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HIMSS09 Education: Exploring How Finance and Healthcare Are Collaborating to Change the Way Business Is Done

At HIMSS09, April 4-8 in Chicago, the industry will gather to explore the changing healthcare finance market. The top thought-leaders in healthcare and finance will offer their perspectives on electronic payments, growing consumer involvement, the expanded role by financial institutions in healthcare and more during a week of cutting-edge education programs, including:

• Financial Systems Symposium: "Show Me the Money!" in Today's Environment, April 4, 8 am – 1pm
• Payer Symposium: Payer/Provider Collaboration - The New Health Information Partnership, April 4, 9 am – 5 pm
• Leveraging HIT in Achieving Price and Quality Reporting Roundtable, April 8, 9:45 - 10:45 am
• Business and Financial Systems Track, with sessions exploring how to refine your revenue cycle for superior results, enhance revenue through automated charge capture and marry banking and health IT to accelerate revenue cycle management.

Visit the HIMSS09 Web site for more details on education programs.

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HIMSS09 Registration/Housing/Travel

There is still time to register for HIMSS09. Registration is open now and remains open throughout conference. Standard registration rates apply through March 9; after that date, attendees registering pay late-registration/on-site rates. HIMSS09 registration includes entrance to keynote presentations, education sessions and the exhibit hall, Sunday, April 5, through Wednesday, April 8; the opening reception; CD-ROM conference proceedings; and a registration tote bag and kit (while supplies last).

On-site, self-service registration kiosks are also available for attendees to register for conference and optional events, as well as to print their badges and tickets. Attendees and exhibitors, who did not receive their registration packets in the mail, can also print their badges and tickets at self-service kiosks with a valid photo ID. Badges and tickets may only be printed once on-site. Changes to previously registered attendees cannot be made at the self-service kiosks on-site. A full-service, staffed registration area is available on-site for these changes. Prior to conference, attendees can return to the registration Web site to add additional events to their registration.

Air Travel and Hotels
The HIMSS09 Web site features air travel and hotel information. Hotels are filling up quickly, so make hotel reservations early through Ambassadors, HIMSS’ official housing and travel bureau. In addition to making reservations online, attendees can contact Ambassadors at 877-517-3038.

When registering and making air and hotel reservations, keep in mind the important schedule change for HIMSS09. Besides the switch to an April event, HIMSS09 kicks off on Saturday, April 4, with the pre-conference symposia and workshops. Keynotes, education sessions, the exhibition and the opening reception begin on Sunday, April 5.

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Save the Date: Revenue Cycle Management: Key Performance Metrics for Access Areas Webinar

Wednesday, February 25, 1 pm – 2:30 pm Eastern

Revenue cycle management is changing, and health systems are challenged to follow with effective changes in order to improve revenue cycle performance in this difficult economic time. This Webinar, open to all HIMSS Chapters and HIMSS Members interested in measuring the performance of their health system’s revenue cycle, offers a great opportunity to begin engaging with fellow HIMSS Members in this important dialogue.

During the Webinar, participants will:

• Identify scheduling, pre-registration, insurance verification, registration, and financial counseling performance measures needed to monitor revenue cycle systems in order to maximize efficiency.
• Learn how these front end performance measures can impact key metrics on the executive dashboard.

Guest Speakers:      

• Shari Bailey, SPHR, Vice President, Verité Healthcare Consulting, LLC—HIMSS Financial Systems Revenue Cycle Task Force Member
• Jill Rumberger, Assistant Professor, Penn State University—HIMSS Financial Systems Revenue Cycle Task Force Chair

Register here for this free event.

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Update on RAC: RAC Protest Resolved, CMS to Continue RAC Program Implementation

Earlier this month, CMS announced the protest of the award of Recovery Audit Contractor (RAC) contracts, filed by Viant, Inc., and PRG Schultz, USA, Inc., has been withdrawn and the permanent RAC program is once again underway. Viant and PRG’s protests were resolved February 4 and the stop work order was lifted. According to CMS, the Government Accountability Office (GAO) had 100 days to issue a decision after the unsuccessful bidders filed their protests on November 4, 2008. The GAO had been set to render a decision on the protests this month.

The RACs by jurisdiction are as follows:

• Region A: Diversified Collection Services
• Region B: CGI Technologies and Solutions
• Region C: Connolly Consulting, Inc.
• Region D: HealthDataInsights, Inc.

Additional details are available on CMS’ Web site.

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Leveraging Banking Core Competencies for Healthcare

By Nav Ranajee

If you asked a healthcare provider a few years ago what they thought of banks, the general reply would have been that banks manage my money or finance my operation. This limited view of banks has started to change over the past two years. Today, healthcare providers are starting to evaluate banks to provide services that dive deeper into their revenue cycle operations. Banks are recognizing the vast opportunity in healthcare and the value they can bring to the table starting with their lockbox service. The biggest drivers of this movement can be attributed to two factors: the large number of payments that flow through the system and the manual inefficient nature of healthcare. Healthcare generates over a billion payments per year. As a natural aggregator of payments, the opportunity to capture this payment stream is very attractive to banks. Banks have long been far ahead of the healthcare industry in terms of technology and automation so the conventional wisdom is to apply this experience and technology to automate the back end processes of healthcare organizations. As banks explore how they can streamline revenue cycle processes for their healthcare clients, the first natural place to begin is to leverage their lockbox and imaging capabilities.

Healthcare Industry

Healthcare generates approximately 3.4B claims and $1.1B payment transactions per year. The management of these transactions occurs in a process termed the revenue cycle. The revenue cycle encompasses all the activities that happen from the time the patient is scheduled for service to when the claim is submitted and then ultimately to the time when the provider is paid. A combination of factors has created a challenging environment for managing revenue cycle transactions, resulting in nearly 40% of every dollar spent on healthcare going to administrative expenses. Healthcare has evolved over the years into a heavy manual-processing environment standing on legacy mainframe systems that have difficulty integrating with one another. The lack of standards has also added to the inefficiencies in the system. Studies show on average the days in AR are approximately 62 days for hospitals, which contributes to cash flow issues. Another contributing factor is the communication between payers and providers that historically has been an adversarial one leading to denials and costly follow-up processes.

The bottom line is that the healthcare industry still shuffles paper and a lot of it. The industry recognizes this issue and as a result they are implementing initiatives such as the upgrading of patient accounting systems, adoption of standard transactions (HIPAA) and the outsourcing of services. Historically, healthcare budgets have been applied to the clinical side of the house but increasingly budgets are being re-allocated to the financial side of the organization.

Read the complete article.

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Doing More With Less—Five Things You Can Do with a Small Investment to Save Big

By Margaret Mayer

Tough economic times require smart solutions that help you manage shrinking resources and speed revenue even in the face of reduced budgets. Here are five common time consuming manual tasks that hospitals have automated by using "scripting technology", the development and implementation of software scripts that automate routine and repetitive manual tasks. These jobs are being performed faster and more accurately than before, helping hospitals streamline processes, work smarter and get the job done with a smaller staff and budget.

Posting Payment Adjustments:  Consider automatically downloading payment files from payers, posting them and generating related reports. You will save thousands of dollars in third party vendor fees or staffing costs. 

Payroll and Personnel Updates:  Tracking and applying individual employee deduction amounts and updating changes to payroll, benefits and personnel information can be quickly and accurately performed—saving eight hours a week or more.

Remittance Posting:  It is extremely time-consuming to implement 270/271, 276/277, 278 and 835 payment posting batch/real time transactions from external sources (payers, collection agencies, etc.) without the use of scripting technology. Automating these postings will save on resources and improve accuracy.

Pricing Updates:  If performed manually, these massive updates can take months of work and slow down billing and revenue. Automating price updates means that self pay accounts are properly billed and reimbursement forecasts are accurate.
 
Automate Transfer DRG Billing:  Medicare has over 250 Transfer Diagnosis Related Groups (DRGs) that result in patients transferring to secondary care facilities, and in Medicare paying for fewer days in the hospital. If a patient did not transfer, the hospital is allowed to re-bill Medicare for the previously withheld charges. Tracking and collecting these re-billable charges can be automated and can result in hundreds of thousands of dollars each year.

Powerful scripting tools act as robots to automate all sorts of time-consuming tasks. They can help you better allocate your valuable resources and accelerate or generate revenue.

Margaret Mayer directs Boston Software Systems' marketing activities, including market strategy, field and technical marketing, marketing communications and public relations. Prior to Boston Software Systems, she was with New Era of Networks, where she was responsible for all marketing communications initiatives as vice president of corporate marketing, and MicroScript Corporation, where she directed the marketing efforts of this healthcare integration products company.

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Vantage Point: Electronic Claims

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 electronic claims.

A tool was recently launched to measure the healthcare industry’s move from paper-based processes to electronic business applications. Called the US Healthcare Efficiency Index, this tool is intended to raise awareness about the cost savings that can be achieved by increasing adoption of electronic business processes. One third of respondents believed that the largest cost savings would come in the area of claims submission. Another quarter believed that cost savings would be achieved in the area of eligibility verification. Only two percent of respondents did not believe that savings could be achieved in one of the areas identified in this survey.

Click here to read to the full results and past Vantage Points. For more information, contact Jennifer Horowitz, senior director, research, HIMSS Analytics.

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Philip Bradley Named January 2009 Spirit of HIMSS Award Recipient

Philip Bradley, a member of the HIMSS Financial Systems Steering Committee, was named a recipient of the January 2009 Spirit of HIMSS Award, which recognizes members who exemplify the mission of HIMSS through their recent volunteer efforts within the society. Mr. Bradley, the vice president of information systems at Harris County Hospital District, led the planning and recruiting of speakers for the HIMSS Financial Systems ICD-10 Webinar on Dec. 3, 2008. His volunteer efforts in developing the presentation garnered record breaking attendance for a financial systems’ Webinar, with 354 participants. The presentation sparked much interest from attendees, and as a result, the formation of a new HIMSS work group is planned for over the next few months.
Mr. Bradley has also volunteered on the HIMSS Financial Systems Transactions Toolkit Task Force and is a member of the Microsoft Health Users Group and the South Central Texas HIMSS Chapter.

Nominations for the Spirit of HIMSS Award are submitted to the Membership Committee for consideration. Nominations should be submitted to HIMSS Member Services Program Manager Jessica Bird at jbird@himss.org, and should include a brief description explaining the accomplishments of the member and how he or she earns the recognition of the Spirit of HIMSS. Recipients will be selected and announced in the HIMSS Insider and HIMSS Weekly Insider.

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Advocacy Update—Health IT and Economic Stimulus

On Tuesday, February 17, 2009, President Obama is expected to sign into law the American Recovery and Reinvestment Act of 2009, H.R. 1. During the week of February 9, 2009, the House and Senate both passed the Conference Report to the legislation.

The legislation includes $787 billion for items such as unemployment benefits, job training, and transportation projects, including $19.2 billion for health IT:

• $2 billion for the Office of the National Coordinator for Health Information Technology (ONC); and
• $17.2 billion for incentives through the Medicare and Medicaid reimbursement systems to reward providers and eligible professionals that demonstrate a meaningful use of certified EHR technology.

The legislation also codifies the ONC and two federal advisory committees (the HIT Standards Committee and the HIT Policy Standards), and provides for grant and loan programs to assist providers and consumers in adopting and utilizing health IT. It also includes a number of privacy and security provisions that aim to strengthen privacy protections for electronic health information through activities that apply the security provisions and penalties as directed by HIPAA to business associates of covered entities and prohibit the sale of a patient’s medical information without the permission of the patient.

Additional funding for health IT is as follows:

• $4.7 billion for the National Telecommunications and Information Administration’s Broadband Technology Opportunities Program;
• $2.5 billion for the U.S. Department of Agriculture’s Distance Learning, Telemedicine, and Broadband Program;
• $1.5 billion for the community health centers through the Health Resources and Services Administration;
• $500 million for the Social Security Administration;
• $85 million for the Indian Health Service; and
• $50 million for the Veterans Benefits Administration.

Upon signature, HIMSS will make available online a detailed summary and analysis of the legislation, including the policy and industry ramifications. 
HIMSS Members can also learn more details about the legislation through an upcoming Webinar series. HIMSS will convene the first in a five-part Educational Webinar Series tomorrow, Wednesday, Feb. 18, at 3 pm EST. The series is complimentary for HIMSS Members. HIMSS President & CEO Steve Lieber will launch the series with a walk-through analysis of the Act, detailing the policy and industry ramifications of the legislation.

If you have any questions regarding the legislation of health IT policy, please contact the HIMSS Government Relations team at advocacy@himss.org.

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HIMSS Call for Committee Applications Open through March 6

HIMSS is currently seeking volunteers to serve on Steering Committees and Committees for Fiscal Year 2010. Applications can be submitted now through March 6. The application and a list and descriptions of steering committees and committees are available online.

Serving on a HIMSS Steering Committee or Committee is an excellent opportunity for professional development and networking. Committee participation is open to all individuals and corporate HIMSS members who are not serving in other leadership positions within the Society and have been a member for at least the past 12 consecutive months. Committee appointments, assigned by the HIMSS Chair-Elect with input from existing committee leadership, are for two years. Terms begin in June and end July 2011.

Members with questions regarding serving on a committee should contact Megan McGuirk, Member Services.

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New Book Examines PHRs’ Potential to Reduce Costs

A new book published by HIMSS argues that personal health record systems are critical tools in healthcare transformation, with the potential to improve care delivery efficiencies and reduce costs.

Personal Health Records: The Essential Missing Element in 21st Century Healthcare provides a comprehensive overview and discussion of the many issues pertaining to the adoption and use of PHRs, a rapidly evolving and essential area of healthcare IT.

“Throughout the book we have emphasized the need for health information to freely flow electronically to providers and other healthcare constituents that have been designated by the individual,” says co-author Holly Dara Miller, MD, MBA, FHIMSS. “The accessibility of accurate information will greatly reduce unnecessary duplication of tests decreasing both healthcare costs and patient discomfort. In order to achieve this, both data and interoperability health information technology standards are essential. Many health information technologists are working toward these goals.”

Surging costs has made healthcare reform an urgent priority in both government and healthcare sectors. Dr. Miller and her co-authors, William A. Yasnoff, MD, PhD, FACMI; and Howard A. Burde, Esquire, argue that PHRs can be an extremely useful tool to address costs, improve provider efficiency and promote healthy behavioral changes in consumers. For example, more employers are encouraging their employees to adopt healthy behaviors, and PHRs are an ideal tool to assist them in realizing their goals.

“It is time that we begin to align all healthcare constituents, including consumers, to achieve better healthcare outcomes and decrease healthcare costs,” says Dr. Miller. “Incentives and disincentives can be used not only to motivate appropriate care from providers, but also to promote healthy behavior, preventive care and medical regimen compliance from healthcare consumers. Providers and consumers need to forge a partnership to achieve these goals and PHRs can be used as a tool to support consumer compliance and enhance provider-patient communication.”

Read the full interview with Dr. Miller. You may purchase the book at the HIMSS Store or by calling 312-915-9295.

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Evolving To a Digital Platform Takes Center Stage at 7th National Medical Banking Institute

March 11 - 13, Nashville (Tenn.) Airport Marriott

Healthcare payment and remittance channels are evolving in lockstep with a call by the nation's leaders to adopt electronic healthcare records technology. Ironically, the same data bridges that are building out the administrative side may be adapted to move clinical data. As this occurs the medical banking story is turning...well... "green." The 7th National Medical Banking Institute, sponsored by The Medical Banking Project - a HIMSS Affiliate Member, will explore how cross-industry workflows between banking and healthcare are impacting how paper is moved out of the system (great for the environment), store data, who views it, how it is presented (great for the consumer) and how fast it moves among the stakeholders (great for commerce). For organizations looking to increase their "data velocity" for faster payments or better enterprise decisioning, the 2009 Institute is a must-attend. See how groups are teaming with banks that have richly capitalized and complex media platforms that are ready, fully secure and adaptable to multiple business requirements. Register today.

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