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Conference Program

Wednesday, September 24
General Session: 10 Steps to Creating an ACO – How to Establish an ACO or Commercial ACO: A Step By Step Guide to the New Business Model Under the Affordable Care Act

4:30 pm - 6:00 pm
Presented by Thomas Anthony, JD, Chair, Health Care Practice Industry, Frost Brown Todd, LLC

Learn how to successfully establish an ACO within the Medicare program, as well as a clinically-integrated network (CIN) that functions like an ACO within the commercial insurance marketplace. Explore the challenges associated with the ownership, management, governance and business operations of an ACO/CIN, along with the complex regulatory regime that establishes the context within which ACO/CIN's operate.

Thursday, September 25
Opening Keynote Presentation
9:00 am - 10:00 am
Presented by Congressman Michael Burgess, MD

What Hospitals Need to Know: Defending Inpatient Admission Claim Denials and Best Practices for Appealing to the ALJ
10:30 am – 11:30 am
Presented by Andrew Wachler, JD, President, Wachler & Associates, P.C.

With the volume of appeals pending under the previous inpatient rules, the prepayment "probe and educate" reviews in full effect, and the anticipated lifting of the moratorium that currently precludes Recover Audit Contractors (RACs) from conducting patient status reviews of inpatient admission claims, it is imperative that your facility is well-equipped to navigate through the Medicare appeals process. Make sure you are fully aware of the fundamentals and nuances relating to the 2-midnight rule, medical review criteria, and inpatient certification and order requirements. In addition, gain successful appeal strategies for defending inpatient admission claim denials, as well as practical tips for appealing denied claims to the ALJ level of the Medicare appeals process based on best practices provided by the Chief ALJ at the OMHA Medicare Appellant Forum held on February 12, 2014.

How to Make Patients Choose Your Hospital Over the Competition
10:30 am – 11:30 am
Presented by Scott Christiansen, Founder and CEO, Root3 Growth Marketing

Hospitals face growing patient acquisition challenges, including fewer referral sources and physicians available, lessening ability to control the continuum of care, and the fastest growing factor - the rise of patient choice, which is proving to be an uphill battle. Learn the patient acquisition cycle - source, convert and retain - and how to use this cycle to influence patient choice.

General Session: Direct Contracting in a Self-Funded Environment
1:00 pm – 2:00 pm
Presented by Ralph Weber, REBC, President and CEO, Route Three Benefits

The Affordable Care Act has led to increased healthcare costs, causing employers to look for alternatives. Reference-based pricing is one of these alternatives, and in particular is one that Physician-Owned Hospitals are well-situated to take advantage of. In this session, you’ll explore strategies for direct contracting and creating profitable opportunities. Learn how to approach employers about creating a community health plan, and how to design a community plan with steerage to your facility.

Responding to Adverse Patient Events
2:00 pm – 3:00 pm
Presented by Rosalie Brown, RN, MHA, Risk Control Director, CNA Insurance

Explore the best ways to respond when an adverse event occurs. This includes what to do immediately following the event, as well as what to expect from patients and their families when things go wrong. You’ll learn about apology do’s and don’ts, as well as the strategies and benefits of apologies.

Appropriate Disclosure and Managing Conflicting Interests: Perspectives from Defense Counsel, Insurance Industry & the Hospital Risk Manager
2:00 pm – 3:00 pm
Presented by Scott Buchholz, JD, Partner, Dummit, Buchholz & Trapp; Brad Briegleb Esq., Senior Director, Claims and Litigation, Stanford University Medical Center; Arlene Luu, BSN, JD, RN, CPHRM, Patient Safety Risk Management Account Executive, The Doctors Company; Dana Orquiza, RN, JD, Assistant Vice President, Risk Management, Stanford University Medical Network Risk Authority, LLC

Disclosure and discussion of adverse events in healthcare is the ethical and right thing to do. However, many physicians are uncertain about what to do after an adverse event, and managing adverse event disclosure poorly can increase the liability risk for the involved parties. Learn how to manage these events in a structured way, and explore the key components of the disclosure process, as well as the importance of documentation from three unique perspectives: the defense lawyer, the insurance industry and the hospital risk manager.

Engaging Physicians in Value-Based Care Transformation
2:00 pm – 3:00 pm
Presented by Ellis "Mac" Knight, MD, MBA, Senior Vice President and Chief Medical Officer, Coker Group; Justin Chamblee, MAcc, CPA, Vice President, Coker Group

Explore a systematic approach to care process transformation that can assist in transitioning from a volume to a value-based business model. This approach, known as the Care Process Design System (CPDS) engages physician leaders and other clinical and non-clinical experts, in a hands-on fashion, to help them re-tool the clinical care enterprise, in order to make it safer, more reliable and cost-efficient. Learn a step-by-step approach to building and implementing a CPDS, backed up with case studies that demonstrate the success of this approach.

General Session: Legal Issues Update

3:15 pm – 4:45 pm
Presented by Amber Walsh, JD, Partner, McGuire Woods, LLP

Learn about the top legal issues in the industry – from facility expansion opportunities, to physician privileges and contracting issues, to hospital sales trends and beyond!

General Session: Political Update
3:15 pm – 4:45 pm
Presented by Jennifer Larkin Lukawski, Principal, Government Affairs, BGR Group

Learn what is happening on Capitol Hill as it relates to healthcare, including an update on how physician owned hospitals can work within the Affordable Care Act.

Friday, September 26
Enhancing the Transitions of Care Experience Through Patient Family Centered Care
9:00 am - 10:00 am
Presented by Anne S. Hast, DNP, RN, CEO, Advanced Surgical Hospital; Kimberle A. Barker, MSN, RN, Director, Perioperative Services, Advanced Surgical Hospital

Patient experience must be viewed comprehensively through the lens of an entire episode of care. Explore all facets of the transition of care experience, and gain a patient family-centered care approach to designing an exceptional transition of care experience, increasing patient satisfaction, loyalty and referral.

2014 Meaningful Use & Quality Measures: Selection, Reporting, Incentives, Oh My!
9:00 am – 10:00 am
Presented by: Carmen Lester, RN, BSN, JD, Co-Owner, Yin Yang Medical Services Inc.; Jan Kleinhessleink, Chief Quality Officer at Lincoln Surgical Hospital

The reporting of clinical quality measures (CQMs) has changed. EHR technology that has been certified to the 2014 standards and capabilities will contain new CQM criteria, and eligible hospitals will report using the new 2014 criteria regardless of whether they are participating in Stage 1 or Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Learn to describe the selection process for approved CQMs, how to identify applicable measures, how to examine reporting and submission periods, and how to ascertain financial impact to hospitals.

The Impact of Metric Driven Co-Management Arrangements on Patient Experience
9:00 am – 10:00 am
Presented by Stacey, Lang, RNC, BSN, CNRN, Senior Vice President, Corazon, Inc.

Review the drivers found to have the most impact in enhancing patient experience within a metric-driven approach to care delivery. Discover strategies for metric development, as well as the capture and utilization of meaningful benchmark, performance, and outcomes data. This session will also touch on the real and measurable results of a fully integrated, metric-driven approach to patient care.

Clinical Success Without the Excess: How Orthopedic Sales Rep Replacement Models Can Take Back Control of the OR
10:15 am – 11:15 am
Presented by Steve Lamb, Vice President and Lead Partner, Implant Partners

Due to the industry shift to value-based care, physician-owned hospitals are under increasing pressures to cut costs while improving overall quality of care. By purchasing surgical devices directly from manufacturers rather than going through a sales representative, hospitals can experience significant cost savings and take back control of the OR. Learn about the hidden costs of PPI, and discuss the long-term financial benefits of direct purchasing in a value-based care environment.

Taming Disruptive Behavior
10:15 am – 11:15 am
Presented by Arthur Snow, MD, Chair, American Medical Association Organized Medical Staff Section (AMA-OMSS) Governing Council and Immediate Past President, Medical Staff, Shawnee Mission Medical Center; Nathan Kottkamp, JD, MA, Partner, McGuireWoods

Gain a working knowledge of what is and is not “acceptable,” “inappropriate” and “disruptive behavior.” Learn about the Joint Commission requirements in this area, and discuss what hospital leaders must do to comply. You will also examine formal and informal processes that physicians and hospitals can use to manage disruptive behavior, with an emphasis on methods already being used successfully by physician-owned hospitals.

Think You Can’t Expand? Case Studies for Expansion
10:15 am – 11:15 am
Presented by Andrea Impicciche, JD, Esquire, Hall Render Killian Heath & Lyman, PC

Explore creative solutions for expanding a physician-owned hospital through hospital acquisition and/or consolidation. Hear about lessons learned when filing an application for expansion, and discuss the Stark Law Whole Hospital Exception and a bullet-point checklist to determine legal compliance with the whole hospital exception.

In Search of a Level Playing Field: Identifying Anti-Competitive Practices That Can Affect Market Performance and Your Bottom Line
11:30 am – 1:00 pm
Presented by Richard Ripley, JD, Partner, Haynes and Boone, LLP, and Nora Whitehead, JD, General Attorney, Federal Trade Commission

Physician-owned medical facilities often draw the ire of rival hospital networks and face business practices by those networks that impair the facility’s ability to compete, which affects the bottom line.  Explore the type of conduct commonly used and discuss certain factual contexts under which these practices violate federal antitrust laws. Attendees will also gain an understanding on an active case litigating these very issues, The Medical Center at Elizabeth Place v. Premier Health Partners, et al., (S.D. Ohio)

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