealthBrooke Runnion - Lockton Companies Carol Meyer - Saint Luke's Health SystemShanda Spire - Lafayette Regional Health Center Steve DohertyMichael Viazzoli - Bank of America Jerry Rutherford - Child Health Corp Of America

Dan Williams - Liberty Hospital10 YEARS Darrell Bieberly - Saint Luke's Health SystemJason Keibler - Coventry Health Care Of Kansas Ron Bremer - Bremer & Co., CPAJanet Mueller - Olathe Medical Center Larry Fogel - Fogel Consulting, LLCKelli Schroeder - North Kansas City Hospital Gordon Glass - Golden Valley Memorial HospitalJames Wilson - Health Outcomes Sciences Marie Nicholson

Frank Devocelle - Olathe Medical Center15 YEARS Larry CrozierCathryn Carter - Wyandot Inc. Kenneth Gross - RetiredJennifer Chrostowski - North Kansas City Hospital Tom Kennedy - RetiredKatie Guhr - Aetna Jim FranklinNatalie Lee - Centura Health Conrad Maygers

20 YearsConnie Cargin - KingswoodBen Ernst - Northwest Health Services, Inc.Teri James - Lafayette Regional Health CenterDavid Makkers - North Kansas City HospitalTammy Shepherd - University of Kansas Health SystemSandra Soerries - Medical Revenue Solutions, LLCJoe Stasi - Saint Lukes East Hospital

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