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  • June 25‐28
    Orlando, FL
  • Session Spotlights

    Preconference Workshop:

    Creating Successful System-Wide Governance

    Learn how an academic health system with a successful system-wide governance structure achieved $270 million in cash flow improvements in 13 months as a result of working together to adopt common metrics and best practices.

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    Session Spotlights

    Preconference Workshop:

    Physician Compensation in a Volume to Value Reimbursement Environment

    Learn now to create a compensation model that benefits physicians, health plans, and health systems by aligning incentives.

    More information >

    Session Spotlights

    Preconference Workshop:

    The Health Care Legal & Financial Partnership (HFMA and the American Bar Association)

    Obtain a comprehensive overview of issues related to compliance programs, legal and regulatory challenges to mergers & acquisitions, and compliance challenges.

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    Session Spotlights

    Medicaid and State Level APMs: Implications for Health Plans, Hospitals, and Physicians

    Francois de Brantes will discuss how states across the country are working to develop or implement payment and delivery system reform programs.

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    Session Spotlights

    Preconference Workshop:

    Improving Cost Report Accuracy through Revenue Cycle Connections

    Explore key drivers of Medicare payment that are directly connected to information developed through a hospital’s revenue cycle function.

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    Session Spotlights

    Preconference Workshop:

    MACRA: Charting Your Course Using Quality and Resource Use Reports

    Find out how analysis of Quality and Resource Use Reports (QRURs) can prepare a healthcare organization for MACRA’s Quality Payment Program.

    More information >

  • Taking the Mystery Out of the Financial Auditing Process

    HFMA News

    June 28—Taking the mystery out of the process of financial auditing can be both educational and fun.

    That was the idea behind a presentation about compliance and risk identification on Wednesday at HFMA’s ANI 2017 in Orlando. “The Great Healthcare Compliance Mystery Event” combined an interactive skit and a kind of dinner theater mystery that was led by Kelly Loya and Kristen Taylor, managing directors of Centennial, Colo.-based Pinnacle Enterprise Risk Consulting Services.

    After a short presentation, attendees became part of the production. They were assigned characters and given different levels of knowledge and responsibility for a particular financial issue that sparked an audit, such as violations of clinical standards, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), or the False Claims Act.

    “You have to figure out what you need to know,” Loya said. “Our objective is for attendees to gain knowledge of the audit process.”

    Along the way, Loya said, participants gained skills; learned new details about coding, billing, and payment; and got to know their fellow ANI attendees. “Usually people in finance [leadership] are not involved directly in the audit,” Loya said. “They just see a problem and want an answer. Typically, they are in the back end of the process.” The goal of this session was to have attendees gain a better understanding of the audit process and its complexity.

    “Things You Shouldn’t Do”

    Attendees at the different tables were assigned roles in various fictional scenarios resulting in billing or medical practice-based violations.

    After a mock investigation, participants had to document and present their findings. Discussion about improving the results of an audit followed.

    The interactive approach reinforced the dangers of making assumptions during an audit. It built understanding of the problems created by a less-than-thorough investigation and awareness of how one operation impacts another, Loya said.

    The Healthcare Compliance Mystery Event program was launched in September and took 1 ½ years to develop.

    “It’s a change of pace,” Loya added. “If you’re at the end of a three- or four-day conference, you need a different way to deliver a message.”

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