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HFMA National Institute Offers Inspiration and Guidance

Published June 18, 2013 12:24 PM by Jill Hoffman

With the sun shining in Orlando, the 2013 Healthcare Financial Management Association (HFMA) National Institute (June 16-19) kicked off with inspirational messages from the association's last and current chair.

Ralph E. Lawson, FHFMA, CPA, 2012-2013 chair, HFMA, executive VP and CFO, Baptist Health South Florida, said now is a great time to work in healthcare despite the fact that there are greater challenges, changes and uncertainty than at any time in the recent past.

"I believe the people in this room will reform healthcare," Lawson said. "I don't think it's going to be done in Washington."

Taking the stage next, Steven P. Rose, FHFMA, CPA, 2013-2014 chair HFMA, CFO, Conway Regional Health System, urged healthcare finance professionals to employ a "whatever it takes" mindset: "I learned early on you can't just be worried about credits and debits."

He said a "whatever it takes" mindset means leading by example and inspiring others to follow. Something as simple as stopping to pick up a piece of paper on the floor of the hospital can show other colleagues and staff members of an executive's or manager's dedication to their organization. "This is not just a slogan for me," Rose said.

Hall of Fame Football Coach Joe Gibbs gave Monday's Keynote Address. The former head coach of the NFL Washington Redskins took the once-failing Redskins to four Super Bowls and three world championships. Later as leader of the Joe Gibbs Racing team, Gibbs won the Daytona 500 in his second year of racing and went on to win two Winston Cup Championships.

Wearing one of his Super Bowl rings during the talk, Gibbs drew parallels between coaching and managing employees, and said he looked at healthcare management professionals as coaches. "You pick people, put them on a team, ask them to sacrifice their individual goals for the goals of a team…We're team-building."

Gibbs offered several specific pieces of advice, including:

  • Define and measure your goals in the shortest timespan possible for your team.
  • Make sure you're handing out rewards. People will compete.
  • What is the most important asset in an organization? Your people.

    "If I pick the right 50 players, they're gonna make me look good," Gibbs said. "What's the hardest thing that you and I have to do? Pick people. How are you picking people? The resumee?"

    He challenged attendees to make sure they were considering the right factors when hiring employees. "What you and I need to do in picking people is to find people that care about what they're doing. They come early. They stay late."

    In a breakout session called "Improving Quality Data to Drive Financial Performance," Kari Conicelli, FHFMA, CPA, vice president and CFO, Sharp Grossmont Hospital, and Garri L. Garrison, RN, director, Consulting Services, 3M Health Information Systems, discussed the importance of getting clinicians and staff members on board with a Clinical Documentation Improvement (CDI) program through education on issues such as the way information is abstracted by coders and potential RAC problems, as well as better training on coding and new technology.  

    Grossmont, part of a Pioneer ACO and two other ACOs, utilized information from the Medicare Severity Index Comparisons from MEDPAR data to learn that $10.1 to $13.4 million of annual revenue could be recaptured, and that their mortality rate was much lower than the state average due to the way physicians were reporting information. The problem, not a quality of care issue, related to understating risk.

    "If you don't report the risk then your data's going to be inaccurate," Garrison said.

    A dedicated effort to improve documentation led to $3.6 million in new revenue for the hospital over three months.

    Later in the day, Paul Keckley, executive director, Deloitte Center for Health Solutions, spoke to a packed room of attendees on the effects of healthcare reform in the coming decade. "This system is a confederacy of self-interest, and what it has now faced is its own mortality," he said. After a number of sobering statistics relating to growing healthcare costs, he concluded that there will be a national referendum by 2020 about a single-payor system.

    Tuesday's Keynote Speaker Don Berwick, MD, former administrator, CMS, and founding CEO, Institute for Healthcare Improvement, discussed the ACA and its triple aim of better care, better health outcomes and lower costs, and gave evidence for why the law is needed. One statistic revealed that 2011 total U.S. healthcare waste cost $558 billion to $1,263 billion. Berwick discussed a variety of quality improvement systems, and listed several examples of health entities in the U.S. and internationally showing early success at improving care and outcomes, and reducing costs.

    "You can't say, ‘It can't be done,'" he told the audience. "It can…It is not a problem of possibility. It is a problem of will."

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