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Strategies for Meeting the Challenges of POA and Other Pay-for-Performance Initiatives
Four-part series
Part 1: September 13
Part 2: September 27
Part 3: October 11
Part 4: October 25
Time: See individual session descriptions for program times.
Register for this audioconference online:
Educate Your Entire Staff Quickly and Economically!
Register for Thriving in the P4P Environment: Strategies for Meeting the Challenges of POA/PQRI/P4P/P4R audioconference to educate your entire staff in a short period of time without incurring multiple registration fees or travel expenses. The registration fee includes one toll-free telephone connection to each presentation, so you can gather numerous staff members in one room to "attend" for one economical price.
Overview
As health care purchasers increasingly link reimbursement and the quality of health care, pay-for-performance is becoming the payment method of choice. This audioconference series will start with an overview of the federal pay-for-performance initiatives and what will be required of health care providers to thrive in the new P4P envirnonment. As stated in the Introduction to the ICD-9-CM Official Guidelines for Coding and Reporting, a joint effort between health care provider and the coeder is essential to achieve comlete and accurate documentation, code assignment, and reporting of diagnoses and procedures. The importance of consistent, complete documentation in the medical record cannot be overemphasized.
Since the early 1990s, health care researchers have argued that differentiating between diseases that are present on admission (i.e, comorbidities or pre-existing conditions) and those that first occur during the hospital stay (i.e. complications or in-hospital adverse events) is essential in hospital administrative data. That ability to distinguish diseases this way significantly increases the efficiency of quality improvement activities in hospitals and improves the accuracy of risk-adjustment methodologies, case mix indices, quality-of-care indicators and hospital comparisons in general.
Beginning October 1, 2007, hospitals are required to submit the "present on admission" (POA) indicator on Medicare inpatient claims. Other payers soon may follow Medicare's leas in using the POA indicator for reimbursement. IN addition to the changes in Medicare reimbursement, the implementation of POA will have an impact on public reporting, the validity of hospital report cards and the results of public mortality reports. Hospitals that successfully forge partnerships with their medical staffs in these endeavors have the potential to flourish in the pay-for-performance - or P4P - environment. Participate in this four-part series to help you understand the impact of the new POA requirement, plus other P4P initiatives that will impact hospital and health care systems.
Who Should Participate:
CEOs, CMOs, medical directors, medical staff members, nurse executives, compliance officers, CFOs, coders/HIM managers, quality and performance improvement managers and case managers will benefit from this program. Hospitals are encouraged to include other department directors as appropriate, based on the specifics of each session.
Program Details
Part 1:
CMS Progress Toward ImplementingValue-Based Purchasing
Thursday, September 13, 2007
11:00 AM to 12:30 PM (CST)
Faculty: Thomas B. Valuck, MD, MHSA, JD
Part 1 Program Description:
As health care purchasers increasingly link reimbursement and the quality of health care, pay-for-performance is becoming the payment method of choice. This presentation will give an overview of the federal pay-for-performance initiatives (POA/PQRI/P4P/Pay for Reporting) that health care providers must be aware of in order to achieve high performance and to thrive in the P4P environment. Learn the status of the various initiatives, the financial benefits of participation to hospitals and physicians, and the clinical benefits to patients.
Part 2:
Present on Admission Indicator: Financial, Legal and Public Reporting Implications for Physicians and Hospitals
Thursday, September 27, 2007
11:00 AM to 12:00 PM (CST) **Note: this session is only 60 minutes
Faculty: Mark S. Michelman, MD, MBA
Part 2 Program Description:
For hospitals to be successful in pay-for-performance as well as reporting accurate present on admission indicators, a joint effort between physicians and the coders will be required. The hospital will be dependent upon the physician to indicate when each diagnosis was identified. In this session, learn from the perspective of a physician the rationale behind POA and documentation requirements for physicians. You’ll hear how physician culture can present barriers to successful adaptation and how to overcome those barriers for success in this joint effort. Discover the actions hospitals can take in anticipation of this new requirement, and identify the potential liability for failure to document a condition if it was actually present.
Part 3:
POA: Practical Implementation Issues
Thursday, October 11, 2007
11:00 AM to 12:30 PM (CST)
Faculty: Caroline R. Piselli, RN, MBA, FACHE and Robert C. Holdenwang, RHIA
Part 3 Program Description:
Under present on admission coding requirements, hospitals must code more completely and make sure that all codes affecting reimbursement are documented and coders will need to query physicians to clarify documentation before it is coded. Piselli and Holdenwang will provide practical guidance on physician documentation requirements and necessary changes to coding practice. Learn what health information technology changes must be made within all systems that capture clinical information for use in the medical record and billing systems and understand how accurate capture of POA information will impact performance management in a pay-for-performance environment.
Part 4:
POA: The Downstream Impact on Hospitals
Thursday, October 25, 2007
11:00 AM to 12:30 PM (CST)
Faculty: Denise Remus, PhD, RN
Part 4 Program Description:
Implementation of the present on admission indicator will bring changes to Medicare reimbursement, and other payers may follow Medicare's lead. Precision will be added to ICD-9-CM coding in administrative data. What impact will the addition of this information have on public reporting? Will your hospital's coding improve the accuracy of safety and quality of care measures such as the AHRQ Patient Safety Indicators? Will this new information in the public domain increase the validity of hospital report cards and improve the accuracy of results of public mortality reports? Will the new information increase the efficiency of your hospital's quality improvement activities? Learn the answers to these questions and more by participating in this session.
Part 5: Save the date!!!
It's 2008 and PQRI and POA have been implemented. Now what?
Thursday, January 24, 2008
Time and faculty to be announced.
Don't miss this follow-up presentation, which will examine hospitals' firsthand experience in implementing POA. This session will focus on case studies and lessons learned. Why do some hospitals have POA quality issues? How have hospitals been able to get medical staff buy-in? How has the POA indicator been used for internal quality improvement?
This session will require a separate registration fee. More detailed information will be available soon on WHA's on-line Education Calendar.
Faculty:
Thomas B. Valuck, M.D., M.H.S.A., J.D.
Valuck is medical officer and senior advisor to Herb Kuhn, acting deputy administrator of the Centers for Medicare & Medicaid Services. He advises Kuhn on clinical and policy issues related to Medicare's payment systems and quality initiatives, particularly pay-for-performance. Recently, Valuck was named director of CMS' new Special Program Office of Value-Based Purchasing, which is responsible for the implementation of Medicare physician and hospital pay-for-performance initiatives.
Mark S. Michelman, M.D., M.B.A.
Michelman received his medical degree from Boston University School of Medicine, and completed his internship, medical residency and hematology fellowship at Albany Medical Center Hospital. He is board certified in internal medicine, hematology, and quality assurance and utilization review. He has practiced in Clearwater, Fla., since 1974, and is a clinical associate professor of medicine at the University of South Florida College of Medicine, where he teaches on a part-time basis. In addition to his clinical practice, Michelman is physician quality advisor, medical director of quality management, medical director of utilization management, and physician coding advisor at Morton Plant Mease Health Care System.
Caroline Piselli, RN, M.B.A., FACHE
Piselli serves as the performance systems program manager for 3M Health Information Systems. She builds on 30 years of experience in health care strategic planning, operational redesign, business development and as a clinician. At 3M, she oversees business strategy for new classification methodologies supporting performance management and pay-for-performance, in collaboration with clinical research, development and marketing. Previously, she was director of strategic planning and marketing for the Yale New Haven Health System and owned a consulting firm specializing in health care reengineering. She holds degrees from the University of Bridgeport, Rensselaer Polytechnic Institute, and is a fellow in the American College of Healthcare Executives.
Robert C. Holdenwang, RHIA
Holdenwang is a senior consultant with the Consulting Services business of 3M Health Information Systems. He has more than 23 years of managerial and consulting experience in health information management for facilities ranging from 200 beds to 1,450 beds, in for-profit, nonprofit and teaching institutions. In his current position, he consults with physician groups and hospital administration, HIM departments and case management/utilization review departments to implement effective documentation improvement programs, coding and data quality assurance, compliance audits, and performance management programs. Holdenwang is a graduate of the University of Texas Medical Branch in Galveston and is a Registered Health Information Administrator through the American Health Information Management Association.
Denise Remus, Ph.D., RN
Remus serves as the chief quality officer for the Baycare Health System in Florida. A clinical quality measurement expert, she is responsible for overseeing all aspects of BayCare's quality programs and its system-wide clinical efficiency. She previously was the vice president of clinical informatics for Premier. She also has served as the senior research scientist for quality indicators at the Agency for Healthcare Research and Quality, an arm of the U.S. Department of Health and Human Services. Remus received her bachelor of nursing degree from the College of St. Scholastica in Minnesota and her master's and doctorate degrees in nursing from the University of Minnesota, with an emphasis in gerontology and ethics. She has practiced in a variety of clinical areas including medical and surgical nursing, critical care, hospice home care, long-term care and as a geriatric clinical nurse specialist. Remus also was a commissioned officer in the U.S. Air Force.
The views expressed by the speaker do not necessarily reflect the policies or opinions or the Wisconsin Hospital Association.
Registration Information:
Fee - if registering for one or more sessions individually:
$169.00 for one phone line per site per session
Please register only one name per connection.
Additional phone lines will be billed at $169.00 each.
Fee - if registering for the four-part series:
$600.00 for one phone line per site (includes access to all four sessions)
Registration Deadline:
Monday, September 10, for the full series or three business days prior to the event date, for individual session registrations.
Substitution, Transfer and Cancellation Policy
Cancellations received in writing up to five business days prior to an event will be given a full refund less a $25 processing fee. Transfer to another WHA education program is not permitted, and for cancellations received less than five business days prior to program, no financial credit will be granted. WHA reserves the right to cancel or rescheduled programs as determined necessary. If a program is canceled by WHA, full registration refunds will be issued.
Register for this audioconference online:
How the Audioconference Will Work
With the audioconference, there is no limit to the number of staff from your office per connection who can tune in to the seminar via speakerphone. Additional connections dialing in will be billed. Enjoy the benefits of attending a live conference without having to leave the office. Upon receipt of registration and payment, confirmation will be emailed to the registrant.
Dial-in instructions and reference materials will be emailed to registrant approximately three days prior to the conference. If you do not receive them by this date, please email Lisa Geishirt at lgeishirt@wha.org.
It is the responsibility of the registrant to access presentation materials prior to the day of the event. If your e-mail address changes, you do not receive an e-mail with instructions from WHA, or if you are unable to open presentation materials, please contact WHA two days prior to the event to allow time to address the issue.
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