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Mark your calendars for Kansas Hospital Association's Critical Issues Summit for Hospital Boards, Aug. 27-28, at the Marriott Hotel in Wichita. Our keynote speaker will be George H. Labovitz, PhD, who will share how he has helped health care organizations achieve greater levels of organizational alignment and dramatically increased continuous quality improvement efforts.
Misaligned organizations, like cars out of alignment, can develop serious problems if not corrected quickly. They are hard to steer and don't respond well to changes in direction. Leaders must keep their people centered in the midst of change, deemphasize hierarchy, and distribute leadership by distributing authority, information, knowledge and customer data throughout their organization.
The Power of Alignment offers a new way to reestablish focus and sustain energy, and is a dynamic approach for staying balanced and achieving extraordinary levels of performance. In essence, alignment links the five key elements of an organization - people, processes, customers, business strategies, and of course, leadership - to obtain breakthrough results, chief among them, sustained growth, loyal customers and a high-performance work force.
Our second speaker at the Critical Issues Summit is Mac McCrary. Many board members and CEOs may have heard the maxim, "the board's job is to govern, and the CEO's job is to manage," although this is widely quoted, it is challenging to understand and implement. Boards find themselves asking such questions as: exactly where does governance stop and management begin? Is it ever appropriate for the board to "get its fingers" into management? Do the respective roles of boards and CEOs change as the circumstances within which the hospital operates change? During this session, McCrary will take a detailed look at the major aspects of this issue, how problems develop, what some hospitals are doing about it, and suggestions as to how your board and CEO can decide what their respective jobs are and what they will be in the future.
Another topic you won't want to miss at the Critical Issues Summit: The Board's Role in Managing Quality and Patient Safety. Leadership is the critical element in a successful quality and patient safety program. The board is a critical driver in moving the organization to higher levels of safety and effectiveness. During this session, Tom Evans, MD, president and CEO, Iowa Healthcare Collaborative, will discuss the various roles boards can play, like setting goals for organizational improvement; reviewing data related to key organizational metrics; reviewing adverse event reports and root cause analyses; providing resources for improved infrastructure, education and staffing; and holding management accountable for addressing quality and patient safety issues. In addition, he will talk about the many quality and patient safety initiatives available for hospitals to participate in and how to decide what the right approach is for your organization.
Is your hospital ready for the Recovery Audit Contractor program? The Medicare Modernization Act of 2003 established the Medicare RAC program as a demonstration program to identify improper Medicare payments - both overpayments and underpayments. RACs are paid on a contingency-fee basis, receiving a percentage of the improper overpayments and underpayments they collect from providers. The RAC program will be expanded to include all Kansas hospitals, including Critical Access Hospitals, on or shortly after August 2009. During this timely session, Martie Ross, with Lathrop & Gage, LLP, will provide insight into what role boards can play in making sure their hospital is ready for these audits, what your rights and responsibilities are under the program, and an overview of the appeals process on claims that are identified as overpayments.
In addition, the KHA Hospital Governance Task Force has suggested an optional pre-session on Thursday that will discuss hospital finance. Health care finance is unlike that of any other industry and uses terminology that is unique. It can be an overwhelming and confusing process to those outside of the hospital finance department. This pre-session will provide a basic overview of hospital finances to help the hospital trustee understand the complexities of hospital finance. An overview of the various Medicare hospital payment systems will be discussed, including cost-based reimbursement, prospective payment system and fee schedules. Information also will be provided on Medicaid eligibility, benefits and reimbursement. Participants will receive sample financial reports and be instructed on how to look for key indicators of financial performance. This session will be presented by Gloria Kupferman with DataGen, a HANYS Solution Company.
The Critical Issues Summit for Hospital Boards will be Aug. 27 and 28 at the Marriott Hotel in Wichita. The brochure and online registration form are available on the KHA Web site. Questions can be directed to the KHA Education Department at (785) 233-7436.
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How exciting (or not) to be a hospital trustee in a year when everyone's talking about "our business." You've no doubt been inundated with health reform in the news and at the water cooler. If you had the opportunity to watch President Barack Obama's recent nationally televised news conference, you are aware that he continues to make the case for health reform.
The Kansas Hospital Association's message to the Kansas Congressional Delegation has been consistent: There is undeniably a need for health reform, and it should be based on principles related to coverage for all, wellness, information, affordable care and quality. At the same time, it is extremely important that reform should be done in a bipartisan way. Finally, there is concern about a public program option that would pay everyone at the current Medicare level. We also have continually encouraged our Kansas delegation to take part in the discussions in Washington, so the interests of Kansas community hospitals and the patients they serve are well represented.
Needless to say, July has been a busy month for KHA, while we communicate our issues to policymakers in Washington. KHA President and CEO Tom Bell attended a meeting in Washington with Health and Human Services Secretary Kathleen Sebelius. KHA helped set up this meeting to introduce American Hospital Association President Rich Umbdenstock to the Secretary. Former KHA and AHA Board Member Maynard Oliverius also attended. Secretary Sebelius is extremely involved in the ongoing health reform efforts in Washington, but she also is engaged in many of the regulatory efforts underway at the Centers for Medicare and Medicaid Services.
Also in July, the Executive Committee of the KHA Board of Directors went to Washington to visit in person with the Kansas Congressional Delegation regarding health reform issues. It just so happened that we were there on Wednesday, when the agreement was announced between Senate Finance Committee Chairman Max Baucus, the White House, AHA, the Catholic Health Association of the United States, and the Federation of American Hospitals.
While some members of the Kansas Congressional Delegation expressed concern about the agreement between hospital groups and the White House, they understood that we must continue to work together toward what is best for Kansas community hospitals and the patients they serve. As such, we discussed with our elected officials a number of important rural health issues that hopefully can be included in whatever package ultimately is considered.
And that is where this issue gets confusing, as it is hard to know what package will prevail. The Democratic House Leadership released their 1,000 page health reform bill – "America's Affordable Health Choices Act of 2009." The Senate Health, Education, Labor and Pensions (HELP) Committee passed out of committee on a strict party line vote (13-10) their health reform bill, "Affordable Health Choices Act." And as mentioned above, Senator Max Baucus, the Senate Finance Committee Chair, and the White House, along with AHA, CHA and FAH reached agreement on a set of financing principles for their Senate bill. Confused yet?
From the rumors and rumblings about disgruntled House conservative Democrats threatening to derail health reform, to a reported deal between them and the House Energy and Commerce Chairman Henry Waxman and the White House brokered, its becoming increasingly difficult to determine what is being proposed and by whom. The difficulty is that each new "deal" has a little bit of sugar but a whole lot of sour, making it immensely hard for anyone to support any of the proposals.
Here are the main elements of most concern for hospitals that the Blue Dog Democrats brokered with the Administration. First, because the Congressional Budget Office contends the previous House bill offered little as it related to cost containment, they scored the bill much higher than leadership expected. As a result of this pressure, the "Super MedPAC" model, called the Independent Medicare Advisory Commission or IMAC, was agreed to "in principle." The IMAC would be charged with adopting payment policies that achieved substantial cost containment (see bigger payment reductions) if certain targets were not met. Congress would then have 30 days to pass resolutions to either accept or reject the Commission's recommendations. The real problem with this model is that the President can veto Congress' resolution. If that were the case, then Congress would have to work to override the veto, and that would require a two-thirds majority vote.
Oh, the sugar part, the House would back off of their strong "public plan" option and model it more like the Senate Finance Committee's cooperative approach.
KHA has advised our Congressional Delegation that a "Super MedPAC" or IMAC would be bad for hospitals and other providers. Congress alone needs to be allowed to make major payment and policy decisions for the Medicare and Medicaid programs and not some alleged independent commission. Low cost states with a lot of Critical Access Hospitals like Kansas would not be fairly represented in this type of scenario. We currently see that with MedPAC and their repeated recommendations to cut Graduate Medical Education payments, Disproportionate Share payments and their misguided attempts to significantly retard the CAH program.
President Obama is determined to get a bill passed – that is a certainty. Given the sense of urgency the White House is placing on passing a health care reform bill, we must continue to let our delegation know if something they are considering is bad for Kansas hospitals and, therefore, bad for Kansans. The Super MedPAC, or whatever it is called, would be bad for Kansas hospitals.
We will continue to keep our membership updated on a regular basis about what we are hearing coming out of Washington.
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Several opportunities for state grant funds under the American Recovery and Reinvestment Act relate directly to the needs and interests of Kansas Hospital Association members. KHA is actively representing the needs of community hospitals in Kansas, as planning efforts get underway in preparation for guidance to be released in the next weeks and months.
KHA Hospital Workforce Center staff is convening partners to plan for opportunities through the Employment and Training Administration grants designated for projects that prepare workers for careers in the high demand fields, with a particular focus on health care. The Department of Commerce is working closely with KHA to craft a framework and priorities for potential projects. In the absence of a defined state initiative around workforce, KHA has an opportunity to provide leadership in this area.
Opportunities for ARRA funds directed at Broadband Expansion and Demand Priming also are assigned to the Kansas Department of Commerce. KHA is participating in this planning process. The group has begun a set of invitational forums or focus groups to discuss activities and opportunities in the areas of health, government, economic development and education/libraries. KHA has made sure that a hospital voice is represented in each of the seven forums.
Coordination of grant opportunities for health information technology/health information exchange was originally assigned to the Kansas Health Policy Authority. Due to budget reductions, the lead was reassigned to the Kansas Department of Health and Environment. In July, KHA staff met with KDHE Secretary Roderick L. Bremby to discuss KDHE's new role as lead agency for the American Economic Recovery and Reinvestment Act's HIE activities in Kansas. In addition, Bremby provided attendees at the Health 3.0 Conference with a preview of his strategy for taking on their new responsibilities. In summary, strategies include:
- Engaging content and process consultants to assist in developing strategies and a vision or roadmap for Kansas HIE;
- Having conversations with key stakeholder representatives and participants in the KHPA Stakeholder Conference, held by KHPA earlier this year;
- Re-convening an "expanded" E-Health Advisory Committee, the group originally convened by the Governor's office and KHPA in late 2008;
- Cataloging shovel-ready projects in preparation for potential state grant applications to leverage what has already been accomplished;
- When guidance is released, applying for federal grant funds to both;
- Building upon and expanding current KDHE-based HIE projects, such as WebIZ (an active exchange of immunization records) and the chronic disease electronic management system; and
- Funding a planning process.
KHA continues to advocate for the more immediate needs of KHA members in their efforts to meet meaningful use, as well as the broader, more long-term strategies embodied in our Principles for the Adoption of Health Information Technology that will assist Kansas in realizing the value of the technology.
Be sure to check out the updated FAQs posted on KHA's ARRA Web page.
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Last year, the Kansas Medical Society and the Kansas Hospital Association jointly founded the Kansas Healthcare Collaborative, a provider-led organization designed to promote quality care through improvements in clinical practices and patient safety. Since that time, there has been much activity related to getting this collaborative effort moving forward. We have established a steering committee of health care leaders that has met several times and worked hard to focus the efforts of KHC on the right issues. We hired Kendra Tinsley as the KHC program director. Tinsley has been extremely busy planning numerous activities to help reach the objectives of the collaborative.
On Friday, Oct. 16, 2009, KHC (joined by KMS and KHA) will host its first "Summit on Quality." The event is designed to be a dynamic, interactive symposium focused on providing attendees information that can translate directly into enhanced patient care. KHC's inaugural "Summit on Quality" will bring together hospital CEOs, physicians, nurses, hospital senior management, quality and risk managers, clinic managers and trustees from across Kansas to actively discuss and identify initiatives geared toward clinical and systems improvement for the benefit of their communities.
The Summit's agenda will include morning and afternoon breakout sessions, each comprised of four broad topic areas:
- Value in health care - Presentations will demonstrate enhanced "value," including saved resources, cost reductions or improved patient satisfaction. Examples include hospital/physician partnerships, value-based purchasing and pay-for-performance.
- Culture and leadership - Presentations will reflect an effort to create an organizational culture related to improved quality, safety or enhanced engagement with patients and families. Examples include a balanced scorecard, LEAN in health care and patient-centered initiatives.
- Applications in the ambulatory environment - Presentations will cover initiatives focused on the physician office setting. Examples include the physician quality reporting initiative,
e-prescribing, workflow redesign, health information technology and effective use of registries.
- Clinical best practices - Presentations may cover innovative approaches or successful initiatives related to implementing clinical best practices. Examples include health care acquired condition reduction, "present on admission" or "never events," or other performance improvement efforts.
To augment the Summit's programming, KHC is seeking proposals from individuals and organizations interested in sharing the experiences they have had related to implementing quality improvement initiatives in hospitals and clinics. Trustees may participate in a "Call for Presentations" for those interested in demonstrating how quality projects in their own facilities have helped to enhance care.
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Join Kansas Hospital Association staff from noon to 1 p.m. on Wednesday, Aug. 5, for a Noon Briefing focusing on the IRS Form 990. This Webinar, led by Doug Anning of Polsinelli, Shughart, PC, will discuss the completion of the Form 990, policies that might need to be revised to be compliant and managing questions that may be raised by the public once your form is filed. Anning will bring special insight from his work with hospital industry associations and the IRS in creating the new IRS Form 990. The brochure and online registration form are available on the KHA Web site. Questions can be directed to the KHA Education Department at (785) 233-7436.
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Did you know the Kansas Hospital Association has a section of our Web site dedicated to Trustee Resources? Check it out by clicking on the Trustee Resources icon at www.kha-net.org. And if you haven't done so already, register for access to the members-only sections of the KHA Web site. Trustees are eligible to view member-only areas. Go to www.kha-net.org and click on "Login" (located in the upper, left-hand side of the home page). Scroll down to "NEW USER?" and then click on "Create username and password." Once you enter your information, a member of the KHA staff will verify your request during regular business hours. You will receive an e-mail confirmation as quickly as possible when your username and password have been activated. If you forget your username and password, click on "Login" (located in the upper, left-hand side of the home page), and scroll down to "E-mail Reminder? and then click on "Click here for a username and/or password reminder." Your username and password will then automatically be e-mailed to you.
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The Kansas Hospital Association Political Advocacy Committee Steering Committee, chaired by Jim Reagan, CEO, of Morris County Hospital, Council Grove, established the hospital-specific goals for this year's campaign. The overall goal is set at $60,000, a 4 percent increase over last year's goal of $57,500. Hospitals have received their PAC supplies and information to assist them in raising their individual goals. If you are interested in supporting the KHA-PAC, let your hospital CEO or administrator know. We appreciate your support.
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