SPRING 2015
Impact of Health Insurance Exchanges on Orthopaedics What we know— and don’t know
F E AT U R E S 4 President’s Message Winjie Tang Miao, FACHE 5 Regent’s Message John Allen, FACHE 10 Member Spotlight 12 National News 13 Chapter Updates 14 Path to Becoming FACHE 16 Event Encore 21 New Fellows & Members
6 Impact of Health Insurance Exchanges on Orthopaedics What we know— and don’t know
Editor-In-Chief
Dr. Valerie A. Shoup, PE, FACHE
Contributing Editor
Jessica Fuhrman
Contributing Writers
Fraser Hay, FACHE Amanda Bloom Amanda O’Neal Brumitt, FACHE Stan Kovarik LaToya Rivers Mike Belkin, FACHE Michael Vinson, FACHE
Creative Direction
Caleb Wills
Advertising/ Subscriptions
info@northtexas.ache.org
Questions and Comments:
ACHE of North Texas Editorial Office, c/o Executive Connection 250 Decker Drive | Irving, TX 75062 p: 972.413.8144 e: info@northtexas.ache.org w: achentx.org
2015 Chapter Officers
2015 Board of Directors Teresa Baker, FACHE John Peter Smith Health Network Jennifer Conrad CORGAN Jessica Fuhrman, FACHE BroadJump Forney Fleming University of Texas at Dallas Michael Hicks, MD, FACHE UNT Health Science Center Ben Isgur PricewaterhouseCoopers
President
Winjie Tang Miao Texas Health Resources
Kristin Jenkins, JD, FACHE DFW Hospital Council Foundation
Past President
Josh Floren, FACHE Texas Health Presbyterian Hospital Plano
Kevin Stevenson, FACHE ERDMAN
President-Elect
Dresdene Flynn White, FACHE Strategic Leadership Solutions
Secretary
Janet Holland, FACHE BroadJump
Treasurer
Pam Stoyanoff, FACHE Methodist Health System
Regent
John Allen, MHA, MPH, FACHE UNT Health Science Center
Demetria Wilhite University of Texas at Arlington Chip Zahn, FACHE Surgical Care AďŹƒliates
The ACHE of North Texas e-magazine, The Executive Connection, is published quarterly (Spring, Summer, Fall and Winter) and includes information on the latest regulatory and legislative developments, as well as the quality improvement and leadership trends that are shaping and influencing the healthcare industry. Readers get indepth reporting on the issues and challenges facing hospital and health system leaders today. We make it our job to tell you about the great things the organization and Chapter are doing every day to ensure the health of our community. If you have any news and updates that you want to share with other members, please e-mail your items to info@northtexas.ache.org. Microsoft Word or compatible format is preferable. If you have a graphic or picture that you'd like to include, please send it as a separate file. The following are the types of information that our members shared in past ACHE of North Texas magazines, Advocacy Issues, Legislative Issues, Educational Opportunities, Awards / Achievements, Promotions (Members On the Move), Committee Updates, journal submissions, conference submissions, and workshop participations, sharing mentoring experiences, etc.
President’s Message
W
elcome to the summer edition of the ACHE North Texas newsletter! Summer means hot temperatures, family vacations and, of course, America’s favorite pastime – baseball! We hope you were able to join us for our annual after hours networking event on July 28th at the ballpark, where the Rangers hosted the Yankees. If you did not notice after registering for this event, we encourage you to take a few moments, to browse our newly upgraded website. You will find details on all of our upcoming events and more information on our chapter, now in a dynamic, interactive format. I’d like to take this opportunity to thank our Communications Committee for their fabulous work. Speaking of upcoming events, our next super-efficient double panel education event will be held on August 27th at Baylor Heart Hospital in Plano. Topics will include Health Insurance Exchanges and their Effect on Healthcare Delivery Organizations and Achieving the Triple Aim. As always, 3.0 Face to Face credits will be offered. While it is still summer, the ACHE North Texas board is already thinking about 2016. We are accepting applications for available seats on the 2016 Board of Directors. All affiliates of ACHE of North Texas, in good standing, may nominate themselves or others for review by the chapter Nominations Committee. ACHE of North Texas Board Members must meet the following criteria:
4
1. Hold current membership in the ACHE 2. Be able to meet the attendance requirements as outlined in the Chapter Bylaws 3. Have sponsorship ability (financial donation to the Chapter or provide contacts) 4. Serve as a mentor on the Chapter’s Mentor/ Mentee Program 5. Have the ability to influence senior leadership in the local healthcare market 6. Be involved in the Chapter activities Nominations should be submitted by September 23rd to info@northtexas.ache.org. As always, I encourage you to find a way to participate, get involved and make the most of your membership. For more information on how to become involved or to send us feedback on our programs visit us at our website at achentx.org or send us an email at info@texas.ache.org.
All the best, Winjie Miao
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
Regent’s Message Colleagues,
Development, Medical Health
I hope the summer is treating
Brian J. Bessent, FACHE, Vice
Center, Odessa, TX President, Hendrick Health
you well.
System, Abilene, TX
I am happy to report the North Texas Regional Advisory Committee (RAC) held its first meeting on July 7. The
I believe this dynamic group will effectively represent all members of the ACHE North Texas Region very well.
purpose of the first meeting was to make introductions and identify the top one to three issues each member felt were important to the North Texas Region, from their perspective. Some of the topics identified were improving outreach to rural hospitals, hosting
I also wanted to highlight something that I believe is of utmost importance in today’s healthcare landscape: continuing education. Maintaining a current knowledge of today’s critical issues such as ICD 10, nursing home
interregional clusters, increasing
ratings, meaningful use, value based
collaboration between chapters,
healthcare, ongoing challenges
leadership, ethics, and other areas. Our next step is to translate these into actionable efforts/programs/initiatives. RAC members have rich backgrounds, making for a diverse group. The North Texas RAC comprises
to the Affordable Care Act, and other issues is essential to not only ensuring survival in today’s healthcare climate, but also proactively preparing health systems for these changes.
these members:
Fortunately, education is highly valued throughout the North
Michael J. Ojeda, FACHE, CCP, VHA-CM, Compliance Officer,
on chapter education events on topics ranging from the
Texas Region and its chapters. I regularly receive emails
Veterans Affairs, VISN 17 Heart of Texas, Dallas, TX Bob S. Ellzey, FACHE, President, Texas Health Harris Methodist Hospital Azle, TX Michael Belkin, JD, FACHE, CMPE, Vice President, Tyler & Company, Dallas/Fort Worth, TX Julie R. Idoine-Fries, MHA, Geriatric Service Line Administrator, John Peter Smith Hospital, Fort Worth, TX Britt R. Berrett, PhD, FACHE, Program Director/ Faculty, University of Texas at Dallas Mark A. Dame, MHA, CPHRM, FACHE, Assistant Professor, TTUHSC, Lubbock, TX John H. Everett, FACHE, CFO, Cogdell Memorial Hospital, Snyder, TX Betty Briscoe, CEO, Seminole Hospital District, Seminole, TX John D. OHearn, Executive Director of Planning and
financial and non-financial impacts of hospital readmissions to insurance exchanges to the Triple Aim. I encourage you to take part in these events as much as your schedule allows. It provides for a high quality educational experience and a chance to network with other ACHE members. Universities in the North Texas Region are also an important component as part of ACHE’s Higher Education Network (HEN), affording students the chance to learn about the benefits of joining ACHE. In July, I shared ACHE with MBA students at Texas Tech University Health Sciences Center and I am in the process of scheduling other colleges for this fall. I wish you a memorable and safe summer, John G. Allen, CMPE, FACHE Regent for Texas - Northern
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
5
Impact of Health Insurance Exchanges on Orthopaedics What we know—and don’t know Lalit Puri, MD, and Daniel M. Adair, M
On Oct. 1, a key component of the Affordable Care Act (ACA) fell into place with the opening of public health insurance exchanges (HIX). The impact of these exchanges will be significant; according to Accenture Consulting, as many as 20 percent of employed Americans will be using an exchange to obtain health insurance by 2017. The introduction of public exchanges corresponds to what may become an even more significant event—the creation of private exchanges. Private exchange models have been established by major employers such as Walgreens Pharmacy, which recently shifted its employee coverage to a private exchange model. (See “What Is a Health Insurance Exchange?” below.) Orthopaedic providers navigating this new health system are headed into largely uncharted territory. HIX present a complex new realm of care delivery that will be accompanied by implementation difficulties and early changes. Media reports have already focused on issues such as imperfect information technology, additional rules and regulations, and previously uninsured patients who have pent-up medical needs. State exchanges Under the ACA, each state is required to offer an exchange to its residents by creating and running its own exchange (state-based exchanges, or SBEs), by offering a federally run exchange (federally facilitated exchanges, or FFEs), or by
6
partnering with the federal government to offer an exchange (state partnership exchanges, or SPEs). More than half (26) of the states are using FFEs, 17 have SBEs, and 7 have SPEs (Fig. 1). State HIX extend health insurance coverage to the uninsured through two key mechanisms—expanding Medicaid eligibility and offering subsidized private insurance for people with income levels between 133 percent and 400 percent of poverty level. Individuals earning up to four times the poverty level will be eligible for federal subsidies in the form of tax credits, while individuals opting out of insurance coverage will face penalties. Coverage under the exchange-based program is scheduled to become effective Jan. 1, 2014. The ACA imposes strict conditions on insurers who participate in the exchanges, including the following: › Individuals can no longer be denied coverage due to preexisting conditions, nor can claims due to preexisting conditions be rescinded or denied. › Lifetime and annual limits on coverage have been eliminated. › Rates will be dependent on age, geography within a state, smoking history, family composition, and income levels. In addition, small group employers (those with fewer than 100 employees) will be able to purchase coverage through the Small Business Health Options Program (SHOP). All plans will cover a set of required benefits, including preventive and wellness services, prescription drugs, and hospital stays (Table 1). However, individuals will be able to choose a plan to fit their health needs and budgets. Plans will be tiered into bronze, silver, gold, and platinum levels, with incremental out-of-pocket costs and monthly premiums depending on the level chosen. Potential impact The Congressional Budget Office estimates that as many as 22 million individuals will obtain insurance
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
through the HIX. However, individuals may opt out and choose to pay the mandated penalty, which will likely leave a disproportionate population of higher risk patients in this federally funded program. Although premiums are designed to be affordable, they will likely vary from state to state and may rise depending on the insurance companies’ exposure to high-risk populations. The HIX may limit participation by providers and hospitals, resulting in access issues such as long wait times, discontinuity of care, and limited access to specialists. Or providers may opt to not participate in the exchanges, depending on reimbursement rates, resulting in similar access issues for patients. Some research already suggests that California exchanges are seeing these detrimental effects.
recently joined Sears Holdings, Darden Restaurants, and a growing list of national companies testing this new approach to providing health insurance for their employees. According to Scott Kiriakos, vice president at Memorial Medical Center in Springfield, Ill., this new approach represents a movement away from the traditional “defined benefit” health plans (under which the company purchases health coverage on behalf of its employees) to a “defined contribution” approach (under which the company gives employees a fixed dollar amount to purchase coverage). This is similar to what many companies did to help control pension costs by replacing defined benefit plans with defined contribution 401K plans. The result is more predictability and efficiency in managing healthcare spending. Private HIX are run by a private-sector company or nonprofit organization and operate similar to the state HIX. They provide an alternative to the traditional employer-based insurance coverage model. Although employees may select from a variety of coverages, no federal subsidies are available through this process.
States Respond to Health Care Law
Among the benefits attributed to private HIX are standardization of care, utilization review by a third party, private insurance participation. and product simplification. Their popularity continues to grow; recently, Wal-Mart and 17 other large employers partnered with Aon Hewitt Corporate Health Exchange to provide coverage to their employees. Non Declared State-based Exchange Planning for Partnership Exchange Default to Federal Exchange Fig. 1 More than half the states are using federally facilitated health insurance exchanges under the Affordable Care Act. Source: Kaiser Family Foundation
Employers may decide not to offer health insurance and to pay the penalties instead. The drop in employer-provided coverage could push a large and unexpected influx of workers into the exchange system, with staggering financial implications. Private exchanges Of potentially greater significance for healthcare providers is the concurrent development of private HIX. Walgreens
Financial impact of HIX What impact might HIX have on the finances of orthopaedic practices? Although the potential for new patients is significant, considerable uncertainty exists with regard to reimbursement rates.
In some states, HIX plan reimbursement rates are aligned with Medicaid rates. The few states that have released reimbursement information have shown significant reductions in payments for services under HIX plans compared to private plans. Insurers participating in HIX face significant pressure to reduce costs and may reduce reimbursement rates accordingly. In Connecticut, for example, early proposals by insurance companies participating in the HIX are 30 percent to 40 percent
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
7
lower than standard commercial reimbursement rates. But Matthew Katz, MS, executive vice president and CEO of the Connecticut State Medical Society, believes it’s too early to make a judgment: “The jury is still out on whether exchanges will be a good thing or a bad thing for physicians.” Although the details of individual plans participating in public or private HIX are presently lacking, the following factors will be relevant: › Out-of-pocket expenses—Recent data from commercial plans show increased copayments and deductibles. If the same trend applies to private or public HIX, patient copayments and deductibles will increase and providers may find it difficult to collect. › Resource allocations—Determining eligibility requirements, insurers’ responsibility, and coverage gaps, and dealing with technology glitches, will require additional time and energy by orthopaedic practice staff. › Sicker patients—Previously uninsured individuals may have untreated conditions and be more difficult and expensive to care for. This segment of patients could potentially increase medical expenditures by as much as 60 percent. › Patient access—Both the design of the HIX and the costs of treating patients could limit patient access to primary and specialty care. › Physician profile—Private HIX may use cost and quality data to create narrow networks of physicians. › Service pricing—The recent move by CalPERS (California Public Employees Retirement System) to reference pricing shows that volume will follow low-cost providers. When CalPERS set a limit on how much it would pay for certain surgeries and shifted any excess costs to participants, surgical volumes at low-price hospitals increased, while higher-priced hospitals saw a decrease in use by CalPERS members. Cost will increasingly become a clear driver of patient volume to a practice or hospital. Next steps Many experts believe that the rise of a consumer-driven market appears unstoppable. Implications for providers are significant and providers should be prepared to take the following steps: › Be ready to compete on cost. Transparency will enable comparison shopping. › Commit to continuous quality improvement. Quality improvement requires a team effort; outcomes depend on
8
collaboration and effective patient engagement. › Upgrade and improve collections; the ability to collect patient balances will become increasingly important as employers shift costs to employees. › Be able to clearly differentiate the practice from the competition, focused in particularly on ways the practice delivers higher value. HIX—both public and private—present a paradigm shift in the delivery of health care. Insurance companies, notably Blue Cross/Blue Shield, are preparing individual physician score cards and a tiered approach to narrow networks based on quality and costs. As copayments and deductibles rise, patients will assume a stronger role in medical decision making. Physicians must be prepared to partner with them. Although the orthopaedic community may be rightly concerned about pricing pressures and access issues, the evolution to HIX may allow for some positive changes, including the following: › Reimbursement for procedures (primarily trauma cases) previously unreimbursed due to lack of insurance coverage › A shift to settings other than the emergency department for the delivery of orthopaedic care › An increase in the number of insured patients by more than 20 million people, who will require appropriate care that will be reimbursed at some level, offsetting potential financial burdens › A shift in consciousness about the quality of care delivered, which may equate to better outcomes and a more effective healthcare system overall. Beginning in January 2014, members of the AAOS Health Care Systems Committee will be hosting a series of free webinars on payment reform issues; the first will be on healthcare exchanges. Check the AAOS course calendar and watch AAOS Headline News Now for more complete details. Lalit Puri, MD, and Daniel M. Adair, MD, are members of the AAOS Health Care Systems Committee. Bottom Line › The emergence of public and private HIX marks a paradigm shift in the way health care is purchased. › Although much is not yet known about how the design of HIX will affect orthopaedic practices, they do present
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
opportunities for practitioners willing to engage in efforts to improve cost transparency, deliver quality outcomes, and partner with patients. › The impact of private HIX may be even more significant than that of state HIX established under the ACA. What is a Health Insurance Exchange? Health insurance exchanges (HIX) established under the Affordable Care Act (ACA) are marketplaces where individuals can go to obtain health insurance coverage from private insurance companies. Each state and the District of Columbia has a public HIX, which offers a set of government-regulated and standardized health care plans from which individuals may purchase health insurance eligible for federal subsidies. The idea behind the HIX is to increase competition among insurers, thus bringing down the price for health insurance. In addition, the HIX enable small businesses to participate in a group insurance pool with other small businesses, thus enabling them to secure lower costs. Private HIX are similar in that they are also marketplaces of health insurance. These private exchanges will compete with the federally mandated state-based HIX. However, they are more flexible and can be customized to address the needs of an employer group. Employers purchase health insurance through the private exchange, and then their employees can choose a health plan from those supplied by participating payers.
Changing Health Care. For Life. BaylorScottand White.com Physicians provide clinical services as members of the medical staff at one of Baylor Scott & White Health’s subsidiary, community or affiliated medical centers and do not provide clinical services as employees or agents of those medical centers, Baylor Health Care System, Scott & White Healthcare or Baylor Scott & White Health.©2015 Baylor Scott & White Health BSWH_140_2015 RT
WALTER P MOORE Structural Engineering Civil Engineering Diagnostics Parking Consulting Traffic Engineering
Private HIX mark a change from defined benefit health plans, under which employees are provided with a specific list of health coverage, to defined contribution health plans, under which employers allot a specific amount to each employee to purchase coverage that suits that employee’s need. This also enables employers to better control healthcare costs. Reprinted with permission from OrthoInfo. © American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org
214.740.6200 www.WALTERPMOORE.com ©RTKL/David Whitcomb
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
9
Member Spotlight Stacey Howard, MHA, FACHE Associate Administrator North Hills Hospital While enjoying the great conversation at the North Texas Chapter Women’s Breakfast, Stacey Howard, a steadfast leader, discussed her experience with ACHE. Stacey began her membership with ACHE as a student in the mid-1990’s and now affirms, “ACHE provides an opportunity to learn from and network with professionals facing similar challenges.” Also, Stacey indicated, “we are all busy, so I always find it extremely beneficial to take the opportunity to stop for a few hours and learn a new skill or explore solutions to the various challenges we (healthcare professionals) face each day.” Stacey Howard’s 15 years with HCA is very impressive. She works with the staff and the physicians to make sure they can do the very best they can for the patient. “The staff and the physicians do the hard part. My job is to keep the hospital running smoothly so that they can deliver the care,” she proclaimed. Stacey’s work with the executive team members helps determine the strategic direction of the facility. Her implementation of the respective strategic action plan is critical to operations. When asked her opinion on the most important
10
issue facing Healthcare today, Stacey responded, “Healthcare has become very complex. Managing the expectations of patients, staff members, physicians, and administrators can be a difficult task in this ever-changing healthcare environment. At the end of the day, the most important issue is, and always will be, providing expert care to the patient in the midst of this complexity.” Stacey’s advice to early careerists and/or to those considering membership, “never be afraid to take on new challenges, especially those that you might be considered risky. Not only will you prove your worth, but you will learn valuable lessons that can be applied later in your career.” Learning about Stacey was very interesting. Also, Stacey shared, “unlike many in the profession with experience at six or seven providers, I have long-standing tenure with two health care systems. Both (companies) are highly respected and well known health care systems. This experience has allowed me the opportunity to gain a deep understanding of not only the healthcare market, but the unique offerings of these highly respected organizations. “It was an honor to be in the company of much knowledge and passion.
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
Member Spotlight Chetan Bhasin, MBA, MSC Director, Rehabilitation Services Texas Health Presbyterian Hospital Dallas Chet Bhasin gave an impressive presentation, Folding Down the Walls of the Hospital, earlier this year. Exploration of population health, care team panels, information sharing by Post-Acute care providers, and bundled payments in perspective of quality care are important in this era of healthcare reform. Bhasin joined ACHE in college to support navigating through the healthcare career journey. He supports spreading the value proposition of ACHE to students as an organization engaged in educating professionals on how to provide quality care that transforms with the evolution of healthcare. Also, he conveyed, “Midto-upper-level career professionals can increase the bandwidth of the organization by encouraging colleagues to contribute to lifelong education and give back by supporting new talent.”
Chet Bhasin’s healthcare career started at IPC Healthcare as a business development/operations executive in the Chicago area. Through the ACHE continuing education programs his knowledge evolved as he gained hospital experience. Now Chet is a physical rehabilitation service line director at Texas Health Presbyterian Hospital Dallas with oversight of inpatient and ambulatory activities. Chet’s leadership experience over acute and post-acute projects includes adding an inpatient hospice and skilled nursing unit to the facility. What makes this healthcare leader unique is that he has visited 30 countries and was also a DJ in college! Chet’s efforts in coordinating CARF designation and STAR certification for oncological rehabilitation makes Texas Health Presbyterian Hospital the 3rd in Texas and the only one in the DFW metro to uphold excellence in this specialization. Way to keep pushing for quality care!
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
11
National News New Video Details ACHE’s Strategic Plan A video revealed during ACHE’s annual Congress on Healthcare Leadership detailed ACHE’s 2015–2017 strategic plan. The organization adopted the plan to ensure its ongoing value in today’s rapidly changing healthcare environment. Based on input from members, chapter leaders and Regents, the ACHE Board of Governors created the plan to direct the organization’s focus during the next three to five years. Watch the highlight video and read more about ACHE’s 2015– 2017 Strategic Plan.
Exam Online Community Offers a Complimentary Interactive Learning Platform Members preparing for the Board of Governors Examination can access the Exam Online Community as a complimentary and supplementary resource that can boost their confidence and help them succeed. The online community is an interactive platform to learn and glean study tips from other Members taking the Exam. Plus, there is the opportunity to discuss Exam topics with experts for a higher level of understanding and the option to participate in study groups. Interested Members can join the Exam Online Community at bogcommunity.ache.org.
Healthcare Consultants and Physician Executives Forum Education Programs The Physician Executives Forum and Healthcare Consultants Forum provides added value to physician executive and healthcare consultant members via tailored resources to meet these groups’ unique professional development needs. A oneday education program is a cornerstone benefit of both Forums that offers an affordable learning and networking opportunity. Dates and location for these programs are as follows: Healthcare Consultants Forum Education Program Sept. 11, 2015 Hyatt Regency O’Hare Rosemont, Ill. More details available at ache.org/HCProgram
Physician Executives Forum Education Program Oct. 10, 2015 Hyatt Regency Washington on Capitol Hill Washington, D.C. More details available at ache.org/PEProgram
ACHE Launches New Social Media Accounts ACHE has expanded its social media presence once again by relaunching its Facebook and Twitter pages. We will now share news about healthcare management and insight from our organization year-round, in addition to news related to the annual Congress on Healthcare Leadership. ACHE will post on topics relevant to healthcare leaders and share the organization’s content and resources for members and events happening within ACHE. Join ACHE’s more than 4,000 fans on Facebook by ”liking” the American College of Healthcare Executives page. You can also follow ACHE on Twitter at our recently relaunched account, @ACHEConnect. elines.
Tuition Waiver Assistance Program
To reduce the barriers to ACHE educational programming for ACHE members experiencing economic hardship, ACHE has established the Tuition Waiver Assistance Program. ACHE makes available a limited number of tuition waivers to ACHE Members and Fellows whose organizations lack the resources to fund their tuition for education programs. Members and Fellows in career transition are also encouraged to apply. Tuition waivers are based on financial need and are available for the following ACHE education programs: •Congress on Healthcare Leadership •Cluster Seminars •Self-Study Programs •Online Education Programs •Online Tutorial (Board of Governors Exam preparation) •ACHE Board of Governors Exam Review Course All requests are due no less than eight weeks before the program date, except for ACHE self-study courses; see quarterly application deadlines on the FAQ page of the tuition waiver application. Incomplete applications and those received after the deadline will not be considered. Recipients will be notified of the waiver review panel’s decision no less than six weeks before the program date. For ACHE self-study courses, applicants will be notified three weeks after the quarterly application deadline. If you have questions about the program, please contact Teri Somrak, associate director, Division of Professional Development, at (312) 424-9354 or tsomrak@ache.org. For more information, visit ache.org/Tuitionwaiver.
Members on the Move Congratulations and best wishes Jana Voege on your recent move to UT Arlington! Peter Blanchard was promoted to Vice President of Business Development for Christus Care at Home! Way to go Peter! Rashard Johnson was promoted to Vice President and Chief Operating Officer for St. Luke’s Health in the Woodlands, Texas! Congratulations Rashard! Charles Cobb is now the Vice President of Supply Chain at UT Southwestern. Welcome to Texas Charlie! Members please let us know if you have changed positions or have been promoted so we can recognize you in our quarterly newsletter!
Centers for Medicare and Medicaid Services Update According to the Centers for Medicare and Medicaid, the Affordable Care Act is working. On March 31, 2015 about 10.2 million Americans had active coverage through the Health Insurance Marketplace, 16. 4 million uninsured have gained healthcare coverage, 12.3 million additional individuals enrolled in Medicaid CHIP as of April 2015 as compared to October 2013, and, as a result hospitals experienced a reduction in uncompensated costs of $7.4 billion (hhs. gov, healthcare factsheet 2014). In regard to fighting health inequity, the uninsured rate for African Americans declined 9.2 percentage points, 12.3 percentage points for Latinos,
and 7.7 percentage points for women (hhs.gov, healthcare factsheet 2014). In regard to quality and safety, falls and traumas have fallen by 17 percent, saving 50,000 lives and $12 billion dollars. Medicare all-cause 30-day readmission rate fell 17.5 percent in 2013, translating into 150,000 fewer hospital readmissions (hhs.gov, healthcare factsheet 2014). Hospital administrators are making a difference. Congratulations to all of the healthcare executives, and to all of our business partners in the healthcare field who are transforming healthcare nationwide.
The Education Committee The Education Committee completed its first Local Program Council (LPC) event in Denton on June 25 presenting The Impact of the ACA: How Readmission Penalties Will Affect the Healthcare Executive’s Mission. Local Program Councils allow us to repeat education panels in markets outside of the main Metroplex, increasing face to face credit opportunities for our 19 county membership base. With 32 members in attendance, our first LPC event was a success. We look forward to seeing you at our remaining double panel events in 2015:
8/27/2015: The Heart Hospital Baylor Plano › 3:30 – 7:30 pm › Health Insurance Exchanges and their Effect on Healthcare Delivery Organizations › Achieving the Triple Aim
10/22/15: Children’s Health Dallas › 3:30 – 7:30 pm › The Impact of the ICD – 10: How Implementation Will Affect the Healthcare Executive’s Mission › Technology Innovation Changing the Face of Healthcare Delivery
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
13
The Path to Becoming a FACHE Why Become a FACHE? By: Michael Vinson, FACHE & Fraser Hay, FACHE
Earning the distinction of board certification in healthcare management as a Fellow of the American College of Healthcare Executives signifies your expertise, experience, and commitment to continuing education and professional development. Just as members of the medical staff are board certified, having the FACHE credential by your name indicates a level of achievement in the healthcare profession. What are the application requirements? » Active ACHE membership » Hold a Master’s or other advanced degree » Hold a healthcare management position and have at least two years of healthcare management experience » Three references from current Fellows (one of which must be a structured interview) » Provide a copy of your current job description, organizational chart, and resume » $250 fee (The North Texas chapter will reimburse the first ten applicants that pass the exam.)
» A passing score on the Board of Governors Examination in Healthcare Management » Three years of ACHE membership tenure
Once the application is approved, ACHE members have three years complete the remaining criteria which include: » A minimum of five years of healthcare management experience » 36 hours of Healthcare Management Continuing Education credit earned during the three years preceding becoming a Fellow; 12 hours must be ACHE Face-to-Face Education » Participation in two healthcare related and two community/civic activities within the past three years
Many ACHE members meet several of the criteria to become a fellow. The North Texas ACHE chapter and the ACHE headquarters in Chicago offer programs to minimize the both the application and exam fees. The prestige and satisfaction of becoming board certified and proudly displaying the FACHE credential will strengthen your credentials as a seasoned healthcare professional.
What is the best way to prepare for the exam? The North Texas chapter hosts two separate BOG preparation courses. The first preparation course is a ten-week noon webinar series held in the spring, and the second is an in-person one-day training session held the fall. The next one-day training course is scheduled for September 25.
Congress Scholarship Summary By: Sheeba Kuriakose
I had the privilege of attending the 2015 Congress on Healthcare Leadership in Chicago, Illinois. With this being my first opportunity, it was truly a wonderful experience. I had the chance to listen to speakers who make a real difference in their areas of expertise, such as Dr. David B. Nash on Population Health, Sandra B. Bruce on Women in Healthcare Leadership, and Dr. Christopher Olivia on Empowering Physicians for Population Health. I was able to attain a better understanding of how Information Technology plays a pivotal role in our growing healthcare field. The members of American College of Healthcare Executives created an environment that was welcoming and inspiring. The camaraderie amongst the attendees was immeasurable and made me realize that I was a part of something much greater than I had imagined. I highly recommend other early careerists who are seeking advancement, motivation, and knowledge of our ever-changing industry to attend Congress in the future.
VISIT US ONLINE
ACHENTX.org
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
15
EVENT ENCORE
ACHE Spring Education Event Thursday April 23, 2015 The North Texas ACHE Spring education event was hosted by Cook Children’s Health Care System. ACHE members listened to two sets of panel speakers. Panel 1: Diversity in Healthcare Management: Value Added Business Sense was moderated by Michael D. Sanborn, President and CEO of Baylor Medical Center at Carrollton. Panelists included Dresdene Flynn-White, Strategic Leadership Solutions, Mina Kini, with Texas Health Resources, Di Ann Sanchez, with DAS HR Consulting, and Tonya Veasey with Open Channels Group. Discussion ensued on the importance of diversity in healthcare delivery. Panel 2: Reinventing Customer Service in Healthcare: Lessons Learned from the Best was moderated by Linda Nall, Vice President at Texas Health Resources. Panelists included Frederick Crampton, with Sg2, Kathy Harper, with Parkland Health System, and Pamela Stoyanoff with Methodist Health System.
readmissions will decline if administrators meet the diverse needs of the customer. One example of diverse needs is in a segment of the population that is becoming more prevalent, the LGBT population. Hospital administrators at Kaiser have developed a team specializing in LGBT care. In the changing healthcare environment, patient safety, customer focus, and convenience of care have become increasingly important. While clinical excellence remains crucial to good care, customer satisfaction results when customers receive help navigating the system, customers perceive comfort with the system, and patients receive coordinated care. Mandatory training of how to talk to patients has become standard in the healthcare system as systems become increasingly customer focused. Do no harm; means hospital teams must build safety into their processes. Safety includes the prevention of errors, communicating effectively, treating patients with compassion and dignity. In an effort to increase patient safety, service providers must train their employee’s on services standards, and how to ascertain continuum of care rather than episodes of care.
Comments from various panelists included the following. Patients, who are the customers, care about diversity, and therefore the caregivers should attend to diversity in care. There are over 238 languages spoken in north Texas, and cultural competence has become increasingly important as hospitals focus on the patient experience. In today’s healthcare environment, innovation is a key success factor and innovation becomes more powerful with a diverse healthcare team. The cost of
16
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
Breakfast with the CEO UNTHSC Wednesday, June 3, 2015 On June 3rd the ACHE of North Texas event committee held a breakfast with the CEO event for ACHE members and guests. University of North Texas Health Science Center (UNTHSC) in Fort Worth, TX hosted the event. Several dozen attendees listened as Dr. Michael Williams and Dr. Michael Hicks spoke to the strategic direction of UNTHSC. The UNTHSC is comprised of five separate schools of study: the Texas College of Osteopathic Medicine, the Graduate School of Biomedical Sciences, the School of Public Health, the School of Health Professions, and the UNT System College of Pharmacy. Dr. Williams, is the current president of UNTHSC. Previous to moving to Fort Worth, Dr. Williams was CEO of Hill Country Memorial Hospital
in Fredericksburg, TX where he had practiced anesthesiology and critical care medicine for over 20 years. Dr. Hicks, the Executive Vice President of Clinical Affairs, was the co-founder, president, and board chairman of DFW Anesthesia Associates, which began in 1990 as a physician-owned anesthesiology practice and eventually became Pinnacle Partners in Medicine.
of schools of medicine and to create “an academia that will contain various educational demographics”. Williams and Hicks are on a mission to create caregivers of the future by studying problems and bringing together policy and medicine. Williams and Hicks responded to questions about the cost of education; currently annual medical student education costs about $55,000 Dr. Williams and Dr. Hicks together shared a year for a health system to provide education to a medical student. Health experiences that prepared them to systems without an established residency transform the medical education space at UNTHSC. Dr. Williams understands today’s program require about $170,000 a year to educate a medical student. Williams healthcare culture and asserted that “the care being given today is not the care that and Hicks indicated that to control costs, it is imperative for medical institutions will be needed tomorrow.” Williams and Hicks indicated that their strategic vision to collaborate with health systems to capitalize on the recent Senate Bill 18 is to abandon the longstanding culture which raises the cap on the amount of General Medical Education slots allowed at hospitals. Based on the vision, mission, and current initiatives occurring at UTNHSC, Dr. Williams’ goal of becoming the best place to work would seem to be right around the corner. The event was interactive and educational. ACHE committee members would like to thank Dr. Williams and Dr. Hicks for providing insight into the medical education space and the strategic initiatives at UNTHSC. Additionally, thanks to our members and guests for taking time out of busy schedules to attend the session. For more information on future events, please visit us achentx.org or send us an email at info@northtex.ache.org.
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
17
EVENT ENCORE
ACHENTX Summer Networking Event and Membership Drive The ACHE North Texas Networking and Membership Drive was a delightful event hosted at the Alexander Camp House inside the renowned Arboretum. Engaged members brought interested colleagues along to share experiences and exhibit the interactive and professional proficiency of our chapter. The cozy venue was filled with almost 100 members and potentials. With views of White Rock Lake in the background executive recruiters, service line directors, performance improvement specialist, legal professionals, students, and other specialized healthcare administrators discussed their current roles, healthcare reform, and the value of ACHE to the industry. Stimulating conversation about the ACHE chapter engaged students, midcareerists, and senior executives in understanding how chapter membership can help them navigate through organizations and provide quality care efficiently and reducing cost. Through interesting conversation and decadent hors d’oeuvres, various innovative activities taking place at local healthcare organizations emerged. The dialogue ranged from regulatory legal consultation for operational compliance in the changing market; simulation lab and modeling programs to streamline responses to clinical events and operational efficacy; and improving cardiovascular patient
18
population outcomes via data and process improvement. ACHENTX signed nine new members during the event. We are grateful to the Arboretum for hosting our group and to the participating members who shared the value of ACHE. For more information on future events, please visit us achentx.org or send us an email at info@northtexas.ache.org.
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
EVENT ENCORE
June 2015 LPC Education Event
The topic of the North Texas Chapter of ACHE June LPC Education Event in June was the Impact of the ACA: How Readmission Penalties will affect the Healthcare Executive’s Mission. Brad Morgan, Baylor Heart Hospital of Denton VP of Operations, hosted the event. Brad began by introducing the new heart hospital which opened January 2014. William Cooksey, Baylor Scott & White Health System Director of Quality improvement for the Corporate Cardiovascular Service Line, moderated the panel of distinguished executives. The executives offered strategic advice on how to adapt to the changing healthcare industry. Jill Studley, M.D., a geriatric medical specialist who oversees home care and transitions of care, provided a unique perspective to the effect of ACA on home care. Kim Hatchel, RN emphasized how the role of the CNO has evolved over the last 18 years. Kim spent time developing models of communication between patients and care team members. She shared quality data with hospital executives in order to enhance care in the evolving environment. Jay Duty, MHA, discussed the framework for the care continuum from acute care to post-acute care.
liaisons may be conduits for reduction in readmissions. Jay Duty discussed changes needed to urge patients to seek outpatient physicians for management of chronic disease and minimize unnecessary acute care utilization. Members asked the panel about the cost of quality and how to effectively implement programs. Dr. Studley suggested that QI metrics achieve cost reduction by changing the way care providers administer care. Quality improvement programs are important to an organization’s success. Jay Duty suggested that “65% of readmissions are due to lack of medication adherence.”
The evolution of healthcare has lead leaders to focus on post-acute spend. When the panel was asked to elaborate, members suggested that when referring patients to quality ambulatory companies, data is critical to ensure continuum of care in the competitive Texas Home Health and Skilled Nursing Facility market. ACHE North Texas thanks Baylor Heart Hospital of Denton administrators and ACHE members for participating in this learning opportunity as all healthcare professionals are working toward better outcomes and value-based quality. Also, for more information on future events, please visit us achentx.org or send us an email at info@northtexas.ache.org.
50 members of the chapter engaged in consideration of the most ‘clinically appropriate and cost effective placement’ of patients. Kim Hatchel asserted that the present demand for a care coordination model is critical for continuum of care as a post-acute setting
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
19
A Night at the Ballpark – Texas Rangers Networking Event July 28, 2015. Thanks to Sterling Barnett-Little for hosting another great after hours networking event at the Rangers’ Ballpark. With a total turnout of 46 we just doubled the Yankees winning score of 21 - 5 over the Rangers. No disappointment here, where the Rangers let us down, the hot dogs and nachos kept us smiling. Don’t forget this wasn’t just about networking. Between members and non-members, the North Texas ACHE Chapter was able to support Arlington ISD with a back to school drive. Enough supplies were donated that a second box was needed to carry them out. Way to go North Texas ACHE!
20
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2015
ACHENTX’S
NEWEST
FELLOWS
Pamela J. Stoyanoff Karen H. Dowling Gary Jouett II
Dani-Bree Bialek Noah Longino Patrick P. Makarewich
Jason Naranjoe Isabell M. Pacheco Derrick E. Cuenca
WELCOME ACHENTX’S NEWEST MEMBERS Members who recently passed the Board of Governors Exam
MARCH Aaron R. Bailey Keith V. Zimmerman
APRIL Gary Fullerton
JUNE Gary A. Bonacquisti Julie R. Idoine-Fries
JULY Tammy Cohen Brent Glover Recertified Fellows
JUNE Kristin M. Jenkins Wilson J. Weber III Phillip D. Weinman
FEBRUARY
Raymond L. Ford Randall F. Jones
MARCH Matthew S. Chance Susan Steed Cobb Tracy Giacoma Fraser Hay Rosemaria Levinsk John L. Schinske Suellen M. Smith
APRIL
JANUARY
Richard R. Baland Madhura Chandak Brian A. Craft
Jan K. Althouse Michael Belkin Kelly P. Dunavant Daniel L. Gideon Sandra L. Haire David A. Helfer
Virginia V. Cohen Robert A. Di Domizio Natalie D. Lamberton Scott B. Ransom
MAY
Amy Assenmacher Edmond D. Hardin Jr. Mark C. Hood Amanda S. O’Neal Corey G. Wilson
JULY Kelvin A. Baggett, MD Stanley E. Davis Eric D. Jacobsen T. Douglas Lawson Kimberly M. Montes Stan C. Morton Monte K. Parker Michael D. Sanborn James A. Summersett III Mary R. Wylie, DHA Newest Members
MAY Adetola Adeyeye Richmond Agyekum Vyacheslav Alaytsev David Biggerstaff Ericka Criner Emily Grendon Matthew J. Hal Milton Johnson Jr. Frank Koen Kelly A. McSperitt Richard Peters Jr.
JUNE Michele Andrews Frances Atiase Jeanine Connolly Greg Dalrymple Christopher Franklin Randy F. Heidrich Jeane S. Holmes Khalid Mahmood, MD Jay Manns Michael C. Marino Hillary Miller Carmen R. Pace, RN Adam T. Panter Keith W. Plowden Rachel Radimecky Kristina A. Rodarte Sarmistha Sen Cynthia L. St. John, PhD Melanie Strickland-Rufus Carmen D. Vitton Fallon Wallace Melissa Winans, RN Cathy Woodard
JULY Pamela Colviny Ratana K. DeLuca Christopher G. Ellis Zubair Faiz Rebecca A. Harrell
Dan Killebrew Helen Malick Lisa N. Mason Sunitha Nalamada John J. Nulty Leigh A. Patterson, CPA Shakeydra S. Ratcliff Haylee R. Rigdon Joann Robertson Tanya K. Sosolik Kathy L. Valentine Lynn C. Whitehair Bryan P. Winkler Enrique Zavala III
DESIGNING
Find success in today’s changing marketplace
Healthcare providers and health plans look to Point B for leadership and expertise to thrive in today’s changing environment. Point B is an award-winning management consulting firm that has been leading healthcare clients through change and toward success since 1995.
ARCHITECTURE · INTERIOR DESIGN · CORGAN.COM
pointb.com Dallas • Seattle • Portland • Southern California • Bay Area • Phoenix • Chicago • Denver
How are you using digital signage?
Re-imagining Healthcare Advancing health and wellness globally and in local communities is at the heart of our endeavors. This is where great begins.
www.ddrp.com (214)741-6330 www.healthcareartconsulting.com
hdrinc.com
ts: n e v E g n i m Upco
For the latest updates on Chapter events, programs and promotions please check our website or watch your inbox for the event guide.
Quarterly Education Event - Health Insurance Exchanges and their Effect on Healthcare Delivery Organizations and Achieving the Triple Aim in Healthcare Thursday, August 27th - 3:00 – 7.30pm The Heart Hospital Baylor Plano Breakfast with the CEO: Hosted by Michael Wiggins Wednesday, September 23rd - 7:30am – 9:00am Children’s Medical Center Plano BOG One Day Review Course with Paula Zalucki Friday, September 25th - 8:00am – 5:00pm Texas Health Resources, Arlington
ACHE of North Texas thanks the following Corporate Sponsors for assisting the organization’s mission. By sponsoring various events throughout the year, these sponsors are provided local and national exposure with an opportunity to showcase their organization, brand, career opportunities, products and services to the ACHE membership and its affiliates.
Women’s Event October 7th - 7.30-9am La Cima Club, Irving Quarterly Education Event Thursday, October 22nd - 3:00pm – 7.30pm Children’s Medical Center, Dallas Annual Membership Dinner Thursday, November 5th - 5.30-8.30pm TBD, Dallas