Welcome to Financial Edge

Thank you for subscribing to Financial Edge, HIMSS’ financial systems eNewsletter—your source for the latest issues and emerging trends focused on financial systems and related technologies within healthcare delivery.

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Story ideas and other comments can be emailed to Nancy Vitucci, Manager, Publications.

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Vantage Point: Adoption of ICD-10 Code Sets

The HIMSS Vantage Point captures the opinion of healthcare IT professionals on the most relevant issues and hottest topics. In the past, Vantage Point has provided information about initiatives undertaken by the federal government, PHRs, patient safety and EHRs. Published the first Monday of the month, each 5-question survey is very narrowly focused on a current event or issue. This month’s Vantage Point measured healthcare IT professionals’ views on the adoption of ICD-10 Code Sets.

In August, the Department of Health and Human Services issued a proposed rule that would require healthcare providers to adopt ICD-10 Code Sets for electronic transactions by October 2011. Only one-quarter of respondents believe the industry will be able to meet this deadline. Half of respondents were concerned that either a lack of readiness on the part of the vendor community or by insurers/clearinghouses to accept ICD-10 claims will impact their ability to be ready on time.

Click here to take the November survey (the topic is quality of care, patient safety and IT) or read past Vantage Points. For more information, contact Jennifer Horowitz, senior director, research, HIMSS Analytics.

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HIMSS Seeks Volunteers for Two New Financial Systems Work Groups

HIMSS is looking for volunteers to participate in the new financial systems work groups:

• Financial Systems Revenue Cycle Management Ambulatory Work Group—This new work group, which launches Oct. 29, will leverage the Financial Systems Revenue Cycle Task Force White Paper Re-engineering the Revenue Cycle for the Emerging Medical Consumer, in developing a resource relevant to the ambulatory environment. Areas of focus for this work group include leveraging information technology with eligibility verification, denial process management, accounts receivable management and revenue cycle management. The deliverable of this work group will be an ambulatory addendum to the original white paper. The work group call will be the last Wednesday of each month at 11 am EST. The first call is Wednesday, Oct. 29.
• Financial Systems and Quality Joint Work Group—This collaborative work group between the financial systems and patient safety and quality content areas, launching this week, focuses around quality and price reporting. Efforts include an environmental scan of key quality/price reporting initiatives, identification of how healthcare IT is currently leveraged with these initiatives and review of future opportunities to leverage healthcare IT with these types of efforts. The results of this work group’s effort will be highlighted in a roundtable presentation at HIMSS09. This work group’s call will be the 2nd Thursday of each month at 1 pm EST.

Individuals interested in joining these work groups can contact Holly Gaebel, coordinator, healthcare information systems.

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HIMSS Virtual Conference Highlights Financial Systems Solutions

The fourth HIMSS Virtual Conference & Expo on Nov. 19-20 makes it easy for senior IT leaders, directors, analysts, project managers, clinicians and others to grow professionally; research technology solutions and connect with their peers online. Complimentary to qualified registrants,* the HIMSS Virtual Conference & Expo educational program includes opening and closing keynote sessions, education sessions around IT leadership, clinical informatics, ambulatory information systems and financial systems.

Led by industry thought leaders and designed to provide guidance to those connecting clinical and financial systems, the following HIMSS Virtual Conference sessions explore trends and changes in financial systems:

• New Drivers in Healthcare Revenue Cycle Management: What You Need to Know...Now!—Demands on financial management, new approaches in patient satisfaction, consumerism and quality issues have all impacted the healthcare revenue cycle. In direct response to these issues, Penn State University, School of Public Affairs, Assistant Professor Jill Rumberger’s presentation will focus on best practices, anticipated industry forces and technology trends that can keep pace with the changing needs in revenue cycle management.
• Stepping Stones in HIT Adoption: Leveraging Technology, Enhancing Revenue—Focused on how physician practices can leverage technology to maintain a positive revenue stream,this session by Laura D. Jantos, FHIMSS, principal, ECG Consultants, will share processes and technology solutions from practice leaders who have made it happen.

View the full educational program online.

But the education does not end there for attendees: At the HIMSS Virtual Conference & Expo, attendees can also gain product knowledge and connect with their peers. Attendees interact with speakers in live Q&A sessions after their presentations, as well as with peers and exhibitors in real time via threaded discussion boards in virtual lounges, like one hosted by the Management Engineering – Process Improvement Community, or by using the internal instant messenger and e-mail systems. The virtual exhibit hall brings together attendees and leading industry vendors to easily explore cutting-edge product solutions through video demonstrations, downloadable product brochures and documents, as well as live chat. Plus, if registrants miss part of the live event, they can access all education sessions, keynote speeches and exhibits on demand for 30 days after conference.

Register and learn more about HIMSS Virtual Conference & Expo online. Contact HIMSS Distance Education Manager Mary Beth Micucci with questions.

* Registration is complimentary to qualified registrants: Non-qualified individuals may attend for a nominal fee ($79 HIMSS Members/$99 non-members).

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Viewpoint: Risk Analysis—How Upgrading Systems Can Impact Revenue

When planning a system upgrade, providers must consider the impact on revenue and ensure vendors are on schedule with system updates. Conducting a risk analysis can ensure all systems are “talking” with one another.

We posed the question “If all the necessary steps for updating software and interfacing with adjudication systems and databases have not been explored and a “gameplan” outlined, how will this affect a provider’s revenue cycle?” to a few of our industry stakeholders. Here is what they are saying:

A poorly planned and executed conversion can have devastating effects throughout the revenue cycle—from patient access to charge capture to billing and collections. In the event of delayed implementation or unexpected problems, the hospital will struggle to deal with a ballooning A/R and negative public relations. If contingency plans are not created in advance for correct billing to third-party insurances and individual guarantors, cash posting, customer service, charity and bad debt placement, the negative impact on A/R could be felt for some time.

Part of any conversion strategy should also include a business office staffing assessment to ensure appropriate coverage and continued cash flow during training and implementation timelines. A program that begins 120-days to 90-days prior to a planned system change is most effective in driving down A/R balances. With the right program in place, the hospital’s overall revenue cycle performance should remain strong.

—Terry Armstrong, senior vice president, Perot Systems, Revenue Cycle Solutions

Given that most hospitals rely on credit for funding large-scale building and IT projects, and an increasing number are finding they are not immune to tightening credit, perhaps a better question should be “Is a system upgrade – and its associated risks and costs – the only way to enhance system performance?” With the availability of surround technologies that can tie together disparate information systems, some hospitals, such as the University of Maryland Medical System (UMMS) have opted for a more innovative, low-risk, low-cost approach to a “system upgrade.” Instead of investing years and multiple millions of dollars to standardize its four disparate patient accounting systems, four central business offices serving seven hospitals, UMMS implemented one new "surround technology" solution, rather than upgrading current systems. In one year and a fraction of the cost, executive management gained seamless data gathering and access to configurable, aggregated reports, plus workflow enhancements to improve management of accounts receivable.

—Jim Jacobs, Vice President of Sales Development, CareMedic Systems, Inc.

Looking ahead to the November Viewpoint, our topic will be:

The Impact of Adopting and Implementing ICD-10 and 5010 Code Sets

In August, HHS announced proposed regulations to replace the ICD-9-CM code sets now used to report healthcare diagnoses and procedures with greatly expanded ICD-10 code sets, effective October 1, 2011. In a separate proposed regulation, HHS has proposed adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as healthcare claims.  Click here for the full report on both proposed rules.

What do you anticipate to be the major area of impact in adopting and implementing ICD-10 and 5010 within your organization? Will your software vendors include these upgrades as part of their annual software upgrade, or will either one of these compliance efforts require expense above and beyond your anticipated support fees? Is all or part of these two efforts addressed within the “federal and state” clauses in your software contracts? 

Click here to submit a 150-word editorial outlining your perspectives on the impact of adopting and implementing ICD-10 and 5010 Code Sets. Submissions are due by close of business on Monday, Nov. 10th.

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Webinar Explores New Grants Advantage Program

Nov. 6, 1 pm EST

The grants management lifecycle can be a costly and time-consuming process. Not long after you sift through scores of potential funding resources, you are neck-deep in detailed submission processes and proposal writing. HIMSS understands the complexity of this process, which is why the Society has teamed up with the Grants Office LLC to offer HIMSS Grants Advantage, a comprehensive source of up-to date grants information, live grants support and a host of additional training and community-building opportunities, at a reasonable annual cost.

On Nov. 6, Edna Boone, senior director of healthcare information systems at HIMSS, and Grants Office CEO Michael Paddock, are hosting a free Webinar to  introduce HIMSS members to the service, the landscape of funding for healthcare and healthcare IT and useful tips for getting the most from your subscription.

HIMSS Grants Advantage also provides education, mentoring and collaboration that spans from identification to submission to receipt of award and to closure. Other features include an exclusive toll-free phone number for help-desk support; monthly Webinars featuring topics of interest and best practices among grantees in the industry; a moderated listserv to facilitate discussion among subscribers; a report suite of weekly updates; a quarterly e-newsletter; a SharePoint portal for additional collaboration; and a 30-percent-off discount for grants writing services. Further, subscribers may choose to participate in an annual meeting at the HIMSS Annual Conference for networking in person.

Learn more about the HIMSS Grants Advantage.

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Advocacy Updates

110th Congress Ends, Legislators Plan for 2009
Although Congress left town on Friday, Oct. 3, before passing prominent healthcare IT legislation (H.R. 6898, H.R. 6357, and S. 1693), they did pass a number of bills that supported the use of healthcare IT within the DoD and VA, rural areas and for the tracking of chronic diseases. Examples of legislation can be accessed at HIMSS News.

With the exception of committee hearings underway concerning the financial crisis, the U.S. House of Representatives will reconvene on January 3, 2009. The U.S. Senate could reconvene by November 17 for a lame duck session. During the lame duck session, committees are expected to convene and new senators will be trained on the rules of the Senate. As Members of Congress and their staff prepare for the 111th Congress, the industry can expect much planning and collaboration on healthcare IT legislation for next year.

For additional information or answers to specific healthcare IT legislation-related questions, contact Meredith Taylor, director of congressional relations.

Free Webinar: Post-Election Highlights & Implications for Healthcare IT Policy Changes in 2009

Nov. 12, 11 am - 12 pm CST

The outcomes of Nov. 4 elections are predicted to have a tremendous impact on everyone connected to the healthcare IT industry. Led by national experts and a former congressman, the Webinar will prepare attendees for the new presidential administration and 111th Congress, as well as provide insight to how healthcare IT policy changes will affect their communities, states and the nation as a whole. Register online.

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Tool/Resource of the Month: Medical Banking 101 Presentation

The Medical Banking 101 presentation facilitates learning about medical banking—how banking infrastructure and systems are being integrated with administrative operations to drive EDI-enabled workflow processes within healthcare delivery systems and how the medical banking market is poised to impact healthcare. This presentation, a collaboration with the 2008 – 2009 HIMSS Financial Systems Steering Committee and The Medical Banking Project, a HIMSS Affiliate member, was offered via a Webinar* last month.

*Special acknowledgment is extended to John Casillas, chair, Medical Banking Institute, executive director, Medical Banking Project, for his support and materials provided for this event.

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Final Reminder: HIMSS Calls for Award Nominations and Scholarship Applications Close Next Week

There is still time to submit nominations for HIMSS’ 2008 awards and applications for 2008 HIMSS scholarships; both calls close next week.

Award Nominations—Call Closes Oct. 30
The awards—presented in four categories: Industry, Service, Publications and Chapters—recognize the special contributions of individuals, groups and organizations to the advancement of the healthcare profession as encompassed by the Society’s mission. Submit nominations online. Contact Awards or call Member Services at 312-915-9202 for more information.

HIMSS Foundation Scholarships Applications—Call Closes Oct. 31
Young Professional Members studying healthcare information or management systems are recognized for academic excellence and future industry leadership potential with a cash award and an all-expense paid trip to HIMSS09 (some restrictions may apply). Scholarship applications are available online. For more information, contact HIMSS Member Services Coordinator Yvonne Horton.

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