Educational Sessions Descriptions

Pre-Conferences (Separate registration is required) Pre-Conference 1 Getting the Greatest Value from Home Care and Hospice Technologies Pre-Conference 2 Establishing Financial Systems and Making the Cost Report Work for All Pre-Conference 3 Hospice Financial Management

THURSDAY, July 30, 2009
Concurrent Educational Sessions (100 series)
11:30 am to 1:15 pm

Session 101
Managing Non-labor Direct Costs

One of the key issues facing home health leaders is how to manage non- labor direct costs. With the future of increased reimbursement in question, today’s home care leader needs to be focused on keeping all costs in line to include non-labor direct costs. This program will discuss some of the programs that one organization has used to significantly reduce non-labor direct costs and effectively apply cost management techniques to support the organization’s strategic plan.

Objectives:

• Explain the difference between direct labor costs and non-labor direct costs;
• Identify the benefits of a medical supply formulary as a tool for managing medical supplies within a home health agency and a hospice program;
• Discuss the issues impacting per diem pricing for hospice non-labor direct costs; and
• Describe alternatives for managing mileage costs.

Faculty: Larry Leahy, Foundation Management Services, Inc., Denton, Texas.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/ MAS).

Prerequisite: Basic knowledge of cost control systems.

Session 102
Financial Reporting; Access to Capital Markets

Capital access is challenging in these uncertain economic times. Health care organizations are finding capital to be difficult to access, expensive, time consuming and a potential outcome that may be less predictable than in the past. This has, in turn, shifted the paradigm for funding capital projects, acquisitions and growth. Financial reporting has always been a critical function for a home health organization. It has become, however, an even more essential internal function as management seeks strategic and operational guidance and the organization “tells its story” to the capital markets. This session will outline the essential financial reporting elements, both historical and prospective, and best practices of finance teams. It will also offer insights to organizations seeking advice in planning, presenting and accessing capital funding.

Objectives:

• Describe the historical and prospective financial reporting elements;
• Review upcoming GAAP financial reporting standards that may have an impact on home health or hospice agencies;
• Outline the ways to prepare and plan for accessing third-party capital; and
• Discuss potential capital funding alternatives, and key issues related to structure, process and valuation.

Faculty: John Richter, LarsonAllen LLP, Charlotte, N.C.; Greg Hathorne, LarsonAllen LLP, Charlotte, N.C.; and Mark Francis, Managing Director, Healthcare Investment Banking, Houlihan, Lokey & Howard, Zukin, Dallas, Texas.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/FIN).

Prerequisite: Basic knowledge of financial reporting and capital markets.

Session 103
Optimizing the Home Care Revenue Cycle

Optimizing the home care revenue cycle requires the ability to critically examine the processes leading up to the point of billing. A successful initiative to enhance the revenue cycle provides substantial returns beyond improved cash flow and working capital. This session will provide attendees with insights on how to examine the revenue cycle to identify opportunities to enhance performance, as well as provide benchmarks by which to compare current revenue cycle performance.

Objectives:

• Apply benchmarks by which to evaluate revenue cycle performance;
• Establish realistic revenue cycle performance goals;
• Recognize typical revenue cycle challenges; and
• Apply successful methods of evaluating revenue cycle operations in such a way to identify opportunities for improved performance.

Faculty: M. Aaron Little, CPA, Senior Managing Consultant, BKD, LLP, Springfield, Mo.

Course level: Intermediate; 1.6 nursing CEs; 2.0 accounting CPEs (NASBA/FIN).

Prerequisite: Basic knowledge of financial systems.

THURSDAY, July, 30, 2009
Concurrent Educational Sessions (200 series)
2:30 to 4:10 pm

Session 201
Clinical Compensation: Aligning Incentives Increases Case Capacity, Productivity and Improves Outcomes While Controlling Costs, Even if under a Collective Bargaining Agreement

PPS 2008 and the anticipated Valued Based Purchasing (P4P) has and will create greater demands upon home health agencies to become more sophisticated, anticipate increased patient census, achieve better clinical outcomes and take patient care management to new levels. All incentives throughout the agency should align with these goals, including compensation, care management and the measures of clinical outcomes, even if the agency is subject to a collective bargaining agreement. This program provides a discussion and analysis of creative solutions that address these issues and the advantages for recruitment and retention control of costs.

Objectives:

• Determine current compensation options to recruit and retain staff;
• Identify agency-wide incentives to achieve overall clinical and financial outcomes; and
• Discuss the staff performance issues and the resulting approach to improve productivity, case capacity and clinical outcomes under a Collective Bargaining Agreement.

Faculty: Pat Laff, CPA, Managing Principal, Laff Associates, Hilton Head, S.C.; Walter Borginis, CPA, Chief Financial Officer, VNA of Greater Philadelphia, Philadelphia, Penn.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/PHR).

Prerequisite: Basic knowledge of value based purchasing, incentives and outcomes.

Session 202
Proven Success Strategies for Hospice Cap Management

More and more hospice agencies are finding themselves hitting the annual payment cap and owing money back to Medicare. All too often, the cap liability comes as a surprise to the agency’s management. This session will provide attendees with insights on how to monitor the hospice cap throughout the cap year. Participants will also walk away with proven strategies to manage around the annual payment cap and avoid cap liabilities.

Objectives:

• Identify the rules of the annual hospice payment caps;
• Establish a hospice payment cap monitoring tool; and
• Apply successful practices for avoiding hospice payment cap liabilities.

Faculty: Mark Sharp, CPA, Partner, BKD, LLP., Springfield, Mo.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/RE).

Prerequisite: Basic knowledge of financial management for Medicare hospice.

Session 203
Diversification and Growth Strategies: Private Duty Services and More

With both Medicare Home Health and Hospice under increased MedPAC and budget scrutiny, providers are increasingly considering private duty services as a means to spur growth and diversify risk. In this session, we will discuss the unique characteristics of private duty services from a financial, operational, managerial and clinical perspective, and how these differences must be considered in developing a profitable private duty presence. Moreover, we will discuss the financial implications of diversification strategies in general, from revenue stimulation, to synergies, to leveraging infrastructure, to profit generation, and ultimately, value creation.

Objectives:

• Determine the unique characteristics of private duty services and how these characteristics impact development strategies;
• Identify best practices to diversify in private duty and other ancillary home care services; and
• Discuss the overall impact of diversification strategies in general with respect to revenue growth, profitability and value.

Faculty: Dexter W. Braff, The Braff Group, Pittsburgh, Penn.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/MKT).

Prerequisite: Basic knowledge of development, growth and operations of private duty services.

THURSDAY, July 30, 2009
Concurrent Educational Sessions (300 series)
4:20 to 6:00 pm

Session 301
Achieving Cost Efficiencies in Back Office Staffing and Structure

In the current days of facing more and more potential cuts in home care reimbursement, all agencies are trying to decide how best to cut/ preserve cost. This session will assist agencies in drilling down into processes, paperwork flow, technology efficiencies/deficiencies and much more. Agencies must achieve the highest level of cost efficiencies possible in the back office as well as in clinical care. This session is sure to highlight spots of cost efficiency consideration that the agency may not have investigated before. Do not overlook overhead cost that could be spent more effectively.

Objectives:

• Identify the cost indicators that must be understood in making operational decisions regarding back office staff;
• Develop billing department performance measures; and
• List statistical data that is key to establishing cost per visit/ episode information for the agency from annual Medicare cost report.

Faculty: Melinda A. Gaboury, CEO, Healthcare Provider Solutions, Inc., Nashville, Tenn.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs NASBA/BMO).

Prerequisite: Basic knowledge of back office operations.

Session 302
Benchmarking for Home Care and Hospice: Heading in the Right Direction

The world of home care and hospice has been flooded with new information derived from endless inputs of raw data into analytical formats. However, what in the explosion of data is useful information that will help guide your business to success? This program focuses on the essential components to any benchmarking effort in home care and hospice. This program presents what matters and how to use it in the most effective way. Information, not data, is what makes a difference.

Objectives:

• Identify essential components of the benchmarking process;
• Describe sources of data for development of agency or program-specific benchmarks;
• Identify at least five key benchmarks for both home care and hospice; and
• Explain how to turn data into information and action.

Faculty: Robert J. Simione, Principal, Simione Consultants, LLC., Hamden, Conn.; Mark Sharp, CPA, Partner, BKD, Ltd., Springfield, Mo.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/RE).

Prerequisite: Basic knowledge of quality improvement and benchmarking in home care and hospice.

Session 303
The Five Dysfunctions of the Home Care and Hospice Referral Process: How Much are they Costing Your Organization?

Explore common dysfunctions costing home care and hospice organizations money. Follow the process from start to finish and discover, at each stop along the way, what these dysfunctions are and how to remedy them. Learn from case studies and examples how the implementation of simple strategies and training are delivering strong return on investment. You will not want to miss this fast paced, interactive session. Lessons learned will pay dividends in all types of organizations.

Objectives:

• Define the five dysfunctions of the referral process;
• Relate how to turn them into strengths; and
• Calculate potential return on investment.

Faculty: Michael T. Ferris, Director, Marketing, Sales and Customer Service Consulting Division, Simione Consultants, LLC; Hamden, Conn.; Polly Rehnwall, Senior Manager, Marketing, Sales and Customer Service Consulting Division, Simione Consultants, LLC., Hamden, Conn.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/MAS).

Prerequisite: Basic knowledge of the referral process for home care and hospice.

FRIDAY, July 31, 2009
Concurrent Educational Sessions (400 series)
9:00 to 10:40 am

Session 401
Establishing Cost Controls in Workers Compensation and Unemployment

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/PHR).

Prerequisite: Basic knowledge of worker’s compensation and cost issues.

Session 402
Consolidation Strategies For Non-Profit and For Profit Companies

With many providers looking at mergers and acquisitions as a means to a.) spur growth and profits; b.) diversify risk; c.) expand service offerings; and d.) leverage infrastructures in an environment of declining reimbursement, consolidation continues to be a major force in both the for-profit and not-for-profit home care sectors. In this session, we will discuss key consolidation strategies, paying particular attention to the differences in approach, objectives and execution between for-profit and not-for profit players. Additionally, we will discuss the challenges that consolidation creates, and perhaps more importantly, how to insure that transactions succeed after the ink on the purchase agreement dries – cultural assessments, pre-integration strategies, due diligence, when and how to inform employees of pending deals, minimizing pre and post transaction stress, the value of strategically developed employee retention agreements and more.

Objectives:

• Identify key consolidation strategies to spur growth, diversify risk, expand service offerings and leverage infrastructure;
• Determine the differences in consolidation strategies for-profit and not-for-profit providers; and
• Discuss the challenges consolidation creates and the strategies to insure successful transactions.

Faculty: Dexter Braff, The Braff Group, Pittsburgh, Penn.; William Simione, III, Principal, Simione Consultants, Hamden, Conn.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/BMO).

Prerequisite: Basic knowledge of operations for non-profit and for-profit companies.

Session 403
Effective Financial Management of Medicaid Home Care Programs

Medicaid home care is a large but often misunderstood business that all too often gets painted with the same “Medicare business” brush. This program is designed to focus on the unique features of the Medicaid business, identify its strengths, weaknesses, and the keys to making it successful.

Objectives:

• Determine the unique features of the Medicaid business in contrast with the Medicare business;
• Identify the strengths and weaknesses of the Medicaid business model; and
• Discuss the keys to a successful Medicaid business.

Faculty: Steve Wood, Executive Vice President, Harden Health Care, Austin, Texas; John Richter, LarsonAllen LLP, Charlotte, N.C.

Course level: Intermediate; 1.6 nursing CEs; 2.0 accounting CPEs (NASBA/RE).

Prerequisite: Basic knowledge of Medicaid Home Care Financial Management.

FRIDAY, July 31, 2009
Concurrent Educational Sessions (500 series)
11:00 am to 12:40 pm

Session 501
Evaluating Employee Health Insurance Costs, Structures and Options

Health insurance serves as a major challenge for financial managers. On the one hand we are told that we have to keep on increasing it to attract and retain staff, but on the other hand the costs are continuing to rise disproportionately to revenue. This program is designed to help you manage these conflicting challenges.

Objectives:

• Identify different cost metrics;
• Understand cost trends; and
• Identify the different approaches and structures used, the funding and risk transfer options and potential options and strategies.

Faculty: Steve Wood, Executive Vice President, Harden Health Care, Austin, Texas; Michael Pokora, Managing Director, Willis, Chicago, Ill.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/PHR).

Prerequisite: Knowledge of health insurance options and costs for a business.

Session 502
Compliance Risks, Prevention and Management Techniques

The home care industry is the target of increased Medicare/Medicaid enforcement from intermediaries, program safeguard contractors, Medicaid Integrity contractors, soon the RACs, and eventually the ZPICS – an alphabet soup of government contractor enforcers. Find out about the major risk areas facing home care, and the concrete actions you can take to protect your agency or hospice before these contractors arrive at your door. Be prepared to implement an effective Compliance Program at your agency or hospice.

Objectives:

• Identify major Medicare/Medicaid compliance risk areas;
• Discuss actions to address risks in your agency or hospice; and
• Describe how to implement an effective compliance program.

Faculty: Denise Bonn, Deputy Director, Center for Health Care Law, National Association for Home Care and Hospice, Washington, D.C.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/RE).

Prerequisite: Knowledge of Medicare/Medicaid compliance requirements.

Session 503
Achieving Optimal Clincal Episode Management and Financial Balance

Home health care organizations have substantial opportunities to manage their costs, revenue and clinical outcomes effectively and efficiently. The keys to successful clinical and financial performance are within your reach – you just have to know where to look! This session will discuss the balanced scorecard approach to managing clinical care and revenue.

Objectives:

• Identify key elements of clinical episode management;
• Develop a financially and clinically balanced scorecard; and
• Evaluate strategies to increase productivity, timeliness of documentation and home health compare scores.

Faculty: Donna Gouveia, Chief Financial Officer, Visiting Nurse Service of Greater Rhode Island, Lincoln, R.I.; Linda Laff, Principal, Laff Associates, Hilton Head, S.C.

Course level: Intermediate; 1.6 Nursing CEs; 2.0 Accounting CPEs (NASBA/MAS).

Prerequisite: Knowledge of episodic management under Medicare prospective payment.

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