Pinnacle Blog

HCCA is excited for the upcoming Compliance Institute and so is Pinnacle Healthcare Consulting and the Physician FMV Team!

Come visit us at booth 511 to learn more about our services and enter to win either a free Physician FMV License or the award winning Nook Color!

Conference Hotel

Caesars Palace

3570 Las Vegas Blvd

Las Vegas, NV 89109

Pinnacle Healthcare Consulting’s Services Include:

– Fair Market Value Assessment / Opinion

– Business Valuation / Transaction Support

– Physician Compensation Audit / Investigation

– Physician Practice Development & Management

– Physician Compensation Design

– Hospital / Physician Integration

– Billing & Coding Audits

– Market Research & Strategic Analysis

Get a Head Start on Compliance With our Fair Market Value Checklist & Risk Assessment for Physician Contracts Tool!

About The Physician Fair Market Value (FMV) Program

The Physician Fair Market Value (FMV) Program dramatically reduces the complexity of determining fair market value for physician compensation. It builds internal capacity and gives hospitals more control over the process by providing proprietary tools and powerful information to help make defensible decisions about physician relationships. Over 200 hospitals and healthcare organizations have found that the Physician Fair Market Value (FMV) Program empowers users to make smart and supportable decisions with regard to physician compensation and fair market value matters. The Physician Fair Market Value (FMV) Program’s key benefits include: Hospitals using the Physician Fair Market Value (FMV) Program immediately possess greater knowledge on which to base physician contracting decisions, the reliability of a proven physician fair market value analytical methodology and improved capacity to manage / document compensation and other contractual terms. Furthermore, Physician Fair Market Value (FMV) Program support includes: training, ongoing coaching, technical support and focused consulting (if necessary).

About Pinnacle Healthcare Consulting

Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations. Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support. Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services. Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

Contact Pinnacle Healthcare Consulting Today – 303.801.0123 orkberkey@pinnaclegrouphc.com

Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

Physician FMV Program – 2012 New Additions

With over 200 hospitals and health systems – and growing, the Physician FMV Program strives to create innovative and beneficial services for our licensed Program members. 

79 Physician Specialties & Growing

The Physician Fair Market Value Program pays close attention to our clients’ ever-growing needs for an expansive list of physician specialties. Physician specialties new this year include: Anatomic Pathology Specialty, Bariatric Surgery Specialty, Breast Surgery Specialty, Clinical Pathology Specialty, Hospice & Palliative Care Specialty, Nurse Practitioner (General) Specialty, Pediatric (Otolaryngology) Specialty, Surgical Podiatry Specialty and Thoracic Surgery Specialty. If your organization requires a specific physician specialty that is not currently listed, please contact a Physician FMV Program team member, who can help you find the information you need.

Showing 25th, 50th, 75th and Now 90th Percentile (online only)

The Physician FMV Program is a proven solution for supporting “in-the-box” arrangements. However, when faced with compensating highly productive physicians, contracting with Key Opinion Leaders, and working with extraordinary recruitment / retention challenges, hospitals / health systems may need to pay “above the Workbook Program” range to secure physician services. As reference, Physician FMV Online now provides 90th percentile reference information for employed physician compensation. Although Pinnacle’s third party FMV opinion does not extend beyond the 75th percentile, Physician FMV’s goal is to provide client members with flexibility through data-driven resources.

Blended Call Arrangement Estimator Tool

Physician FMV Online introduces our new Blended Call Arrangement Estimator. This tool is intended to assist hospitals with an estimate of reasonable daily compensation for blended call coverage arrangements (those arrangements that combine restricted / in-house call with unrestricted / beeper call). The calculation derived by this model proportionally combines FMV Hourly Compensation data for restricted time with the Unrestricted Call data for unrestricted time. The calculation provides a useful starting point  to evaluate FMV compensation for more complex call arrangements.

Compensation Per Work RVU

Physician compensation and benchmarking models continue to rely on productivity metrics, especially physician work relative value units (WRVUs). Contract negotiations, incentive plans and the success of physician compensation strategies often hinge on WRVU measurements. Payor mix issues can be mitigated through the utilization of WRVUs to balance individual physician production and declining unfavorable reimbursement levels. With survey sources now providing more robust compensation to WRVU data, the Physician FMV Program is making compensation to WRVU data by specialty available for reference.

We look forward to seeing you at the upcoming  Colorado HFMA – Annual Conference  

April 18-20th, 2012 

Be sure to stop by and visit Pinnacle Healthcare Consulting at our exhibit booth!

This year’s Annual Conference focuses on the changes taking place in healthcare. Speakers will address such issues as Leadership, Healthcare Reform, Revenue Cycle, and Accounting. Last but not least, an interactive Point/Counter Point discussion on Healthcare Reform from both political sides of the issue should generate some lively discussion.

Hotel Information:

Marriott Denver South at Park Meadows

Park Meadows Drive, Lone Tree, CO

Annual Conference Agenda

Wednesday April 18, 2012

Certification Coaching Course- Registration details on Program. This course is designed to help you in taking the HFMA Certification Exam as well as the self-study materials you need to purchase in advance of the course.

Thursday April 19, 2012

Keynote Presentation: “Challenges Facing Hospitals and Strategy that PVHS is Building to Ensure Success”

Speaker: Rulon Stacey PhD, FACHE, President and CEO, Poudre Valley Health System, Fort Collins, CO

Rulon Stacy has been CEO of Poudre Valley Health System since 1996 and has led the transformation of PVHS into a health system with more than 5,300 employees and a dozen facilities in three states. He has found ways to align incentives with regional providers in order to maximize value to patients, developed nearly 20 joint ventures which focus on quality outcomes and in the process quadrupled the net revenue and net assets of the health system. He will share how this has been accomplished along with the leadership skills he used to make it happen.

Rulon has received numerous awards including the Young Healthcare Executive of the Year from the American College of Healthcare Administrators (ACHE) and the 100 Most Influential People in Healthcare by Modern Healthcare. He served on the governing board of ACHE and was the 77th Chairman of their board. In 2008, PVHS was recognized by the President of the United States as the only health system in the United States to receive the Malcolm Baldrige National Quality Award.

You will want to hear his message on how he has led this organization to excellence and what you need to do to lead your organization in these challenging times.

General Session: “Creating an Exquisite Patient Revenue Cycle Experience Growing Your Bottom Line and Market Share”

Speaker: Bobette Gustafson, Founder, President and CEO, Gustafson & Associates, Nakomis, FL

HCAHPS along with the more sophisticated and demanding patient/consumer require that financial executives and revenue cycle professionals protect the lifetime revenue value of each patient served. But, a mere “patient-focused” approach is no longer enough. Quality clinical experiences must be enhanced by truly exceptional revenue cycle touch point outcomes – from pre-access through account closure. Therefore, the organizational culture and process, technology and people models must be fully transformed. An essential strategy of all other industries except healthcare… Customer Relationship Management (CRM)… is the key.

Attendees Will Be Able to:

 – Quantify the financial impact of the total patient experience and the lifetime revenue value of current and future volumes

•  – Define the critical revenue cycle patient touch points and their relationship to clinical touch points; more effectively and objectively assess patients’ current total revenue cycle satisfaction level and gain specific insight into their expectations that must be met or exceeded to ensure their unquestionable future loyalty

•  – Identify and eliminate avoidable revenue cycle processing costs; secure future patient lifetime revenues by crafting a CRM-based, patient-preference driven, and clinically integrated revenue cycle process, technology, and people model; and prepare for successful implementation by identifying and mitigating cultural and other organizational risks.

General Session: “PPACA from the Perspective of the Health Plan”

Speakers: Donna Lynne, DrPH, Group President, Kaiser Foundation and Kaiser Foundation Health Plan. President, Kaiser Foundation Health Plan, Denver, CO

   What have been impacts of PPACA to date?

•  – Age 26 dependents=more members

•  – Changes in preventive services=higher costs short term

•  – Lifting of annual and lifetime max=higher costs/premiums

•  – Medical Benefits Ratio (MBR)=more dollars devoted to benefits

•  – Medicare Five Star/P4P=more money to plans with high ratings, and more focus on quality and service

•  – HIT/payments for meaningful use=more money to plans, faster adoption of IT, improved quality and service and more affordability

   What challenges are ahead of us?

•  – Accountable Care Organizations (ACOs): will they save money, what unintended consequences are there?

•  – Health Exchanges: being ready for 2014/building capabilities

•  – Dealing with hundreds of thousands of newly insured in Colorado

     o Integrating safety net providers

     o Building a sustainable financial model

     o Educating new members about being good users of coverage

     o Making movement in and out of exchange and Medicaid seamless

•  – Payment reform

•  – Uncertainty about PPACA being upheld

 – How is Kaiser Permanente dealing with these challenges; what about other health plans?

General Session: Brian Fellner, Senior Vice President & CFO, American Enterprise Group, Des Moines, IA

“So you think the insurance company (payer) was fun to deal with prior to the Affordable Care Act (ACA)? What’s next????”

The regulatory and competitive landscape is changing rapidly for health care insurers. These changes will result in new product designs and new reimbursement strategies that will impact providers. Hear the inside story from a health insurance company perspective.

Presentation Takeaways:

1. Understand the impacts of health insurer consolidation

2. Review of contracting and reimbursement trends

3. Discuss health insurance product trends

Finance Track PFS Track

“Healthcare Market Update, Rating Agency Outlooks and Pricing Data”

Speaker: Will Douglas, Jr., Director, Wells Fargo Securities, Denver, CO

This session will review the current status of credit markets for various healthcare borrowers. Included will be a historical perspective on interest rate trends, rating agency viewpoints and concerns, general economic and healthcare specific statistics and outlooks for capital access. Participants will learn the current state of credit markets, future concerns that may affect the cost of capital and what can be done to best position their respective organizations in the event accessing capital is needed within the next year or two.

“Medicare Part A Updates and Overview Partners in Compliance”

Speaker: Steven Milward, Project Administrator, TrailBlazer Health Enterprises, LLC, Denison, TX

An overview of the 2012 Medicare Part A updates and changes will be provided along with an overview of Partners in Compliance that includes Recovery Audit Contractor (RAC) Program.

Panel Discussion: “How to use your collection agency as a resource and evaluating their performance”

Panelists: Ruth Benton, MBA, CEO, New West Physicians, Golden, CO, Larry Dupper, FHFMA, CFO, Valley View Hospital, Glenwood Springs, CO and Ron Feret, CHFP, CFO, HealthOne Clinic Services, Denver, CO

The panel will make some opening comments regarding issues they are facing as CFO’s in their organizations and then open it up for an interactive discussion between the panelists and attendees. from four collection agencies addressing the topic above and answering questions from attendees

Panel Facilitator: Tim Brainerd, CEO, Revenue Enterprises, LLC

Panelists:

· Mike Yont, Managing Principal, Integral Healthcare Solutions, Inc.

· Pilar Mank, Director of Revenue Cycle Services, Healthcare Management, LLC

· Jerry Peer, Vice President Collections, Professional Finance Company

· Terri Boettcher, Vice President Collections, BC Services, Inc.

Friday April 20, 2012

General Session –“Creating Bolder, Smarter Partnerships in Health Care”

Speaker: Bruce Schroffel, CEO, University of Colorado Hospital, Aurora, CO

Bruce Schroffel, newly appointed president of University of Colorado Health, will review the transitions the industry is going through and discuss in detail the rational that drove him to form a new partnership with Poudre Valley Health System. He’ll explain the long-term lease with Memorial Health System. He will also state why he thinks this new model of bringing together the best in academic medicine with the best in community will not only work, but thrive in a chaotic industry.

Point/Counter Point Presentation – “Healthcare Reform Act: The View from Two Political Perspectives”

Speakers: Jeanne Scott Matthews, Talking Head in Chief, Health- Politics.com, Gold Canyon, Arizona and Linda Gorman, Director, Healthcare Policy Center, Denver, CO

The two experts will provide their insights from the left and right of the political spectrum on the healthcare reform law. Each of them will give a presentation and then take questions from each other and the audience.

Closing General Session: “Professional Ethics: A Preventive Maintenance Approach”

Speaker: Chris Bauer, PhD, Ethics Expert and Grin Inducer, Bauer Ethics Seminars

This won’t be a review of the ethics code, case studies, or case law! Instead, it will be a unique program designed to help assure that you and your entire organization are able to more easily “walk the talk” of great ethics. This oftenhumorous program will show us ethics risks we never even knew we had and what can be done right now to make sure those risks don’t turn into costly ethical and legal problems on the job. You will also learn how even a slightly changed focus on ethics can significantly build your organization’s bottom line. Ethics and fun aren’t words you normally hear in the same sentence. However, Dr. Christopher Bauer has been making professional ethics both straightforward and fun for international audiences for more than 25 years. He will present ethics differently than you have probably ever experienced them before. The tone will be conversational and the ideas immediately applicable. You will leave with easy, practical ideas and tools to reduce your risk for ethics difficulties while simultaneously reducing the risk of your colleagues, coworkers and entire organizations.

About Pinnacle Healthcare Consulting

Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations. Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support. Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services. Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

Pinnacle Healthcare Consulting was excited to sponsor Fort Collins Area Chamber of Commerce yesterday at the Health Care in Your Future Summit. Over 280 people were in attendance to discuss developments in health care, the outlook for the health care industry in the Fort Collins region and actions that could strengthen the health care sector.

 If you missed yesterday’s event, presentations can be found online and will continue to be added at:  http://bit.ly/FCChamberHealthCare

Yesterday’s Agenda Included:

What’s the Problem with Health Care and How Did We Get Here? – Dr. Rulon Stacey, CEO of University of Colorado Health

Where You Stand on Health Care Reform Depends on Where You Sit: What Does All This Change Mean to Me?

        By David May, Fort Collins Area Chamber of Commerce President & CEO

        Yvonne Myers, Columbine Health Systems Director

        Jim Sampson, Flood & Peterson Benefits Executive

        Dr. Jim Sprowell, Associates in Family Medicine, Executive Director

        Kevin Unger, Poudre Valley Hospital President & CEO

        David Speights, Zila CEO, A Tolmar Company

This is Getting Old Fast: Aging in Northern Colorado – Elizabeth Garner, State of Colorado Demographer

       By Evan Hyatt, Pathways Hospice CEO

       Mike Maguire, Home Instead Senior Care Owner

       Yvonne Myers, Columbine Health Systems Director

All This Reform Stuff Sounds Expensive: Who Pays?

        By Dr. Jandel Allen-Davis, Kaiser Permanente, Vice President of Government and External Relations

        Janet Pogar, Anthem Blue Cross Blue Shield Vice President

        Cynthia Palmer, Colorado Choice Health Plans CEO

        Carl Smith, Poudre Valley Health System Vice President, Payor Relations

Money and Jobs: What Does All This Change Mean to the Economy of Northern Colorado? – Dr. Martin Shields, Colorado State University Regional Economist

UPCOMING EVENT!

Fort Collins Area Chamber of Commerce’s next major event is Celebrating Small Business day on March 25th – including a luncheon with a speaker, a spring showcase and an after hours.  Information can be found here: 

For additional comments or questions about Fort Collins Area Chamber of Commerce Events, Please contact:

         Ann Hutchison, CAE

        Executive Vice President

        Fort Collins Area Chamber of Commerce

        ahutchison@fcchamber.org

About Pinnacle Healthcare Consulting

Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations.  Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support.  Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services.  Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges. 

Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

Colorado’s New Health Benefit Exchange with Patty Fontneau

The Patient Protection and Affordable Care Act (PPACA) authorized states to set up health benefit exchanges to enable individuals and small businesses to purchase health insurance coverage by 2014. Colorado is leading the way in setting up this new marketplace, providing purchasers with quality choices, comparative information about plans and tax credits, consumer protections, and more control. Regardless of the outcomes of pending court cases challenging PPACA’s individual mandate, Colorado has chosen to move ahead with what could become a new national model. Patty Fontneau, the Executive Director and CEO of the new Colorado Health Benefit Exchange (COHBE), will be our featured speaker. This promises to be a “must attend” event!
When	March 9th, 2012 7:00 AM – 9:00 AM
Location	Doubletree Denver Tech Center – Indigo Room 7801 E. Orchard Road Greenwood Village, CO 80111-2508 Map This Location
Contact	Phone: 303-265-9224 Email: customer.service@chsm.org
Program Speaker Patty Fontneau, MBA, is Executive Director and CEO, Colorado Health Benefit Exchange (COHBE) Program Details Registration, Breakfast and Networking 7:00 a.m. – 7:45 a.m. Presentation 7:45 a.m. – 9:00 a.m. Pre Registration Register by March 2, 2012 to save $10. About Our Speaker Patty Fontneau, MBA, is Executive Director and CEO, Colorado Health Benefit Exchange (COHBE). Previously, Ms. Fontneau served as COO at Holme Roberts & Owen LLP. She also served as CAO for The IMA Financial Group Inc. and as VP and General Manager of the Western Service Center of TIAA-CREF, managing the operation of a 1,300-employee office in Denver. Patty serves on the boards of CollegeInvest, the Auraria Foundation, the Downtown Denver Partnership and other organizations. She won the 2007 Outstanding Women in Business Award (banking and finance category) from the Denver Business Journal, and the Leadership Award from the Alumni Association of the University of Colorado at Denver Business School.

Click Here to Register Now

About Pinnacle Healthcare Consulting

Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations.  Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support.  Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services.  Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges. 

Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

 

 

 Envisioning the Future of Healthcare

Where are we going and how do we get there?

With an aging and increasingly sick patient population triggering skyrocketing healthcare costs and changes to delivery and reimbursement systems, the future of the healthcare industry is as complicated as ever.
  
Please join Husch Blackwell, Pinnacle Healthcare Consulting and guest speaker Ford Koles, Executive Director of The Advisory Board Company, for a half-day seminar discussing strategies for mapping out a plan for your healthcare organization’s future. 

Date & Time  
Thursday, April 12, 2012
7:30 a.m. – Registration and continental breakfast
8 a.m. – Noon Program

Registration
The program is complimentary; however, registration is required. Please reply to Shana Hoy at 816.983.8809 by April 5, 2012.

Location 
Warwick Denver Hotel, 1776 Grant Street, Denver, CO 80203
 
| DIRECTIONS |  

About Husch Blackwell LLP

Husch Blackwell LLP is a full-service litigation and business law firm with 600 attorneys in locations across the United States and in London, serving clients with domestic and international operations.

http://www.huschblackwell.com/firm-overview/

About Pinnacle Healthcare Consulting

Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations.  Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support.  Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services.  Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges. 

Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

Join Pinnacle Helathcare Consulting at the Upcoming HFMA – Compliance Conference

Denver Marriott South at Park Meadows

Feb 23, 2012 – feb 24, 2012 – Denver, CO

Click here to register!

February 23rd Agenda:

Keynote Presentation: The Hunting of the Snark: Focus on Vision

Speaker: Ralph Lawson, FHFMA, CPA, Executive Vice President and Chief Financial Officer, Baptist Health South Florida, Coral Gables, FL

The United States consumes more healthcare than any other country in the world while individuals, governments and employers struggle to pay the bill. The U.S. recession has exacerbated the problem for providers and payers alike. With an industry wide focus on increasing quality and decreasing costs, providers must implement innovative value based strategies to survive and thrive in the “new normal” for U.S. healthcare. As the one year anniversary of the passage of historic healthcare reform legislation has come and gone, many believe that the healthcare financing system remains unsustainable as the “Snark” continues to elude capture or even definition.

In addition to providing an understanding of the current state of U.S. healthcare economics and insights into the inevitable changes that will be required over the coming years for providers to survive and prosper under reform, this presentation focuses on current and historical attempts in the healthcare industry to identify, increase, and communicate value to patients, providers, employers. As healthcare providers shift from volume based to value based strategies, key healthcare megatrends will also be identified. The presenter’s views on the “winners and losers” under the “new normal” will also be discussed, providing insights about what the future U.S. healthcare system may eventually look like.

So You Have An EHR… But Are You Operationally Ready for Meaningful Use?

Speakers: Thomas Felch, Manager, ECG Management Consultants, Arlington, VA and David Watson, MD, CMO, Physician Group, Centura Health, Englewood, CO

Now that you have an EHR, do you know who is responsible for what is documented in your patient’s chart? Can your nurse enter that medication? What about the surgery consent forms? How does information entered in the EHR affect your liability and ability to meet Meaningful Use requirements?

1. Who must assume ultimate responsibility for the  patient’s medical record in a multi-practice, integrated electronic health record?

2. How will P&P be set up to ensure people are collecting and inputting the clinical information needed to meet Meaningful Use criteria?

3. How are the CMO and others in a leadership position monitoring the timely completion of provider documentation while ensuring that the appropriate items are captured discretely in the electronic chart?

Collaboration Between Physicians and Hospitals

Speakers: Amy Kolczak, Associate General Counsel, Poudre Valley Health System, Fort Collins, CO and Wallis Stromberg, Of Counsel, Davis, Graham & Stubbs, LLP, Denver CO 

This interactive presentation will focus on compliance considerations for both physicians and hospitals/health systems related to several types of collaborative ventures and new federal rules prompted by accountable care organizations and other reform developments. Practical advice on avoiding pitfalls and achieving a level of integration that will lead to a successful physician-hospital relationship will be covered.

Presentation Take-a-ways:

1. Compliance considerations in forming physician-hospital relationships

2. Keys to successful collaboration between physicians and hospitals

3. How federal rules help or hinder collaborative efforts

 Continuous Government Audit Preparedness: Risk Based Compliance, Auditing and Outcomes –

Speakers: Christine Newgren, FHFMA, Chief Compliance Officer/Director Internal Audit, University of Colorado Hospital, Aurora, CO and Catherine Hicks. Compliance Manager, University of Colorado Hospital, Aurora, CO 

Just when you think you’ve done all the government  audit preparation you can, they change the game and add more issues.  This session will provide information on how to stay ahead of the game by developing a proactive, well-managed auditing program and response plan for government audits and auditors. A useful tool for identifying high risk areas and ideas for  audit-related communication, training/education and governance will be provided. Elements of the Federal Sentencing Guidelines for Compliance Programs will also be discussed. 

Program Take-a-ways:

• Tools for identifying high risk audit areas

• Comprehensive audit process

• Ideas for communications, training/education and governance

Sales and Use Tax Audits and Compliance Related Issues and Property Tax Applications and Appeals

Speakers: Ellen Stewart, FHFMA, JD, Partner, Berenbaum & Weinshienk, PC, Denver, CO and Christine Forkner, CFO, National Jewish Medical and Research Center, Denver, CO 

This session will cover the following:

• Recent sales and use tax audits conducted by the Colorado Department of Revenue and issues related to appeals.  

• Compliance aspect of sales and use tax as well as HIPAA concerns related to such audits.  

• Property tax exemptions, compliance with state law and opportunities for appeals for missed

deadlines along with an overview of the tax exempt property laws in Colorado.

Presentation Take-a-ways:

1. Understanding the scope of sales and use tax compliance

2. Understanding the scope of property tax exemption and appeal rights

3. Examples of an actual sales and use tax audit and appeal issues.

Identify Theft Panel

Panelists: Nima Williams, VP Corporate Responsibility, Centura Health, Denver, CO , Lynel Vallier, CCO Privacy Officer, Boulder Community Hospital, Boulder, CO and Gregg Fanselau, Compliance Officer and Manager, Managed Care, Platte Valley Medical Center, Brighton, CO

What would you do if an identity theft was perpetrated against some of your organization’s patients? Hear three compliance officers discuss how they addressed this nightmare.

Presentation Take-a-ways:

1. What other professionals have learned from experiencing a patient identity theft episode

2. Ways to reduce the risk of identity theft occurring

3. Ways to mitigate the damage of the identity theft episode

4. How identity theft cases work their way through the legal and regulatory system.

February 24^th Agenda:

What’s New with RAC, MAC and Medicaid Audits: Always Fun

Speaker: Day Egusquiza, President, AR Systems, Twin Falls, ID

 This operational focused session will provide national updates on government audits with audit findings and better practice ideas to reduce vulnerabilities.  

Presentation Take-a-ways:

1. Actual audit results and action oriented ideas to improve the process

2. Teaching ideas to attack the vulnerability

3. Practical concepts as they relate to audit focus areas 

ePHI in a Mobile World

Speaker: Stig Ravdal, Principal, Information Security Consultant, Allegheny Digital, Denver, CO

Does your organization permit tablet computers and Smartphone’s for business? Have you been considering how to harness the power of mobile apps? This talk looks at the issues and risks that follow when introducing mobile computing devices and apps in a complex, regulated healthcare organization. By examining the threats, weaknesses and issues with the use of mobile devices, you will learn how you can better prepare for and protect your organization and avoid the potentially severe consequences that can affect ePHI privacy and HIPAA compliance

Presentation Take-a-ways:

• Threats and vulnerabilities of mobile devices and apps.

•  ePHI and compliance risk implications.

•  Criteria for reducing the risk to ePHI when considering the use of mobile devices

Privacy and Security Scenarios: An Interactive Discussion

Speaker: Rich Cohan, MBA, FACHE, CHC, CCEP, System Director, Integrity, Compliance and Privacy.

Enterprise Risk Management Services, Providence Health & Services, Renton, WA

This will be an interactive session using several complex privacy case studies to determine what approach an organization might use in analyzing the facts when  all of the facts might not be known or might be a bit unclear.  How to respond to an incident will also be explored.

Presentation Take-a-ways:

• It looks like a breach…smells like a breach and we will understand what to do when we have an unconfirmable breach

• Responding to a breach in a way that promotes calm and increases support for a privacy program.

• Know how to analyze your duty to notify when in the obscure areas of HIPAA

About The Colorado Chapter of the Healthcare Financial Management Association

HFMA Colorado is a chapter of the Healthcare Financial Management Association (HFMA), which is the premiere professional membership organization for individuals engaged in the financial management of healthcare organizations. HFMA serves and represents members by:

• Providing professional development through education, information, certification, peer interaction, and leadership training.
• Influencing healthcare financial management and accounting policy decisions, principles, and practices through advocacy and dissemination of information.
• Establishing and promoting the highest standards of professional and ethical conduct.

To find out more about the Colorado HFMA Chapter, visit  Chapter Information area.

About Pinnacle Healthcare Consulting

Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations.  Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support.  Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services.  Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges. 

Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

Join Pinnacle Healthcare Consulting at the upcoming American Health Lawyers Association (AHLA) Physicians and Physician Organizations Law Institute and Hospitals and Health Systems Law Institute: February 8-10, 2012 at the Lowes Portofino Bay Hotel in Orlando, FL!

Physicians and Physician Organizations Law Institute

February 8-9, 2012
Loews Portofino Bay Hotel
Orlando, FL
HORNE LLP has provided sponsorship in support of this program.

Program Description

Sessions at the Physicians Law Institute will provide a focused analysis of the legal challenges faced by physicians and their counsel. Some of the topics on this year’s program include:

• Physician-Hospital Syndication Unwind Exploratory – A Primer on the Gross Anatomy of a Complicated Surgery
• Current Antitrust Issues Relating to Physician Mergers, Acquisitions and Combinations
• Special Real Estate Issues for Practice Management Real Estate Tenant and Landlord
• The Latest and Greatest about ACOs and Other Physician Integration Models
• Hospital Physician Affiliations – The Good, The Bad and The Ugly
• The Perils and Pitfalls of Careful Drafting: How Stark has Changed the Risk Calculus
• HIPAA Breach Notification – Case Studies on What to Do and When to Report

The program will also include the Top Legal Developments for Hospitals and Physicians with Jack Schroder and Cindy Wisner.

Attendees can register for just one of the programs or add-on the Hospitals and Health Systems Law Institute and attend three days of programming (February 8-10). The Physicians and Hospitals Law Institutes provide in-house and outside counsel with the latest information needed to advise clients in these two segments of the healthcare industry. The programs are scheduled so that you can attend either the Physicians program or the Hospitals program if your practice focuses on a particular provider or you can register for both for a more comprehensive curriculum that will prepare you to address legal issues facing both segments and gain a better understanding of their distinct legal challenges.

Hospitals and Health Systems Law Institute

February 9-10, 2012
Loews Portofino Bay Hotel
Orlando, FL
HORNE LLP has provided sponsorship in support of this program.

Program Description

Sessions at the Hospitals Law Institute will provide a focused analysis of the legal challenges faced by hospitals and health systems and their counsel. The program will kick-off with a plenary session on the Top Legal Developments for Hospitals and Physicians with Jack Schroder and Cindy Wisner. Some of the topics on this year’s program include:

• On-Call Compensation: Market Trends, FMV and Commercial Reasonableness and Governance Oversight
• Hospital Physician Affiliations – The Good, The Bad and The Ugly
• The Perils and Pitfalls of Careful Drafting: How Stark has Changed the Risk Calculus
• HIPAA Breach Notification – Case Studies on What to Do and When to Report

Practice Group Luncheons

The following Practice Groups will be holding a luncheon presentation at the Physicians and Hospitals programs:

• Antitrust: The Role of Economic Analysis in Healthcare Antitrust: Cutting-Edge Economics Meets the Anomalies of the Healthcare System – February 8
• Labor and Employment: Alternative Dispute Resolution: Obtaining Maximum Benefit From the Process – February 8
• Physician Organizations, sponsored by PYA: Roundtable Discussion of Recent Issues Affecting Physicians – February 9
• Health Information and Technology and Healthcare Liability and Litigation (Joint): Responding to an Alleged Data Breach: Things Outside Counsel Should Know – February 9
• Medical Staff, Credentialing, and Peer Review: Preventative Medicine: Hospitals’ Use of Credentialing and Peer Review to Avoid Liability – February 10
• Business Law and Governance, Hospitals and Health Systems, In-House Counsel, and the Enterprise Risk Management Task Force (Joint), sponsored by Sullivan Cotter and Associates Inc.: I Went to Law School—How in the World Am I Supposed to Help With Quality Initiatives? – February 10

Program Materials

All materials will be available on a website prior to the program and handed out on CD at the program. For those who still do want the binder they will be available for an additional fee; please order on the registration form.

CLE Information

This program will be worth approximately 13.0 credits (including 1.0 ethics credit) for 60-minute states and approximately 15.6 credits (including 1.2 ethics credit) for 50-minute states. Participants will be given CLE Request forms at the program. Forms must be completed and returned to AHLA staff to receive credit. The sessions, unless otherwise designated, are intermediate to advanced in level. There are no prerequisites required to register for this program.

This seminar will be worth approximately 15.0 CPE credits. AHLA is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN 37219-2417. NASBA’s web site is located at http://www.nasba.org.

This program is designed to be an update on developments in the area of physicians and physician organizations. There are no prerequisites or advanced preparations required to register for this group live program. Those seeking accounting credits should be familiar with the basic concepts of law and terminology associated with this area in order to obtain the full educational benefit of this program.

Hotel Information

Loews Portofino Bay Hotel at Universal Orlando Hotel
5601 Universal Blvd.
Orlando, FL 32819
Reservations: (888) 430-4999
Online Reservations

Room Rates: $210 single or double occupancy
Hotel Cut-off Date: Friday, January 20, 2012
Hotel accommodations are not included in the registration fee. When making reservations, please indicate that you are with the American Health Lawyers Association; the room block may sell out prior to hotel cut-off date.

Travel Information

Official Travel Provider – ATC (Association Travel Concepts)

Discounts and Services:

• 5% off applicable classes of service for tickets purchased more than 30 days prior to the meeting. Restrictions apply and not all classes of service apply for the 5% discount. (United Airlines, American Airlines).
• Personalized services.
• Low fare options.
• Discounted meeting rates (Enterprise, Hertz)
• Advanced seat assignment and special meal requests. Frequent flier program updates

Some restrictions may apply. Discounts apply between February 5-13. *Service fees apply to ticketed reservations. You may also call your own agency or the vendors directly and refer to the ID numbers.

Cancellation/Substitutions
Cancellations must be received in writing by February 1, 2012. Refunds will not be issued for cancellations received after the cut-off date. Registration fee, minus the $125 administrative fee, will be refunded approximately 3-4 weeks following the program. If you wish to send a substitute, need more information regarding refund, complaint and program cancellation policies please call (202) 833-1100 prompt #5. Note that the registration fee is based on the AHLA membership status of the individual who actually attends the program.

About Pinnacle Healthcare Consulting

Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations.  Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support.  Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services.  Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges. 

Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com

About The Physician FMV Program

Determining appropriate and compliant physician fair market value (FMV) is complicated.  Diverse factors like the Stark Law and inconsistent internal payment policies make it difficult to confidently approach physician compensation negotiations.  Until now.

–          Access Physician Fair Market Value (FMV) Data anywhere there’s an Internet connection

–          Generate tailored Physician Fair Market Value (FMV) Reports for individual physician relationships

–          Track all physician arrangements and payment terms

–          Research hospital-physician relationships around the country

–          Manage access to the Physician Fair Market Value (FMV) data for others within your organization

The Physician Fair Market Value (FMV) Program dramatically reduces the complexity of determining fair market value for physician compensation.  It builds internal capacity and gives hospitals more control over the process by providing proprietary tools and powerful information to help make defensible decisions about physician relationships.

Over 200 hospitals and healthcare organizations have found that the Physician Fair Market Value (FMV) Program empowers users to make smart and supportable decisions with regard to physician compensation and fair market value mattes.  The Physician Fair Market Value (FMV)Program’s key benefits include:

–          Elevated compliance through broader application of Physician Fair Market Value (FMV) payment terms and greater consistency across physician contracts

–          Significant time savings – where resources can be redirected to other matters (strategy, operations, etc.)

–          Immediate return on investment after just two to three uses (i.e., avoiding fees for focused consulting reports)

–          Enhanced organizational capacity to address physician compensation, contracting and compliance

Hospitals using the Physician Fair Market Value (FMV) Program immediately possess greater knowledge on which to base physician contracting decisions, the reliability of a proven physician fair market value analytical methodology and improved capacity to manage / document compensation and other contractual terms.  Furthermore, Physician Fair Market Value (FMV) Program support includes: training, ongoing coaching, technical support and focused consulting (if necessary). 

Visit: www.physicianfmv.com or contact us today for more information: 303.801.0123

A Note From Pinnacle Healthcare Consulting’s Business Valuation Team

 As we begin a new year, the Business Valuation experts at Pinnacle Healthcare Consulting would like to take this opportunity to thank our friends, colleagues and business partners for a fun and successful 2011!

 Featured below are some examples of Pinnacle’s most unique, complex, and creative business valuation solutions of 2011.  These case studies represent how we continue to assist clients meet their most challenging needs and reduce compliance risk.

 We look forward to the opportunity to work with your organization in 2012!

Sincerely,

The Business Valuation Team of Pinnacle Healthcare Consulting

Please visit: www.PinnacleGroupHC.com or contact Pinnacle Healthcare Consulting for any of your business valuation needs: kberkey@pinnaclegrouphc.com or  (303) 801-0123.

About Pinnacle Healthcare Consulting

Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations.  Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support.  Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services.  Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges.

Valuation & Financial Services

Fair market value (FMV) opinions
Pinnacle Healthcare Consulting performs FMV reviews of over 300 physician service arrangements per year for clients that range from large, multi-state health systems to independent physician practices. Our extensive database of hospital-physician relationships can be quickly tapped to evaluate a range of client transaction needs, speeding up the physician contracting process and eliminating unnecessary compliance costs.

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Business and strategic valuation services
Pinnacle Healthcare Consulting specializes in healthcare business valuations for buy-sell and joint venture (JV) transactions. We provide valuation services that support transactional healthcare fair market value (FMV) requirements with a process that includes:

• Detailed situational assessments
• In-depth fact-finding and interviews
• Market analysis
• Extensive financial modeling
• Rigorous valuation methodologies

Our knowledge of the broader healthcare industry adds valuable insight to the risks and benefits of either a sale or acquisition. We ensure that you enter a transaction fully informed.

Fair value for financial reporting (FAS compliance)
Pinnacle provides a potent combination of in-depth healthcare industry knowledge with a strong understanding of the nuances and best practices surrounding fair value in a GAAP reporting environment, including purchase price allocations, intangible asset and goodwill impairment testing, not-for-profit entities, and other assets, liabilities and equity securities.

Physician compensation/Stark compliance
Stark Law and Anti-kickback compliance are some of the most challenging issues in physician compensation today. Pinnacle Healthcare Consulting can conduct a full audit of your billing and compensation process to determine the effectiveness of your Medicare and IRS compliance efforts. We are adept at working with counsel and financial managers to identify problem areas and create compliant billing, compensation and compliance solutions. Our consultants have also supported a number of Stark self-disclosure audits to assist hospital management and counsel in conducting internal investigations and preparing reports to government authorities.

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Physician compensation/productivity analysis
Refine and reinforce your approach to physician compensation with pay and productivity analysis from Pinnacle Healthcare Consulting. Be confident that your compensation methods and contracts produce results, achieve your goals, and are backed by impartial market intelligence.

Health plan contract analysis/negotiation
Make sure your payer contracts support your business and financial goals. Pinnacle Healthcare Consulting will profile your clinical activities and ensure proper coding to establish equitable contract terms and management systems. It’s a crucial part of bottom line success.

Physician practice assessment
Master the key operational, financial and strategic systems needed for physician practice success. Pinnacle Healthcare Consulting works for hospital and physician practice managers. We evaluate processes and performance against industry best practices and recommend business-building improvements.

Billing/coding audits
Effective billing/coding practices mean more than optimized revenue. They can mean the difference between compliance and fraud. Pinnacle owns and operates a medical billing company with certified coders on staff that can be tapped to evaluate your revenue cycle management program. Our deep experience and expertise can help you enhance both revenue and compliance.

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Strategic & Operational Services

Hospital/Physician strategy development
The rapidly changing healthcare environment is again pushing hospitals and physicians to streamline care delivery methods. Pinnacle helps devise strategies and operational solutions to create high performing, integrated organizations. Importantly, we have the ability to partner with health systems to create and manage the necessary infrastructure to successfully operate integrated practices.

Market research and strategic analysis
A successful healthcare business needs clear, detailed strategies and a deep knowledge of your specific business environment. We help hospitals and physician practices develop innovative and sound solutions that improve performance and business development.

Financial analysis and planning
Pinnacle Healthcare Consulting brings a balanced perspective to business valuation, needs assessments, and feasibility in all financial transactions involving physician practices or ancillary clinics. We have extensive experience in dialysis clinics but can offer our real-world expertise to anyone looking to add physicians, acquire practices, create unique professional service arrangements and more.

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Group formation and mergers
Launching a group is a complex process but one we’ve completed many times. Our proven project management plan helps create or integrate individual practices, form a smaller group from a larger one, or add physicians to hospital integration initiatives. Plus, once we’ve helped create your group, we can provide on-going practice management services to get your doors open as quickly as possible.

Healthcare association strategy and analysis
Pinnacle Healthcare Consulting partners currently sit on the board or advisory panels of several healthcare associations and have worked internally at some leading organizations. If your association needs experienced guidance on membership, management, or strategic issues, we can help with project engagements, executive retreats, industry research and more.

New physician/new manager education
We can help physicians and staff better understand the business of healthcare. In fact, we regularly teach residents at hospitals, demonstrating effective management techniques for running successful practices. If you have new hires, position them to succeed with our training programs.

Pinnacle’s Pick: Husch Blackwell Legal Alert: Missouri Medicaid Proposes Its Provider-Preventable Conditions Policy – January 12, 2012, Contributing Authors: Robert L. Hess II

Missouri’s Medicaid agency is proposing to expand the current payment prohibition to include healthcare acquired conditions as defined by Medicare and to require hospitals and ambulatory surgical centers to bill for provider-preventable conditions as the method for reporting such incidents to the state. Providers have 30 days from January 3, 2012, to file comments on the proposed rule.

 Read full article

About Husch Blackwell LLP

Husch Blackwell LLP is a full-service litigation and business law firm with 600 attorneys in locations across the United States and in London, serving clients with domestic and international operations.

Read more about Husch Blackwell LLP

About Pinnacle Healthcare Consulting

Pinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations.  Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support.  Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services.  Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges. 

Contact Pinnacle Healthcare Consulting Today – 303.801.0123 or kberkey@pinnaclegrouphc.com

Visit: www.PinnacleGroupHC.com & www.PhysicianFMV.com