SPRING 2016
The Growth of Telemedicine and its Relationship to Network Adequacy
F E AT U R E S 4 President’s Message Dresdene Flynn-White, FACHE 5 Regent’s Message John Allen, FACHE 6 Professional Forum - April Member Spotlight 8 14 National News 16 Education Events 20 Event Encore 23 ACHENTX Board of Directors 24 New Members 25 Calendar of Events
10 The Growth of Telemedicine and its Relationship to Network Adequacy
Editor-In-Chief
Joan Clark, DNP, FACHE Thomas Peck, FACHE
2016 Board of Directors
Contributing Editor
Matt Malinak, FACHE
Contributing Writers Creative Direction
Heather Worgo Beau Gee Amanda O’Neal Brumitt, FACHE Ed Bitner, FACHE Ray Dhameja Artie Goldman Valerie Shoup, FACHE
Teresa Baker, FACHE Texas Health Resources
Advertising/ Subscriptions
info@northtexas.ache.org
Caleb Wills, calebsemibold.com
Questions and Comments: ACHE of North Texas Editorial Office, c/o Executive Connection 300 Decker Drive, Suite 300 | Irving, TX 75062 p: 972.413.8144 e: info@northtexas.ache.org w: achentx.org 2016 Chapter Officers President
Dresdene Flynn White, FACHE Strategic Leadership Solutions
President Elect Past President
Janet Holland, FACHE BroadJump
Secretary
Kevin Stevenson IntegraNet Health
Treasurer
Pam Stoyanoff, FACHE Methodist Health System
Regent
John Allen, MHA, MPH, FACHE UNT Health Science Center
Executive Director
John Whittemore ACHE of North Texas
Winjie Tang Miao Texas Health Resources
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 Kristin Jenkins, JD, FACHE DFW Hospital Council Foundation Demetria Wilhite University of Texas at Arlington Jared Shelton TexasHealth Presbyterian Hospital, Allan Nancy Vish, FACHE Baylor Heart & Vascular Hospital Corey Wilson, FACHE Texas Health Harrie Methodist, Fort Worth
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
I
’d like to thank you for the privilege of serving as your president for 2016. I have had the opportunity to communicate with and meet ACHE members across North Texas and I continue to be impressed by the diversity of individuals, positions and organizations represented by our membership. When thinking about what to say to you, I reflected on my twenty-five years in healthcare. To say that things have changed and continue to change is an understatement. While there are many strategic and tactical issues I could address, perhaps the most relevant leadership issue is about change. . .how we, as healthcare leaders, react to it and how we lead and manage it. John Maxwell, in his “A Minute with Maxwell” talks about the need for leadership to stretch, to act as a rubber band. The need to decide to remain “status quo” or to stretch to meet new demands and/or situations. This thought is certainly applicable to today’s healthcare leader. Your chapter’s approach in 2016 is to bring you education, information, networking and mentorship that will equip you to lead and respond to changing times and situations. We are focusing on bringing to the
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chapter, individuals from diverse backgrounds and perspectives, by reaching out to aligned diversity healthcare organizations and availing ourselves of the collective expertise and experience of the over 200 retirees who remain active with ACHE of North Texas. We will continue to seek opportunities to collaborate with other healthcare affiliated organizations such as HFMA, THA and others In order to enhance the value of your leadership skill and knowledge, we will provide opportunities and support for your obtaining and maintaining your FACHE certification though exam preparation and educational events. It is my hope that I meet many more of you at our upcoming events. Should you wish to contact me directly, feel free to do so at dflynnwhite@bellsouth. net or avail yourself of our talented executive director, Mr. John Whittemore at info@northtexas.ache.org. There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things – Niccolo Machiavelli Dresdene Flynn-White, FACHE-R President, ACHE of North Texas
A Publication of the American College of Healthcare Executives of North Texas Chapter | SPRING 2016
Regent’s Message Dear Colleagues,
Be on the lookout for more information
With winter behind us and summer
called “What’s Up Boss.” Borrowed
in the coming weeks for an event from the ACHE Southeast Texas
just around the corner, ACHE
Chapter (SETC), this is an opportunity
activities throughout North Texas are quickly heating up!
for younger careerists to meet with
I hope you
senior and seasoned executives to
will consider some of the upcoming educational opportunities:
participate in a “round robin/speed
The North Texas and East Texas
This has been highly successful for
dating” format to receive career advice. the SETC. If you are a senior executive
Chapters have joined forces to bring
or seasoned administrator interested
you an educational event entitled,
in participating in the “What’s Up
“An Ethical-Basis Move from Volume
Boss” event, please contact me.
to Value.” Presented by William A. Nelson, PhD, HFACHE, from The
Beyond these formal educational
Dartmouth Institute for Health Policy
events, I encourage you to make your
and Clinical Practice, this proactive
personal education a daily priority.
seminar will explore effective,
When I began my career, my mentor
intentional and practical ways for
encouraged me to read professionally
healthcare leaders to strengthen their organizations’ focuses on doing the right thing when moving from volume to value-based care. Expert faculty will discuss the linkage between ethics, quality and value. Hear firsthand from healthcare leaders who have faced ethical challenges and learn from the changes they made in their organizations. This engaging presentation and discussion will provide the opportunity for reflection. The event will take place on June 8, in Terrell, TX and is worth 6.0 Face-to-Face
EVERY day, regardless of how busy I am, even if it just means reviewing top stories or reading a short article. Being informed is the key to staying relevant and growing professionally! Lastly, if you had a chance to attend the ACHE Annual Congress in March, I hope you found the educational and networking opportunities enriching and abundant! A consistent theme I found throughout the Congress is that healthcare is quickly changing. This is no surprise, of course, but with legislation
Credits. Click here to register and for more information.
such as MACRA and other policies quickly becoming a reality,
The leadership team at the Texas Midwest Healthcare
achieve the goals of the Triple Aim: improve population health;
Executives chapter has ramped up their ACHE face-to-face educational offerings over the coming months. On June 29, from 11:30-1:30 p.m., at the Hendrick Medical Center (HMC) in Abilene, there will be a panel discussion entitled “Population Health: What’s Working and Why” with George H. Terrazas from Texas Care Alliance, and Tim Lancaster, FACHE, CEO - HMC. This event is worth 1.5 Face-to-Face credits. A second panel discussion on the same topic will be held on August 4 at HMC. Please contact John H. Everett, FACHE for more information.
health systems are beginning to think about how to better improve the patient experience; decrease total costs. I wish you the very best. As always, I encourage you to become involved in your local chapter. Please feel free to contact me at any time. John G. Allen, FACHE, CMPE Regent for Texas - Northern Program Director, Safe Transitions for the Elderly Patient University of North Texas Health Science Center jgallentexas@gmail.com
A Publication of the American College of Healthcare Executives of North Texas Chapter | WiNTER 2015
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Cocktails with the Chiefs April 19th 2016 ACHE’s focus for the evening’s professional forum on April 19th, 2016 clearly presented the benefit of partnerships and the college’s devotion for excellence. Panelists with backgrounds rooted in health care and managed care, displayed the effectiveness of ACHE’s association and transparency among organizations and care modalities. Around 100 members turned-out for the event from all over the Dallas-Ft. Worth metroplex. George Sauers of SavaSeniorCare shared his system’s focus of the triple-aim, where quality, customer satisfaction and efficiencies remain core. The system was evaluating service models and continuously adjusting to meet sufficient levels of care. Winjie Miao of Texas Health Resources spoke about her role in the transformation efforts at Texas Health, including the recent partnership between Texas Health and UT Southwestern. The new network will incorporate a hospital network, physician network and population health services company and grow medical education across the new networks. Brett Lee of Tenet discussed the future of our industry and how the guided partnerships of Tenet and Baylor-Scott &
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White can fundamentally shift the extent and depth of health services for the Dallas-Ft. Worth community. Strategic partnerships, such as that with BSW and Tenet, can develop and deliver high quality community service hospital while lowering the costs of care for patients. Clay Franklin with HCA spoke about the significance of the payer model and how health strategies need to focus on the payer’s ability to meet the demands of population health. Through the use of data analytics, HCA can negotiate with payers to deliver better outcomes for comprehensive patient delivery models. In synopsis, the best way for systems within the DFW region, or nationally, is to focus on group partnerships, healthcare business development strategies and clear cut objectives that focus on long-term care providers or in a sub-acute setting. While reviewing and reanalyzing the lessons learned through process implementation. Systems can push these population health initiatives through complete transparency, open data sourcing and versatile employee utilization/selections. For more information on future events, click here or send us an email.
A Publication of the American College of Healthcare Executives of North Texas Chapter | SPRING 2016
Congratulations ACHENTX! Our chapter was recently notified we earned ACHE’s Award of Chapter Merit by achieving the performance standard in 2015 for member satisfaction. Through last year’s ACHE membership survey, you gave ACHENTX a 4.02 out of 5. A special thanks to our leadership, volunteers and program participants for making ACHENTX the powerhouse of education and networking it is!
A Publication of the American College of Healthcare Executives of North Texas Chapter | SPRING 2016
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Member Spotlight Charles D. Nasem, FACHE CEO, Forest Park Medical Center Southlake What are you doing now? Celebrating the end of the Forest Park chapter in Southlake! As CEO during the construction, opening, and establishment of Forest Park Medical Center Southlake, we were blessed with an extraordinary nexus of local physician owners, leaders, and associates, assembled together for a singular vision: to create a place where physicians want to be more than anywhere else; patients tell us they can’t wait to come back; families and the community talk glowingly about us; and associates are enthusiastic devotees. We were fire-starters, positive disrupters to the market, and we achieved perfection because we had keys no one else had. Delivering care in an organization that regularly achieves Press Ganey Top 1% Patient Experience metrics is different in every positive way. One aspect our local management didn’t have control of was reimbursement contract negotiations, and it was reimbursement significantly below market that necessitates Southlake moving forward with a new partner this year. What an opportunity for someone to match existing high service, quality, and operational performance, with market reimbursement contracts. In your opinion, what is the most important issue facing Healthcare today? Our greatest opportunity as an industry is to apply the vast assets we have, to improving societal health in a way that no one has ever done before. Familiar aspects to this challenge include resolving access for the uninsured and underinsured, along with aligning financial incentives to support improved population health. It is no less than the basic structure of our system. There has always been broad intellectual consensus that improving overall health is good for society. There is even broad intellectual agreement that management of chronic conditions, end of life care, and processing efficiency, provides the resources to accomplish this. The devil is in navigating our transition, from fee-for-service, to population health, within the constraints of an existing financial and process structure that is destined, but highly resistant, to change.
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How long have you been a member of ACHE? A proud member of ACHE for 17 years, I became a Member in 1999, a Diplomate in 2000, a Fellow in 2008, and a Recertified Fellow for the second time in 2014. Why is being a member important to you? An early mentor taught me the importance of managing your own career, starting with support of the professional organization that would support that career. ACHE has been there for me as a beacon of education, advocacy, opportunity, and fellowship. Most importantly, ACHE has been an important constant at times of change. What advice would you give early careerists or those considering membership? As you strive for greater responsibility, know that with each step forward, you are growing the number of people that you serve. If you aspire to become a CEO, you will have the humbling honor to serve everyone. If you’re blessed to have a servant’s heart, or grow one, you can bask in the sunlight of great things that those around you achieve, knowing that the leader’s role is to inspire, through wisdom, courage, presence, character, hope, vision. Embrace change. Learn. Believe. Join. Tell us one thing that people don’t know about you. As part of our honeymoon 24 years ago, we went to Disney World, somewhat begrudgingly on my part. Since then, we’ve been back to Disney 30 times, mostly when we lived in Florida. It truly is a magical place!
A Publication of the American College of Healthcare Executives of North Texas Chapter | SPRING 2016
Member Spotlight Tina Hicks, FACHE Manager Financial Analysis at Methodist Health System What are you doing now? I am presently employed as the Manager of Financial Analysis for Methodist Health System in Dallas, TX. In your opinion, what is the most important issue facing Healthcare today? Besides increasing costs, I would have to say being as quick to respond to rapidly changing technologies as other industries. How long have you been a member of ACHE? I originally joined ACHE as a graduate student at the University of South Florida. I obtained Fellowship status in December 2015. Why is being a member important to you? Being a member is important for various reasons. One of the things I enjoy are the networking opportunities. I recently moved from South Carolina and am a new Texas resident. Getting to know leaders in the local North Texas chapter would be very difficult without all of the different events I have been able to attend. Finally, the educational opportunities are extremely beneficial. Attending ensures that I am aware of all things new to healthcare and are current on the many changes taking place across the state of Texas and nationwide.
What advice would you give early careerists or those considering membership? There are two pieces of advice that I would offer. The first would be to find a good mentor that can provide guidance as you progress through your career. I have benefitted greatly from people who have seen my potential and invested time into ensuring that I had substantial learning and work experiences that are helping me to be successful in my current position. Lastly, I would stress the importance of being open to learning about areas that may be out of your comfort zone and/or outside of your present scope of work. Volunteering to take on different projects outside of your regular assigned responsibilities allows key individuals to see your ability to perform at a much higher level and helps to build confidence in your abilities.
Tell us one thing that people don’t know about you. I am an avid music lover and have been trained in classical piano.
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A Publication of the American College of Healthcare Executives of North Texas Chapter | SPRING 2016
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THE GROWTH OF TELEMEDICINE AND ITS RELATIONSHIP TO NETWORK ADEQUACY Large hospitals are driving the expansion of telemedicine across the country. Nationally, more than half of hospitals and health systems in the United States are using the technology to increase access to services. From postoperative monitoring of patients at home to connecting specialists with emergency room doctors in rural areas, hospitals are investing in and using telemedicine platforms. Hospitals and health systems are using telemedicine not only to increase access to their services but also to respond to changing payment models that encourage them to emphasize the management of high-risk conditions and chronic diseases such as diabetes, as well as to lower readmissions. In some cases, academic medical centers have taken the lead by drawing down state and federal grants for telemedicine equipment, such as secure broadband connectivity for interactive videoconferencing, so the centers can connect
patients in rural areas to their specialists. To varying degrees, hospitals are using telemedicine to increase access to services and as part of a marketing strategy to attract patients across the broadest possible service area. In addition, employers have become increasingly interested in telemedicine, largely as a way to improve workers’ access to primary care through remote physicians. The employers’ goal is to lower health care costs and reduce absenteeism. A survey of large employers indicates that many expect to offer telemedicine consultations in the next two years, a 68 percent increase from 2014. At the same time, local medical boards and physician groups have been wary of the spread of telemedicine. At the state level,
Telemedicine: Defining Key Terms Originating site: the location of the patient, usually at a physician’s office, clinic, or patient’s home. Facility fee: the fee the insurer or other payer pays to the site where the patient is located. In general, if patients are located at home, there is no facility fee. Distant site: the facility or office in which the health care professional providing the remote health care services is located. Telepresenter: a health care professional present with the patient during a telemedicine encounter to facilitate the interaction between the remote provider and the patient. Some payers require a telepresenter as a condition of payment for the facility fee. The telepresenter’s time, however, is not typically a separately reimbursable service.
some have lobbied for restrictions on when and how services through telemedicine are provided. In resisting the expansion of telemedicine, most of those groups cite concerns about the quality of care and the importance of preserving the physicianpatient relationship. Concerns about losing revenue to remote, out-of-state “teledocs” are undoubtedly also a factor. Although telemedicine can deliver medical care appropriately for some services such as mental or behavioral health or specialty consultations for dermatology, cardiology, or oncology, physician groups point out that many conditions require an inperson examination for proper diagnosis and treatment. Private insurers have taken varying approaches to the delivery of services via telemedicine. Many, such as those interviewed for this study, are offering telemedicine as an add-on benefit for their employer customers, typically at the request of those customers. Others cover services via telemedicine in their individual and group market plans as a convenience for enrollees. When required by state law, insurers reimburse for services delivered via telemedicine at parity with a faceto-face encounter. Without a requirement under state law, insurers make the decisions about whether to cover services via telemedicine and at what level of reimbursement. Getting Paid for Their Services: Varying Approaches to Telemedicine Reimbursement Private insurers, when allowed to make their own decisions, appear to have no standardized approach to coverage and reimbursement. Coverage for telemedicine varies considerably from state to state and at the federal level as well. Some insurers follow the lead of the Medicare program, which limits reimbursement because of concerns that telemedicine could
lead to overuse and to rising costs. Medicare will reimburse only for certain services provided via telemedicine to patients in rural areas with documented physician shortages. Further, payment rules require that the beneficiary receiving the care must be physically present at an approved site (also called the originating site) such as a physician’s office or hospital (text box 1). Under Medicare reimbursement rules, Medicare pays approved health providers the same amount as an in-person visit and also pays the originating site a facility fee, which in 2015 was less than $25. With a few exceptions, Medicare pays only for interactive videoconferencing. With such restrictions, it’s unsurprising that telemedicine accounted for only $14 million of the $615 billion Medicare spent in 2014 for all its programs. Insurers participating in Medicare Advantage have greater flexibility to reimburse for services delivered via telemedicine, but only a limited number choose to do so. Telemedicine reimbursement under Medicaid varies Considerably by state, and it often depends on state law. In general, most state Medicaid programs reimburse for live videoconferencing, but reimbursement varies for other modalities such as store and forward or remote patient monitoring. States also differ in whether they’ll pay the facility fee for the originating site, whether they’ll require informed consent, and what conditions they set for reimbursement. For example, some states will pay facility fees only when a telepresenter is present to assist the remote health care provider with the patient during a telemedicine encounter. In private insurance, more than half of states require insurers to reimburse for services provided through telemedicine at parity with a face-to-face encounter, and reimbursement is subject to the same terms and conditions of the health plan policy (appendix A). No standard definition of telemedicine exists, and varying provider, technology, and medical practice restrictions exist among states. Most states, however, do not require reimbursement for services provided only through audio, fax, or email. Using Telemedicine to Meet Network Adequacy Standards Historically, most states have not held insurers to quantitative standards (such as time and distance requirements or providerto-enrollee ratios) for network adequacy, but rather have relied on insurer attestations that networks are adequate. With the recent trend toward narrower networks, however, more states have established quantitative standards that insurers must meet. Given this evolution in the regulatory approach, insurers may have incentives to use alternative delivery methods
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such as telemedicine to meet network adequacy standards, particularly in regions where insurers face provider shortages. Telemedicine also could be useful for insurers where they face provider monopolies. Over the past 10 to 15 years, primarily because of consolidation, providers in many markets have been able to achieve greater power to raise prices for their services. The expansion of telemedicine could give insurers greater negotiating leverage with some of those providers, particularly if insurers can make a bona fide threat to exclude that provider or specialty group because enrollees can receive the same services via telemedicine. Recently, the National Association of Insurance Commissioners issued a revised model law for network adequacy. The model law does not establish quantitative network adequacy metrics, but it does include the use of telemedicine under its criteria as a health care delivery option that insurers may use to meet a state’s network adequacy standard. The model law requires that carriers include or describe “how the use of telemedicine or telehealth or other technology” is being used in its access plan.
Although it’s too soon to tell whether this model law will prompt states to incorporate telemedicine specifically for the assessment of a plan’s network adequacy standards, this provision demonstrates that state regulators are aware of how the technology could be used to meet enrollees’ needs in areas with gaps in provider access. Widespread consensus about telemedicine’s benefits; telemedicine not a panacea for network problems Stakeholders across the board agree on telemedicine’s potential to improve gaps in network access, particularly in rural and underserved areas. For example, in many of Colorado’s geographically remote and rural areas, insurers face challenges finding and contracting with specialty providers. In such cases, one regulator noted, consumers “can get better access with tele[medicine].” According to one insurer, there is a“huge potential to [reach] rural areas and metro areas where there is a shortage of specialists.” One Maine insurer uses telemedicine to improve enrollees’ access to dermatology and psychiatry providers in particular. Respondents noted that telemedicine
Table 2. Study States’ Standards for Network Adequacy in the Individual Market Explicitly allows use of telemedicine to meet state NA standard
Study State
Standard for network adequacy (NA)
Arkansas
Emergency room within 30-mile radius of where enrollee lives; primary care provider (PCP) within 30-mile radius of where enrollee lives; specialty provider within 60-mile radius of where enrollee lives
No
Colorado
Insurer must establish the following: › Maximum waiting time standards that vary by service type, e.g., emergency care must be available 24 hours/7 days a weekprimary care must be available within 7 calendar days › Provider-to-enrollee ratio of 1-to-1,000 for primary care; pediatric care; obstetrics- gynecology (OB-GYN); mental, behavioral and substance abuse care › Maximum travel distances that vary among 50 listed specialties
Yes, for specialty provider-to-covered person ratios starting January 1, 2017
Illinois
Any point in service area to point of service cannot be greater than › 30-45 miles for PCP, OB-GYN, and general hospital care for urban areas, 60-100 miles for rural
No
› 45-60 miles for specialists in urban areas, 75-100 miles for specialists in rural area PCP-to-enrollee ratio of 1-to-1,000 Specialist ratio varies depending on specialty, but range is 1-to-2,500 to 1-to-10,000
Maine
PCP-to-enrollee ratio of 1-to-2,000
No
Texas
Any point in the service area to point of service cannot be greater than: › 30 miles for PCP and general hospitals in nonrural areas and 60 miles in rural › 75 miles for specialty care and specialty hospitals
No
Washington
› PCP ratio that meets or exceeds prior plan year › 80 percent of enrollees who live or work within 30 miles of PCP in urban area or 60 miles in rural area › PCP appointment within 10 days
No
Sources: Arkansas Admin. Code 054.00.106-5; Colorado Rev. Stat. Ann. § 10-16-704 and Colorado Dept. of Regulatory Agencies, Div. of Insur. Bulletin No. B-4.90; 215 Illinois Code 370i and Illinois Dept. of Insurance, PPO/HMO Network Adequacy Review Requirements Checklist (effective 01/01/2015); 02-031 Code of Maine Rule Ch. 850, § 7; Texas Admin. Code tit. 28, § 3.3704; Washington Admin. Code 284-43-200.
can save consumers a lot of time and travel, especially when there is inclement weather, a geographic barrier, or a lack of access to transit. At the same time, several respondents acknowledged that telemedicine is no panacea for network problems. For some specialty practitioners with whom it has been traditionally hard to contract, such as emergency room physicians and anesthesiologists, there is no telemedicine fix. Those and other specialties generally require in-person encounters with patients. Consequently, insurers report that they are not able to use the availability of telemedicine as negotiating leverage with such specialty providers. Some respondents also indicated that, even for some specialty services that are more amenable to deliver care through telemedicine (such as behavioral health, dermatology, and radiology), the needed workforce and technical infrastructure just do not exist. Moreover, insurers, regulators, and providers alike highlight potential risks to patients as well as regulatory and practical barriers that inhibit insurers from aggressively pursuing
telemedicine to meet network adequacy standards. For example, one practical barrier may be the labor and facility costs associated with use of telemedicine technology. As one provider respondent noted, the professional support for a [telemedicine] visit may be the same—or more—than what is required for an in-person visit because a provider may be required to be in the room to assist the patient, in addition to the provider delivering the service via videoconference hookup. Other respondents indicated that telemedicine has not yet reached a tipping point in terms of widespread acceptance and use among physicians and patients. As one insurer noted, “Getting used to [the] telemedicine idea” is a challenge to expanding its overall use. “Telemedicine isn’t part of our training; it’s a whole new area,” stated a provider respondent. And another insurer found that its enrollees don’t tend to embrace telemedicine, even when it is available and reimbursed. “Demand is not high,” said the insurer respondent, citing a lack of awareness as well as patient discomfort with the less
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personalized interactions with their physicians. Insurers’ embrace of telemedicine has been slow, in part because of regulatory uncertainty In general, insurer respondents have been slower than hospitals and health systems to embrace the use of telemedicine, and most are not currently using it to help them meet state or federal network adequacy standards. Although insurers recognize that many state regulators are or will be strengthening their oversight of network adequacy, there are no current indications that they perceive telemedicine as a potential shortcut to meeting regulators’ expectations. Colorado is the only state—in this study—that has explicitly incorporated the use of telemedicine as a factor to consider in assessing whether a plan meets the state’s network adequacy standards. Enacted in 2015, this provision of Colorado’s network adequacy law is not effective until January 1, 2017.20 Insurers will be allowed to offer remote access to specialty services as a way to meet the state’s network adequacy requirement, so long as the specialty service can be delivered appropriately through telemedicine. Recently Colorado issued guidance establishing quantitative measures—maximum waiting times, provider to enrollee ratios, and travel distances—to assess network adequacy (table 2). Currently, insurers in Colorado are not generally using telemedicine to fulfill network adequacy requirements. One Colorado insurer noted uncertainty about whether telemedicine
can truly help insurers meet network adequacy standards, stating that telemedicine’s impact “remains to be determined.” When asked about the state’s new law, which allows insurers to use telemedicine to satisfy the specialty provider-to-covered person ratio, regulators remarked, “We haven’t gotten into the details of what that looks like at this point.” None of our other study states have issued guidance on if and how insurers can use telemedicine to address network adequacy. Like Colorado, all of the other study states have established quantitative criteria standardizing the requirements that insurers must meet. No state has issued official guidance about using telemedicine with its network adequacy standards. Most regulator respondents express a wait-and-see approach to how telemedicine could be used for network adequacy purposes. And, while most are open to having insurers use telemedicine to meet network adequacy standards, they would generally frown on an insurer’s use of telemedicine encounters that could be perceived as replacing, rather than supplementing, face-to-face access to a physician. They also indicate an interest in better assessing whether and how insurers are using telemedicine and in determining how consumers are faring. As one regulator put it, “We’ll want to know from insurers whether there is a real benefit to enrollees.” Maine regulators appear doubtful that telemedicine would ever be an acceptable method for insurers to fulfill that state’s network adequacy requirements. At the same time, data are lacking about how to assess enrollees’ experiences. In Arkansas, for example, regulators
Table 3. Approaches to Private Coverage Reimbursement for Telemedicine in Our Study States* State
Coverage at parity with in-person encounter?
Arkansas
Yes, as long as care is delivered by an Arkansas-licensed physician and a professional relationship has been established between the provider and the patient. The professional relationship includes a previous in-person examination.
Colorado
Yes, in counties with 150,000 or fewer residents. Beginning January 1, 2017, this restriction is lifted.
Illinois
No, it does not require parity reimbursement. If an insurer covers telemedicine, that coverage prohibits health plans from doing the following: (1) requiring face-to-face encounter, (2) requiring provider to document a barrier to in-person consultation for coverage, and (3) requiring use of telemedicine when either the provider determines it is inappropriate or the patient chooses an in-person consultation.
Maine
Yes.
Texas
Yes.
Washington
Yes, effective January 1, 2017, as long as the service is recognized as an essential health benefit.
Sources: Arkansas Code 23-79-1602 and 17-80-117; Co. Rev. Stat. 10-16-123; Illinois Insurance Code § 356z.22; Maine Rev. Stat. Ann. Title 24, § 4316; Texas Insurance Code § 1455.004; Rev. Code of Washington § 41.05. * There may be certain requirements depending on the telemedicine modality. Also, states differ in whether insurers must pay facility fees to the originating site (the site in which the patient is located) in addition to the payment for the provider being consulted. Texas law requires insurers to pay the facility fee for the originating site whereas Washington leaves it up to the insurer and to the provider’s contract. Colorado also requires a reasonable facility fee unless the originating site is a private residence, which it excludes. Arkansas does not mandate nor does it prohibit a facility fee payment.
state’s network adequacy standards, particularly if a specialty provider was no longer available except through the use of telemedicine. Regulators also indicate a willingness to keep their regulatory stance toward telemedicine flexible, particularly if the use of telemedicine as an alternative delivery mechanism becomes more popular and widespread.
currently are examining new data from insurers and are developing uniform definitions as part of an expanded effort to monitor network adequacy. They acknowledge, however, that the use of telemedicine providers is not explicitly captured in insurer filings. Thus, they have no way to know if insurers are using telemedicine to meet network adequacy standards right now. Similarly, Maine and Washington currently do not require insurer filings to indicate whether enrollees are accessing care via telemedicine. Washington regulators are updating insurers’ monthly reporting requirements so regulators can capture which providers use telemedicine to deliver services; such data should become available in 2017. Washington regulators take a strong stance that insurers should not be able to use telemedicine in place of having providers on the ground to meet the state’s network adequacy standard. “For networks that are lean, insurers may see [telemedicine] as a way to gap fill,” stated a Washington regulator, then noting that Washington has “very specific time, distance, and access standards” and would not accept an insurers’ use of telemedicine as a way of meeting those requirements. Such a stance probably limits insurers’ ability to use the option of remote telemedicine providers as leverage in price negotiations with local provider groups that exercise market power to charge high prices. Although the Washington insurance department has not yet published specific guidance to insurers regarding the use of telemedicine, its unofficial position does not surprise insurer respondents in the state. One respondent indicated it would “love to use telemedicine” for network adequacy but voiced skepticism that it would pass regulatory muster. However, regulator respondents did note that limited circumstances may exist in which insurers could request an alternative access delivery review, which allows insurers to deviate from the
Texas is the only state in which regulators report having seen insurers include the use of telemedicine providers as part of their network adequacy plans, but regulators report that they see it rarely. When insurers do incorporate telemedicine, regulators have found telemedicine more common with certain specialty groups (such as oncologists who are affiliated with large hospital systems) as a way to provide follow-up care or consultations. State officials have not published formal guidance to insurers about how to demonstrate network adequacy using telemedicine. If telemedicine providers are being used, however, insurers must provide a map of their geographic locations and must note that use in their access plans if the providers are not in the health plan’s geographic service area. Policies and practices inhibit telemedicine’s growth and insurers’ ability to leverage it for care delivery Twenty-nine states and the District of Columbia require insurers to reimburse for certain services that are delivered through telemedicine modalities at parity with reimbursement for inperson care (appendix A). In other states without coverage parity requirements, private insurers have flexibility to cover and reimburse for telemedicine services. Some may follow the Medicare reimbursement policy as a model, including the program’s significant restrictions on where and how telemedicine services are covered. Others may choose not to cover it at all because they believe the costs outweigh the potential that telemedicine will enable them to offer a more robust, competitive provider network. Of our study states, only Illinois does not have a coverage parity mandate for telemedicine (table 3). Respondents in that state attribute the lack of a coverage parity requirement to telemedicine’s slow adoption among providers and insurers. According to one respondent, the largest insurer in Illinois “is just not moving [on telemedicine]” because there is no requirement to pay for telemedicine services at parity with faceto-face encounters. Subsequently, although there have been
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States with Parity Laws for Private Insurance Coverage of Telemedicine (March 2016)* States
Parity law for private coverage?
States
Parity law for private coverage?
Alabama
No
Montana
Yes
Alaska
No
Nebraska
No
Arizona
Yes
Nevada
Yes
Arkansas
Yes
New Hampshire
Yes
California
Yes
New Jersey
No
Colorado
Yes
New Mexico
Yes
Connecticut
Yes
New York
Yes
Deleware
Yes
North Carolina
No
District of Columbia
Yes
North Dakota
No
Florida
No
Ohio
No
Georgia
Yes
Oklahoma
Yes
Hawaii
Yes
Oregon
Yes
Idaho
No
Pennsylvania
No
Illinois
No
Rhode Island
No
Indiana
Yes
South Carolina
No
Iowa
No
South Dakota
No
Kansas
No
Tennessee
Yes
Kentucky
Yes
Texas
Yes
Louisiana
Yes
Utah
No
Maine
Yes
Vermont
Yes
Maryland
Yes
Virginia
Yes
Massachusetts
No
Washington
Yes
Michigan
Yes
West Verginia
No
Minnesota
Yes
Wisconsin
No
Mississippi
Yes
Wyoming
No
Missouri
Yes
Source: American Telemedicine Association. State Policy Resource Center. www.americantelemed.org/policy/state-policy-resource-center#.VtRyOPkrLIV. Accessed February 2016. a Arizona’s parity law requires coverage and reimbursement of telemedicine services but includes geographic restrictions. * There may be certain conditions for reimbursement depending on the modality or service.
few attempts at using telemedicine among the many health systems in Illinois, it has not taken off compared with other states because nobody wants to risk it without the assurance that providers at both ends of the telemedicine transaction will be reimbursed at parity with face-to-face encounters.
a professional relationship through telemedicine and not just through an in-person exam. In contrast, Texas respondents indicate that pending litigation between its state medical board and one telemedicine provider has caused insurers to be cautious about its use.
Insurers in Colorado and Washington provide at least some coverage of services delivered via telemedicine, even though their state’s telemedicine parity laws are not yet in effect. They, along with other stakeholders, indicate that a greater barrier to telemedicine’s expansion was not the lack of a coverage parity law but rather the position of the state’s medical community and its regulation of the practice of medicine. Specifically, clinical practice policies from some state boards of medicine can impede the widespread adoption of telemedicine.
Varying reimbursement policies among states and opposition of local medical boards have led to a lack of both payer and provider investment in telemedicine technology. In many areas, there is thus insufficient technology infrastructure and integration into medical practices to make it economical for insurers to rely on telemedicine as an alternative method of delivering care compared to traditional, face-to-face encounters. Insurers themselves have made minimal up-front investments to promote telemedicine use. For example, one Colorado insurer states that it “relies on [hospitals and health systems] to bring the platform to us.” As a result, although some insurers express enthusiasm for telemedicine as a tool with great potential to help them demonstrate network adequacy, they also admit that—for many geographic areas as well as within the desired provider specialties—there is insufficient penetration to make its use practical.
In at least two of our study states, however, their medical boards have adopted or are considering approaches that would make it easier for physicians to use telemedicine. For example, in Colorado, the medical board required an initial face-to-face interaction to establish a physician-patient relationship in order to prescribe medication via telemedicine. Insurers in the state noted that this requirement has inhibited telemedicine from expanding. In August 2015, the medical board changed its position and no longer requires face-to-face encounters. Similarly, Arkansas’ medical board is currently re-examining its policy of requiring an in-person examination to establish a“professional relationship,” which is required under state law as a condition of payment. The state medical board is considering a revision that would allow physicians to establish
Insurer respondents did not voice strong concerns that telemedicine would lead to increased use or to fraud and abuse, concerns that have been cited as reasons to limit its use in the Medicare context. However, insurers’ cautious embrace of telemedicine suggests that they are uncertain that the benefits of the technology will outweigh the costs.
Copyright© November 2015. The Urban Institute. Permission is granted for reproduction of this file, with attribution to the Urban Institute. About the Authors and Acknowledgements Sandy Ahn is an associate research professor, Sabrina Corlette and Kevin Lucia are research professors and project directors at the Georgetown University Health Policy Institute’s Center on Health Insurance Reforms. The authors gratefully acknowledge the expertise provided by the state insurance officials, insurance company executives, and telemedicine providers with whom we spoke. We also thank Linda Blumberg for her thoughtful review and comments, and the Robert Wood Johnson Foundation for its generous support of this project. About the Robert Wood Johnson Foundation The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org. Follow the Foundation on Twitter or Facebook. About Georgetown University’s Health Policy Institute—Center on Health Insurance Reforms The Center on Health Insurance Reforms at Georgetown University’s Health Policy Institute is a nonpartisan, expert team of faculty and staff dedicated to conducting research on the complex and developing relationship between state and federal oversight of the health insurance marketplace. About the Urban Institute The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. For more information, visit www.urban.org. Follow the Urban Institute on Twitter or Facebook. More information specific to the Urban Institute’s Health Policy Center, its staff, and its recent research can be found at www.healthpolicycenter.org.
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National News CareerEDGE
In the rapidly changing healthcare field, a career plan is more important than ever. To help you navigate this evolving marketplace, ACHE is pleased to bring you a unique, interactive and comprehensive tool for planning and managing your career— CareerEDGE™, available as a complimentary benefit to ACHE members.
CareerEDGE Features
• A personalized online Career Dashboard featuring career management tools, job board links, news items and other career resources • Access to several free assessments including a 360° Working Style tool, a modified versions of Meyer’s Briggs Type Indicator and ACHE’s Healthcare Leadership Competencies Assessment Tool • An innovative career planning framework to guide your thinking about career success today and in the future and help you build a solid career plan document • A process to help you make the connection between clarifying goals, identifying the competencies required for success, identifying valuable resources and assessing the level of progress toward developing critical skill sets. CareerEDGE is an easy-to-navigate, one-stop source for the full array of resources needed for a strategic approach to career management at any career level. Log in today to give yourself an edge in the healthcare job market! Click here for more
information.
ACHE Senior Executive Program
The Senior Executive Program prepares senior healthcare leaders for complex environments and new challenges. Past participants have been senior directors, vice presidents, COOs, CNOs and CFOs—many of whom aspire to be a CEO. The program consists of three sessions, each two-and-a-half days in length. Locations and dates are as follows: Chicago (June 6–8), San Diego (Aug. 14–17) and Orlando, Fla. (Oct. 24–26). Participants grow professionally in a supportive learning environment over three sessions. The program includes relevant topics, including reducing medical error, improving board relationships, increasing personal influence, understanding financial management in the era of payment reform, confronting disruptive behavior and influencing organizational change. Enrollment is limited to 30 healthcare executives. A limited number of partial scholarships—underwritten in part by Toshiba America Medical Systems Inc.—are available for those individuals whose organizations lack the resources to fully fund their tuition. For more information, contact Catie Russo, program specialist, at (312) 424-9362, or click here.
ACHE Executive Program The ACHE Executive Program is designed to help healthcare middle managers refine their knowledge, competencies and leadership skills. Participants will have the opportunity to learn, share and grow professionally together over three multiday sessions. The program covers relevant topics, including improving patient safety and clinical quality, understanding physician integration strategies, appraising personal leadership, managing disruptive behavior, increasing talent development, understanding hospital governance and conflict management and measuring financial success. The Executive Program will be held at the following locations and dates: Chicago (June 6–7), San Diego (Aug. 14–17) and Orlando, Fla. (Oct. 24–26). Participants must attend all three sessions in each city. Enrollment is limited to 30 healthcare executives. A limited number of full scholarships underwritten in part by Toshiba America Medical Systems, Inc. are available for those individuals whose organizations lack the resources to fully fund their tuition. For more information, contact Catie Russo, program specialist, at (312) 424-9362, or click
here.
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 click here.
Physician Executives and Healthcare Consultants Forums ACHE’s Physician Executives Forum and Healthcare Consultants Forum enhance value for physician executive and healthcare consultant members through a package of benefits tailored to their unique professional development needs. The Physician Executives Forum offers education, networking and relevant information that address the top issues physician executives face, such as leading quality initiatives and enhancing interdisciplinary communication skills. Benefits include a special designation on ACHE’s online Member Directory, e-newsletter and the opportunity to participate in ACHE’s exclusive LinkedIn Group. Physician executive members with an MD or DO credential are encouraged to click here to learn more about the Forum’s benefits and to join. The Healthcare Consultants Forum can help healthcare consultants stay ahead of the curve and more effectively meet client needs through targeted resources. Benefits include a special designation on ACHE’s online Member Directory, e-newsletter and the opportunity to participate in ACHE’s exclusive LinkedIn Group. More information is available here, where interested consultant members can join. The cost of membership in both Forums is $100 per year, in addition to ACHE annual dues.
ACHE’s Leader–to–Leader Program
ACHE Announces Its 2016–2018 Strategic Plan
At the November Board of Governors meeting, the Board approved the 2016-2018 Strategic Plan. In drafting the plan, ACHE reached out to members, chapter leaders and Regents to learn how ACHE can continue providing the best value to you in the rapidly evolving healthcare environment. As changes in healthcare unfold, we continue to offer top-notch educational programs, as well as research, books, magazines and journals with insight from experts on topics that are vital to your success. We also are expanding our 45,000-member community to include professionals from across the continuum of care, such as physician executives and other clinical leaders. In doing so, we will help prepare a new cadre of healthcare leaders. In addition, ACHE is committed to enhancing the FACHE® credential to ensure relevancy to the marketplace and stakeholders. Through a continued focus on professional development, we strive to help prepare leaders to provide the best care to the patients and communities they serve. ACHE continues to deliver innovative products and meaningful new solutions to keep you on the leading edge. Through new collaborations—such as our recent partnership with the National Patient Safety Foundation in developing a culture of safety—ACHE is working to engage top leaders in innovative leadership solutions. And, additional collaborations are being developed to increase and sustain diversity at the highest levels of healthcare leadership. New challenges and uncertainties test us as we work as a profession toward better health for all. ACHE is keeping a pulse on our environment, expanding resources and growing our community to help you meet those opportunities head on. Gain detailed information on the plan here.
When you share the value of ACHE membership with your colleagues through encouraging them to join or advance to Fellow status, you can earn points to obtain rewards such as gift certificates toward ACHE education programs, clothing, a water bottle, clock and even a chance to be entered into a raffle for a free Congress registration when three or more are sponsored. Each time a person joins ACHE or advances to Fellow status and lists your name as a sponsor on the application, you earn a point. The more points you earn, the more rewards you can receive. Points expire on Dec. 31 of the following year when they were earned (e.g., a point earned on Jan. 1, 2016, will expire on Dec. 31, 2017). You can check your point balance on the My ACHE area of ache.org. To ensure colleagues reference you, referral cards are available that you can pass out so you receive the credit you deserve. When you help grow ACHE, you make a strong statement about your professionalism and leadership in the healthcare field and also strengthen the organization. For more information click here.
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ACHE North Texas Education Events
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A Publication of the American College of Healthcare Executives of North Texas Chapter | SPRING 2016
February 25, 2016 What does successful population health management look like? How do initiatives
Over 100 North Texas ACHE members and guests representing a diverse cross-section of organizations from across the metroplex engaged in candid dialogue about current approaches to population health management and patient centered care. The discussion was led by two complimentary panels composed of local leaders and experts on the subjects.
to provide patient centered care shape population health management strategies? Are we really ‘all in’ with our initiatives to provide patient centered care, or is our current culture holding us back? These are some of the thoughtprovoking questions asked and discussed during the two-panel First Quarter Education Event hosted by JPS Health Network in Fort Worth.
Panel 1: Becoming Accountable: Achieving Success in Population Health Management Paul Aslin, Chief Operating Officer for Clinical Care Associates in Decatur, moderated the panel. Panelists included Daniel Varga, Senior Executive Vice President and Chief Clinical Officer for Texas Health Resources; Danny Ireland, Associate Vice President for Managed Care Contracting, Chief Operating Officer for UT Southwestern Health Systems, and Chief Executive Officer for the UT Southwestern Accountable Care Network; and Brent Hardaway, Vice President at Premier Healthcare Alliance. The panelists elaborated on their successes and lessons learned while devising and implementing strategies to improve population health management. Keys to success: focus on the 5% of the population that accounts for 50%
AAPublication Publicationof ofthe theAmerican AmericanCollege Collegeof ofHealthcare HealthcareExecutives Executivesof ofNorth NorthTexas TexasChapter Chapter | | WINTER SPRING 2015 2016
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of the costs for healthcare, drive the healthcare costs for this population to the lowest level by directing care to the communities where patients reside, and redistribute utilization models to keep hospitals viable and available when inpatient care is the most appropriate option. Panelists warned of the challenges that will be faced, most notably addressing social determinants critical to enabling patient accountability for his / her own health, and redesigning reimbursement models to align with innovative approaches to continuum of care. Panel 2: Integrating the Principles of Patient Centered Care Nancy Vish, President and Chief Nursing Officer for Baylor Jack and Jane Hamilton Heart and VascularHospital, moderated the panel. Panelists included Dan Bent, Director of Service Excellence at Texas Health Resources; John Phillips, President of Methodist Mansfield Medical Center; and Stephen Kimmel, Chief Financial Officer for Cook Children’s Healthcare System. Panelists agreed that the long-standing principles key to delivering patient centered care still ring true: hiring and retaining the right people, observing and correcting patient interactions across all units and disciplines to establish a consistent and positive experience, and streamlining processes
so that the patient experiences not only clinical excellence but also operational excellence. Newer tactics of including patients and family members when designing patient care, including community members on Patient Satisfaction Committees, and holding physicians and staff personally accountable to patient satisfaction feedback were also offered. However, none of these fully addressed the most provocative question of the evening posed by panel moderator Nancy Vish – Are we really striving to provide patient centered care, or is it patient centered care by our direction, driven by what is convenient for us? ACHE North Texas sincerely appreciates JPS Health Network for hosting the event and thanks the members and panelists for the opportunity to discuss and debate the current healthcare environment as it relates to population health management and patient centered care. For more information on future events, please visit us at achentx.org or send us an email at info@northtexas.ache.org.
April 28, 2016
value of telemedicine in healthcare through applications. The system’s initiatives focus on transforming primary care delivery, are built around patient satisfaction as the key metric of success, and ‘experiment’ with payment models that encourage physicians to embrace the lower cost healthcare delivery mechanism. Mr. Nason spoke to telemedicine’s role in providing specialist care and his experience with Specialists on Call, which has shown the value of telemedicine to be the services available anytime, anywhere and a return on investment associated
Panel 1: Telemedicine in the Healthcare Delivery System Fifty-six North Texas ACHE members and guests gathered at Baylor Scott & White Medical Center – McKinney to discuss the current and future role of telemedicine in the delivery of healthcare. Michael Hicks, Executive Vice President for Clinical Affairs at the University of North Texas Health Science Center and Interim Chief Executive Officer for Acclaim Physicians Group, moderated the panel. Panelists included Carl Couch,
Vice President for Innovation at Baylor Scott & White Health; Michael Lemnitzer, Senior Sales Manager for Philips Health; and Alexander Nason, Vice President at Specialists On Call. Mr. Lemnitzer provided an overview of the Philips suite of telehealth technologies, including eICU for virtual monitoring of ICU patients; eConsultant to support rural patient care; and eIAC, eCAC, and eTrAC as tools for intensive, chronic and transition to ambulatory care, respectively. He noted that while these and other telehealth tools have documented success in increasing productivity through economies of scale and reducing the cost of providing healthcare by millions of dollars, payer acceptance of this approach is lagging technology advancement. Dr. Couch agreed, and presented Baylor Scott & White’s ongoing and planned initiatives to further prove the
with moving the patient through the healthcare system more effectively. Additional advantages of telemedicine discussed during panel/audience dialogue included addressing nurse and other staff shortages, leveraging expertise, and reducing highcost emergency room visits and inpatient admissions. However, realizing these benefits will require a fundamental change in how the clinical team thinks about delivering care and the development of payment models acceptable to both providers and payers. ACHE North Texas sincerely appreciates Baylor Scott & White Medical Center – McKinney for hosting the event and thanks the members and panelists for the opportunity to discuss the evolving role of telemedicine in healthcare delivery. For more information on future events, visit us online or send us an email.
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EVENT ENCORE
THA Conference, January 21-22
EVENT ENCORE
Networking Reception with HFMA, February 4th
A Publication of the American College of Healthcare Executives of North Texas Chapter | SPRING 2016
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EVENT ENCORE
Breakfast with President - Nancy Vish, February 16
2016 ACHENTX Board Members From Back left to right: Forney Fleming, Michael Hicks, MD, FACHE Pam Stoyanoff, FACHE, Kevin Stevenson, FACHE, Jared Shelton, Corey Wilson, FACHE, Dresdene Flynn – White, FACHE, Janet Holland, FACHE
Board members not pictured: John Allen, FACHE, Teresa Baker, FACHE, Jennifer Conrad, Jessica Fuhrman, FACHE Ben Isgur, Kristin Jenkins, JD, FACHE, Winjie Tang Miao, Nancy Vish, FACHE Demetria Wilhite
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ACHENTX’S
NEWEST
FELLOWS
Members who recently passed the Board of Governors Exam
Felixia A. Colon, FACHE Brett D. Kirkham, FACHE Cynthia K. Slaydon, FACHE
WELCOME ACHENTX’S NEWEST MEMBERS JANUARY Violet M. Anderson, JD Peter A. Avalos Sam D. Bowers Joni Clements Watson Summer Collins, MD Cyrus Cooper Sydney Davis Lori Hodge William Jackson Sean Ketterick Ameerah Lawhorn David M. Linhares Laura L. Lockwood John A. Manos Robert R. Montgomery Cheryl Nail Jonathan P. Nelson Alfred Prentice Jr. Casie Rivas, JD Christina Roscoe Cameron Rowe Ana L. Sanchez Shahid Shafi Aesha S. Shukla Kelly E. Thornton Aslan Turer, MD Lisa Wagner Michael Walker Kayleen Watson
FEBRUARY Jonathan Banta Phillip Breedlove Kristen E. Bruder Robert Callahan Drew Carlton, RN Mae Centeno Chrystale Cigainero Jonathan Culp Parthenia C. Davis Julie Q. Do Eric Dominguez Jose Estrada Michael Flood Ken Idicula Randy M. Juelg Cory Kent Christie Le James Mendez Anna Olson Jon O. Pope III Jo Ann Pugh, RN Dana Radman, PharmD Holly N. Ragan Mai Tran Tomiko Washington Dan S. Watson Nikoma M. Wolf
MARCH
APRIL
Idowu Ajose Mitch Atkinson DeeDee A. Brooks Beau Burns John P. Carter Erin Clayton, RN John R. Davis Tiffany Etheridge Sullivan Blake Freeman Jason Fry Michael L. Haley Kim M. Hamilton Teresa Huffman, DSc Floreine Inayange Martin L. Koonsman, MD Codie R. Lawrence Lori LeMay Andrew Lim, Garrett Mayberry Tamala Norris, RN Stan Peterson Kendra L. Stewart Christina Tribble
Jennifer J. Alexander Taylor Bailes Danielle Church Christian Claudio Pre D. Cook Sherry Daswani Anthony D. Davis Paul DeBona Mahadev Desai Froy Garza Taylor A. George Matt Goss Gerry Handley Tashina M. Landis HM4 Cody B. McDonnold Preston Miller Demi Norwood Cheryl A. Ringo Brian Romig David M. Schwartz, DPM Erin Sigler Justin T. Simons, Laura A. Swaney Rose W. Wilson Scott C. Wise, MD
Event Calendar
Thursday, June 23
Tuesday, June 21
Membership & Networking: Breakfast with the President Josh Floren, Presby Plano
Education: LPC Education Event at GE Transportation
Texas Health Presbyterian Hospital Plano
July 26-29
ACHENTX co-hosted sessions with University of Alabama - Birmingham at their National Symposium for Healthcare (Enhanced Panel 13-8) Becoming Accountable: Achieving Success in Population Health and (77) Sustainability of Healthcare Organizations: A Plan of Action
GE Transportation
Friday, September 16
Advancement: BOG One Day Review Course THR, Arlington
Friday, June 24
After Hours Networking Event at Rangers Ballpark in Arlington
Thursday, October 27
Education: Diversity & Inclusion (TBD) and (70) Fostering Inclusion of LGBT Patients and Employees TBD
Wednesday, November 16
General Membership Dinner, Honoring Joel Allison; Guest Speaker: Ted Shaw (THA)
A Publication of the American College of Healthcare Executives of North Texas Chapter | SPRING 2016
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