By Beth Friedman
Irregular weather patterns. Unstable insurance exchanges. Capricious presidential tweets. 2018 has been quite an unpredictable year. Amid all the turbulence, the recent Healthcare Financial Management Association (HFMA) 2018 Annual Conference stood strong and lived up to its reputation for educational excellence. The keynote speakers inspired, the breakout sessions informed, and the exhibit hall entertained.
This year’s event was held June 24–27 at the Venetian-Palazzo Sands Expo in Las Vegas. Key themes included collaboration, innovation, and performance. Kevin Brennan, FHFMA, CPA, chair of HFMA’s 2018–2019 board of directors, encouraged attendees to resist the fear of failure and create new business models for optimal revenue cycle efficiency and effectiveness.
Brennan emphasized the need for collaboration, new tools, and changes to existing workflows as key ways to improve performance. He called for greater collaboration with other departments, providers, payers, consumers, and the government. New health care bridges were also being built in the exhibit hall where hundreds of revenue cycle vendors touted technology and services to improve patient satisfaction, payer relationships, and clinical partnerships.
While at HFMA, I had the opportunity to talk with three HIM experts about their top takeaways and insights. Here’s what they had to say.
HIM Outsourcing Shifts Back to Specialty Focus
After several years of supersized revenue cycle vendors taking over HIM services—especially medical record coding—it appears that finance executives are changing course. During HFMA’s one-on-one meeting sessions, Mark Wagner, CEO of KIWI-TEK, LLC, met with several revenue cycle executives who shared their views. Comments included, “I’m going to pull coding away from our end-to-end revenue cycle vendor because we aren’t seeing the results or outcomes we expected.” From coding to patient payments and denial management, more exhibitors offered specialized solutions within health care’s revenue cycle vs one-stop shopping.
Appetites for Business Analytics Are Insatiable
Las Vegas never disappoints when it comes to dining or shopping. I enjoyed both during my three days at the HFMA conference, with more than 38 restaurants and 195 stores contained within the Venetian-Palazzo property—and all under one roof. Similar to the preponderance of food was the overwhelming mention of health care business analytics during this year’s event.
Susan Gatehouse, RHIT, CCS, CPC, AHIMA-approved ICD-10 trainer and CEO of Axea Solutions, recognized the importance of business analytics in every educational session she attended: “Health care business analytics has become more far reaching than we ever expected, which puts even greater pressure on HIM professionals for correct code assignment, accurate charge masters, and clean billing.”
As a corollary to increased volumes of financial data, Gatehouse also mentioned that finance executives are keenly focused on clinical data integrity. “Finance executives are going beyond medical record code assignment to ensure the accuracy of everything that must come together to paint a complete picture of every patient, determine where patients should be placed, and inform how patients should be tracked,” she said.
Exact lab values, specific MRI results, and detailed drug charges are all now top of mind for revenue cycle executives.
Efficiency and Effectiveness Take Center Stage
From Brennan’s session to the standing room only keynote on innovation by Rubin Pillay, MD, PhD, speakers emphasized the need to take health care to new levels of care delivery and operational performance. For Kim Charland, BA, RHIT, CCS, director of revenue cycle services for MRO, efficiency and effectiveness in central business offices (CBOs) and patient financial services departments are paramount to cut costs and reduce risk.
Charland spoke with dozens of HFMA attendees to discuss release of information in the business office. “Clients tell us, and HFMA meetings confirm, that CBO staff become distracted when trying to process payer requests for medical records vs working with HIM to accomplish this task,” Charland says. “By implementing new tools, workflows, and collaboration with HIM, organizations could dramatically improve biller and collector efficiency. There are also HIPAA risks to consider when billers release protected health information instead of having HIM professionals manage these disclosures.”
Focus on Physicians Reaches New Heights
HFMA has historically concentrated on hospital and health system finances. However, at this year’s event, dozens of sessions and a final case study workshop focused on two of health care’s most important care settings—independent physician practices and large medical groups. Value-based care and alternative payment models further encourage the need for greater collaboration and communication between acute-care finance executives and physician revenue cycle leaders.
The Physician Advocacy Institute indicates that 42% of physicians are now employed by hospitals. And in only one year, from July 2016 to July 2017, 5,000 independent physician practices representing 14,000 physicians were acquired by hospitals or health systems. Amid a sea of acquisitions, the physician practices that remain independent are performing at higher levels than ever before by forming super groups—entities that assemble to maintain physician independence and better position practices to flourish.
HIM professionals face new challenges to manage and oversee physician coding as more and more practices partner and integrate with acute care facilities. Per a representative of KIWI-TEK, physician coding support is a common request for his company: “As physician coding becomes more complicated and complex, doctors get worse at coding. Overcoding, undercoding, and bundling issues are more common than most groups would like to admit.”
With physician coding in mind, I attended an informative case study workshop on the conference’s final day. Ellen Steward, partner at Spencer Fane, LLP, spoke about forming physician super groups. According to Steward, market analysis, technology assessments, and financial planning are essential to make a super group work. Decisions about coding and billing, what type of systems to use, and whether to self-manage or hire a practice manager are key considerations right from the beginning.
HFMA Conference Never Disappoints
Collaboration between the revenue cycle and HIM is essential. For this reason alone, HFMA’s annual conference is a must-do event for HIM professionals. New approaches to old, stubborn problems are discovered at HFMA while upcoming health care business challenges are explored.
I invite you to join me at the HFMA 2019 Annual Conference in Orlando, Florida, next June as we all work collectively to take health care to new levels of care delivery and operational performance.
— Beth Friedman is a 30-year HIM professional, former coder, and current CEO of Agency Ten22, a health care public relations and marketing company. She can be reached at email@example.com.