The Newsletter of the Massachusetts-Rhode Island Chapter Volume XLI вЂў Number 6 MASS MEDIA PHYSICIAN PRACTICE MANAGEMENT вЂў Schedule M, Noncash Contributions and Gift-In-Kind Valuations вЂў Privacy Regulators Are Here to Stay: Effective Communication for Your Organization is Key вЂў Assuring the Effectiveness of Physician Compensation Plans вЂў Determining Strategic Physician Recruitment Needs Under Population Health Management: 5 Key Variables to Consider вЂў Reducing Unwarranted Variation in Care MM ISSUE 6_.cs5.5 .indd 1 8/29/14 5:07 PM THE MASSACHUSETTS - RHODE ISLAND CHAPTER OF HFMA GRATEFULLY ACKNOWLEDGES THE 2013-2014 CORPORATE SPONSORS PLATINUM American Express* вЂў Bank of America Merrill Lynch вЂў Beecher Carlson BESLER Consulting вЂў Dubraski & Associates Insurance Services вЂў Feeley & Driscoll, P.C. HBCS вЂў Logix Health вЂў MDS (Medical Data Systems, Inc.) PricewaterhouseCoopers LLP вЂў Siemens* вЂў TD Bank вЂў Verrill Dana LLP GOLD Ropes & Gray вЂў The Outsource Group SILVER Account Recovery Services вЂў CliftonLarsonAllen, LLP вЂў ECG Management Consultants, Inc. Gragil Associates, Inc. вЂў Health Management Associates, Inc. вЂў Healthcare Financial, Inc. вЂў Kaufman Hall KPMG LLP вЂў Medical Bureau/ROI вЂў ParrishShaw вЂў Phillips DiPisa вЂў ProMedical, LLC The PFM Group вЂў TriNet Healthcare Consultants, Inc. BRONZE Action Collection Agency of Boston вЂў athenahealth вЂў Baker Newman Noyes Carter Business Service, Inc. вЂў Cerner Corporation вЂў Citizens Bank вЂў Conifer Health Solutions* Deloitte Services LP вЂў HSM Consulting вЂў Marcam Associates вЂў Meridian Leasing Corporation Passport Health Communications вЂў PV Kent & Associates вЂў Trace by TWSG *Half-Year Sponsor On the Cover Account Recovery Services 27 American Express 25 Bank of America Merrill Lynch 26 Beecher Carlson 13 BESLER Consulting L to R вЂ“ Bronze Follmer Award recipients James Kenney, Lahey Clinic Health System, Stephen Doneski, Feeley & Driscoll, P.C., Lori Burgiel, Healthcare Administrative Solutions, Jan Costa, Senior Whole Health, John Droney, Pratt Radiation Oncology Associates, Inc., Nan Jones, Massachusetts General Physicians Organization, and Ames Ryba, Allscripts. 2 MM ISSUE 6_.cs5.5 .indd 2 8 Dubraski & Associates Ins. Serv., LLC 11 ECG Management Consultants, Inc. 16 Feeley & Driscoll, P.C. 9 Gragil Associates, Inc. 6 HBCS 7 Healthcare Financial, Inc. 22 Kaufman Hall 10 Logix Health 23 Medical Data Systems (MDS) 15 Phillips DiPisa 10 PricewaterhouseCoopers LLP 19 Ropes & Gray 17 Siemens 17 TD Bank 14 The Outsource Group 16 Verrill Dana LLP 12 Mass Media 8/29/14 5:07 PM The HFMA 2013-2014 year was a great success! I am proud to report that we achieved a perfect score on our Chapter Balanced Score Card. Our goals are primarily tied to membership counts, educational hours, certification levels, and member satisfaction. We also won three Yerger awards from National for the work we did to enhance certification opportunities, location of educational events and the revenue cycle meeting. On behalf of the Board of Directors, thank you to all of our leaders and volunteers who contributed to such a great year! IвЂ™d also like to thank our Immediate Past President, Roger Boucher, for his strong leadership and commitment to HFMA. May was a busy month with the Annual Awards Dinner and Social Night at the Downtown Harvard Club. Once again, this event was sold out. Congratulations to our award winners for their achievements and contributions to HFMA over the years. Special congratulations to Dan Phillips who was awarded the Hernan Award for his exceptional service to HFMA. The HFMA Region 1 conference at Mohegan Sun in May was a great conference followed by HFMAвЂ™s Annual National Meeting from June 22nd - June 25th in Las Vegas. Both of these conferences were filled with exceptional educational content and great speakers. Networking opportunities included a night at the Red Sox on May 28, 2014. Attendees got to see the 2004 World Series team including Manny, Pedro, Curt, and Jason! It was a great venue, the Red Sox won, and all we needed to make it a perfect night were temperatures that werenвЂ™t in the 40s! We had a wonderful golf event on August 25, 2014 at Granite Links, voted one of the top 100 Greatest Golf Courses. It was a picture perfect day at a top facility in our region! WeвЂ™ve begun to plan for the 2014-2015 year and encourage you to join a committee and put our educational events in your calendar for the upcoming year. We anticipate great speakers and educational content for these sessions. Accounting & Regulatory 10-17-2014 Capital Finance11-20-2014 Revenue Cycle 1-23-2015 Joint Practice Mgmt. & Enterprise Performance Mgmt 3-20-2015 Managed Care 6-5-2015 As we look forward to the upcoming year, our goal is to provide educational events that help you navigate the challenges of healthcare finance. If you have any questions about becoming more involved, please feel free to reach out to me directly at President@ma-ri-hfma.org. Best wishes for a wonderful summer! Sincerely, Deb Wilson President MM ISSUE 6_.cs5.5 .indd 3 8/29/14 5:07 PM 2014 - 2015 OFFICERS & DIRECTORS President Deborah Wilson, CPA MASS MEDIA HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION President Elect Timothy Hogan, FHFMA Secretary Beth O'Toole Treasurer Rosemary Rotty, MHA, FHFMA Immediate Past President Roger Boucher Directors Marvin Berkowitz, FHFMA Karen Bowden, RHIA Linda Burns, MBA, MHA Linda Guerra, MBA Umesh Kurpad Erik Lynch Kathleen Maher Laurie Nelle, FHFMA, MBA Robert Nelson, FHFMA, CPA Richard Russo Ames Ryba Deborah Schoenthaler Rosemary Sheehan David Tolley Gerard Vitti Ex Officio Jeffrey Dykens, CPA Garrett Gillespie Gerald OвЂ™Neill, FHFMA John Reardon, FHFMA Jeanne Schuster, CPA Michael Souza, FHFMA Richard Wichmann Contents Volume XLI Number 6 3 PresidentвЂ™s IMessage by: Deb Wilson The HFMA 2013-2014 year was a great success! I am proud to report that we achieved a perfect score on our Chapter Balanced Score Card. Region 1 20 HFMA Annual Healthcare Conference the Effectiveness of 6 Assuring Physician Compensation Plans I by: Marc Mertz, MHA, FACMPE To assess how effectively a physician compensation plan prepares an organization for future success, ask the following questions. Strategic Physician 7 Determining Recruitment Needs Under Popu- lation Health Management: 5 Key Variables to Consider I by: Tori Manis, MBA and Panos Lykidis, MBA HFMA held its Region 1 Annual Healthcare Conference on May 14 вЂ“ 15, 2014. The conference was again held at the Mohegan Sun Resort in Uncasville, Connecticut and was attended by over 450 attendees and exhibiting sponsors. 24 Annual Social & Awards Night With evolving payment models and the shift from volume to value-based care across the continuum, organizations throughout the country are designing and building clinically integrated networks of regional providers and hospitals with goals to improve access, quality, and outcomes. Regulators Are Here to 13 Privacy Stay: Effective Communication for Your Organization is Key I by: David C. Tolley, JD, MA Many healthcare organizations are increasingly focused on data privacy, and the same goes for regulators. Unwarranted 17 Reducing Variation In Care Many members of the Massachusetts-Rhode Island Chapter of HFMA gathered on the evening of May 22nd for our Annual Social and Awards Night. This year, well over 160 members and guests enjoyed a delightful evening of wine, food, and award presentations. M, Noncash 26 Schedule Contributions and Gift-In-Kind Valuations I by: Kenneth Kaufman, James W. Blake, and Mark E. Grube More care at higher costs does not necessarily result in better outcomes; in fact, the opposite often is true. I by: Karen L. Henderson, CPA and Haley Shulman, CPA Federal Form 990, Schedule M, Noncash Contributions, is used by tax-exempt organizations that are required to report noncash contributions received during the year. Newsletter Committee Jeanne Schuster, Executive Director, Ernst & Young, LLP Rosemary Rotty, FHFMA, Director of Service Line Finance, UMass Memorial Health Care, Inc. MASS MEDIA is a publication of the Massachusetts - Rhode Island Chapter of the Healthcare Financial Management Association devoted to keeping membership current on national & local healthcare financial topics. Opinions and views expressed in the articles and features of the publication are those of the author(s) and do not necessarily reflect the position of the Massachusetts-Rhode Island Chapter or The National Chapter of Healthcare Financial Management Association. Articles submitted are subject to editorial changes made by the committee. Article submissions, comments and requests for further information and advertising rates may be forwarded to: Jeanne Schuster and Rosemary Rotty, HFMA Massachusetts-Rhode Island Chapter, 411 Waverley Oaks Road, Suite 331B, Waltham, MA 02452, admin@ma-ri-hfma.org MM ISSUE 6_.cs5.5 .indd 4 8/29/14 5:07 PM Welcome New Members! PHYSICIAN PRACTICE MANAGEMENT The following members recently joined the Massachusetts-Rhode Island Chapter of HFMA. We welcome you to the Chapter and encourage you to take advantage of the many professional development, networking and information resources available to you at HFMA. Other HFMA members are a terrific resource for your everyday professional challenges вЂ“ we encourage all members, current and new, to get involved with HFMA committees and social activities. AndвЂ¦ use the Membership Directory вЂ“ itвЂ™s a great resource! We value your membership, so please send us feedback or questions on your HFMA experiences to admin@ma-ri-hfma.org. June 1 1, 2014 вЂ“ July 31, 2014 Bernard Bettencourt, DO Lahey Health Richard Buzzee New England Regional Health Care Cooperative Thomas Greeley Hallmark Health VNA & Hospice, Inc. Brenda Hudd Partners Healthcare Patrick Campbell MedAptus Annette Hughes Cape Cod Hospital Theresa Coffey Marlborough Hospital Jared Kesselheim Bain Capital Ventures Mark Crane North Bridge Growth Equity Karen Delio Erin Finn Brookhaven at Lexington MM ISSUE 6_.cs5.5 .indd 5 Thomas Lee, MD Press Ganey Assoc Leigh Martin Infor Dynamic Science Labs Joshua Pascoe Aptitude Software Cheryl Perry Vibra HealthCare Tonya Skeen Nuance Mah-Jabeen Soobader MedAssets Scott Wilson Recondo Tecnology Geoff Wingar Aptitude Software Kristen Yakimow Ken McCumber AthenaHealth, Inc. Nuance 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT Assuring the Effectiveness of Physician Compensation Plans By: Marc Mertz, MHA, FACMPE T o assess how effectively a physician compensation plan prepares an organization for future success, ask the following questions: вЂў Are compensation levels competitive in the market? Can the organization recruit and retain high quality physicians? вЂў Is compensation consistent across the organization? Are physicians, especially those in the same specialty, paid under the same general compensation plan and rates? Or are there many compensation plans? Variation can lead to internal competition as well as physician dissatisfaction. вЂў Does the compensation plan include incentives that are consistent with the goals of the organization? Does the plan include compensation for quality, patient satisfaction, access to care, citizenship, achievement of organizational goals, financial performance, participation in committees, and other factors valued by the organization? вЂў Does the compensation plan put enough physician income at risk for performance? Our experience shows that 15 to 20 percent of total compensation must be at risk to truly influence behavior. Performance measures must be for factors that physicians control or at least influence. вЂў Is the compensation plan responsive to the local market? As payers increasingly reimburse the organization based on value rather than units of service, does the compensation plan adapt the way that it compensates physicians? вЂў Is the use of advanced practice providers (вЂњAPPsвЂќ) effectively encouraged? APPs can help increase patient access to care and reduce the overall cost of care. If the plan is not designed and implemented effectively, it can encourage physician behavior that is inconsistent with the organizationвЂ™s objectives. Failure to include physicians in the process can also lead to physician dissatisfaction and potentially the ability to recruit and retain quality physicians. вќЏ For more information on assessing physician compensation plans, please contact Marc Mertz, MHA, FACMPE at 310.320.3990 or mmertz@ thecamdengroup.com. 6 MM ISSUE 6_.cs5.5 .indd 6 Mass Media 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT Determining Strategic Physician Recruitment Needs Under Population Health Management: 5 Key Variables to Consider By: Tori Manis, MBA and Panos Lykidis, MBA With evolving payment models and the shift from volume to value-based care across the continuum, organizations throughout the country are designing and building clinically integrated networks of regional providers and hospitals with goals to improve access, quality, and outcomes. To align with the organizational strategic planning process, physician recruitment will no longer be based solely on projected physician fulltime equivalent supply numbers and demographic adjustments. Recruitment planning must take into account the clinical and strategic impacts of current developments in population health management, care model redesign, regional market dynamics, use of technology, and the changing role of the physician in the patient care continuum. Issue 6 MM ISSUE 6_.cs5.5 .indd 7 Below are five considerations to evaluate in determining future physician recruitment needs. 1.Align with organizational strategic goals. It is essential that physician recruiting efforts support the fundamental strategic goals identified at the organization related to clinical integration, physician alignment, information technology, care model and quality metrics, and the alignment of new hospitals and medical groups. Organizations should evaluate both the mix of current physician relationships to the hospital or health system (employed, contracted, aligned, and independent) and the new types of providers or sites across the continuum, and determine whether this will (continued on page 9) 7 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT This is your chance to win a $100 gift card AND earn educational credits for the Chapter! How do you win? First, read the below four articles in this issue of Mass Media and answer five questions for each article to be entered into a random drawing for the $100.00 gift card. How do you enter? First, read the below four articles in this issue 1. 2. 3. 4. Schedule M, Noncash Contributions and Gift-In-Kind Valuations Determining Strategic Physician Recruitment Needs Under Population Health Management: 5 Key Variables to Consider Privacy Regulators Are Here to Stay: Effective Communication for Your Organization is Key Reducing Unwarranted Variation in Care Next, follow this link to a survey with the article questions: http://survey.constantcontact.com/survey/a07e9n3iz38hyai8m75/start Finally, answer the questions and provide your name and HFMA ID number (you must be an HFMA member to qualify for the drawing). We will close the survey 60 days after the newsletter is released. The winner will be notified soon after and the $100 gift card will be delivered. Good Luck! 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Consider access, volumes, quality, outcomes, leadership, and referrals based on the existing relationships, and determine whether additional physicians or groups should be employed or aligned with the organization through another structure such as a clinically integrated network, in order to meet the organizationвЂ™s overall goals. If physicians are identified and recruited to align with the overall goals, it will contribute to the organizationвЂ™s overall success in the market and caring for its population. 2. Redefine geographic reach and market dynamics. Organizations have traditionally defined their service area based on draw rates of patients within their primary and secondary service areas. Organizations should strategically look at their service area through a different lens and focus on identifying strategic ZIP codes in their extended market where access, referrals, and physician office location gaps exist in order to build their regional networks and recruit where the greatest strategic need exists. Recognizing access by specialty, physician practice locations, and dynamics around regional clinically integrated networks will help organizations determine what physicians they are able to align with and where physicians have previous ties (e.g., through Medicare Shared Savings Program participants). In addition, as health plans and health systems continue to curtail healthcare (continued on page 10) Feeley & Driscoll, P.C. CertiпїЅied Public Accountants Business Consultants Service Quality Expertise Feeley & Driscoll represents a full spectrum of healthcare organizations. We are one of the largest regionally-based providers of accounting and business advisory services to the healthcare industry in New England. Our experience and expertise covers an extensive and diverse range of clients and engagements. вЂў Hospitals вЂў Physician Group Practices вЂў Ancillary Service Providers вЂў Senior Care Providers вЂў Home Healthcare & Hospice Providers вЂў Physician Hospital Organizations вЂў Human Service Providers вЂў Integrated Delivery Systems вЂў Community Health Centers вЂў Long Term Care Facilities Feeley & Driscoll, P.C. | 200 Portland Street | Boston, MA 02114 | 617.742.7788 | www.fdcpa.com Issue 6 MM ISSUE 6_.cs5.5 .indd 9 Stephen J. Doneski Director SteveD@fdcpa.com 617.456.2449 Erik W. Lynch Director ErikL@fdcpa.com 617.456.2446 Douglas J. McGregor Director DougM@fdcpa.com 617.456.2402 Christopher J. Previte Director ChrisP@fdcpa.com 617.456.2481 9 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (5 Key Variables to Consider - continued from page 9) costs, more aggressive levels of population management are anticipated, in areas such as preventive screening, inappropriate utilization, and avoidable admissions and readmissions. With management shaping care delivery and daily physician activity and visits, transitioning from a low to a moderately managed patient population or a moderately to a high managed patient population will influence future physician needs and recruiting plans, with the highest recruiting impact in specialties focused on chronic diseases (e.g., primary care, cardiology, nephrology). of hospitalists and nurse practitioners), patient engagement, and physician practice dynamics are becoming increasingly important. The factors listed in the table should all be taken into account when determining physician need, as they could have a material impact on the number of physi- 3. Incorporate care model adjustments. In addition to adjusting physician demand ratios within a needs model for demographics based on population growth, aging, and ethnicity, consider adjustments in ratios based on discharge use rates of the local population. Care delivery models and geographic access across the continuum (both inside and outside the hospital with the rising use (continued on page 11) Helping Hospitals Achieve Success in the вЂњNew EconomyвЂќ For all hospitals and health systems, the financial crisis and the potential impact of healthcare reform have prompted the need to proactively identify and evaluate strategic options. Major initiatives must be on-target strategically and affordable, given the changing healthcare delivery environment. Access to capital to fund the selected initiatives must be secured under the best-possible terms, and capital structure risk should be managed on both sides of the balance sheet. These are not вЂњnice-to-haveвЂќ actions, but management imperatives. To learn more about how Kaufman Hall can help your organization to achieve success in the new economy, please call 847.441.8780 or visit kaufmanhall.com. Integrated Management Solutions for Healthcare CHICAGO вЂў ATLANTA вЂў BOSTON вЂў LOS ANGELES вЂў NEW YORK 847.441.8780 / kaufmanhall.com 10 MM ISSUE 6_.cs5.5 .indd 10 (continued on page 10) Mass Media 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (5 Key Variables to Consider - continued from page 10) cians a particular population requires. In addition, while historically physicians were organized in solo or small practices, with support from a nurse and/or office manager, todayвЂ™s care teams are redesigned across roles and functions to support the physician and increase quality of care and productivity. Care teams include the provider, clinical support, front office support, and physician recruiting must support the redesigned care team. The expanding role and use of clinical support staff, in many specialties, for example primary care and surgical specialties, may mitigate the need for additional physicians. 4. Evaluate specialty market share and continuum access. Specialties must be clearly defined (e.g., spine, vascular, gastroenterology) by organizations in order to determine the current and future physician need. In addition to inpatient market share, organizations must also consider their market role in the particular specialty (e.g., market leader, presence of a specialty institute). This is important given the significant role of the outpatient and physician office setting within certain specialties (e.g., ophthalmology, allergy, and immunology). Patient care protocols and access along the full continuum becomes increasingly important and will help determine individual specialty need (e.g., having specified back protocols within spine that are shared with primary care can decrease the volume of non-surgical spine cases). In developing specialty-specific recruitment plans, evaluate specialty access, including wait time (new and current patient), hours of operation, and productivity within physician practices, which can inform the actual need for physicians. Another key market variable to evaluate is the presence of retail and on-site employer clinics in the market, which may reduce the need for additional physicians or clinicians. (continued on page 12) Dubraski & Associates is a Privately-Held, Independent Insurance Brokerage and consulting company that specializes in providing unbiased solutions to the health care industry across all lines of business. HEALTHCARE EXPERTISE вЂў вЂў вЂў вЂў вЂў ManagedCareStopLossInsurance&Reinsurance ProfessionalLiability,Property,Casualty&ExecutiveLiability EmployeeBenefits,PharmacyBenefitManagement,Communications &Enrollment EquipmentMaintenanceManagementPrograms HealthCareDataPrivacy&Security Tracy Hoffman вЂў Principal 860.927.0995 вЂў THoffman@dubraski.com Issue 6 MM ISSUE 6_.cs5.5 .indd 11 11 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (5 Key Variables to Consider - continued from page 11) 5. Determine physician recruitment essentials. Aside from traditional physician recruitment packages, new requirements are becoming the standard in physician recruitment packages. Organizations must understand what physicians want, clinically, financially, and administratively, in order to successfully recruit or align them with their organization. School loan repayments and housing subsidies/ support are also other benefits offered. For more information regarding the development or update of your organizationвЂ™s medical staff strategic development plan, please contact Tori Manis, MBA at: tmanis@thecamdengroup.com or Panos Lykidis, MBA at: plykidis@thecamdengroup.com. If Clara Barton had faced an OIG or RAC audit, she might have turned to us for help. Okay, maybe we didnвЂ™t offer health law services 150 years ago. But our lawyers have over 150 years of combined experience handling payment and revenue cycle issues at every stage вЂ” compliance planning, claims submission, audit defense, internal investigations, public and private payer negotiations and appeals, and external enforcement response and resolution. Clara Barton didnвЂ™t have 21st century health law problems. But if you do, you might like our solutions вЂ” and our 20th century rates. Learn more about our Health Care Group at verrilldana.com/healthcare. Courtesy of Clara Barton National Historic Site Boston (617) 309-2600 | Portland (207) 774-4000 12 VERD.18625 ClaraBartonHealthcareAd.2014.FR.indd 1 MM ISSUE 6_.cs5.5 .indd 12 Mass Media 2/4/14 4:26 PM 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT Privacy Regulators Are Here to Stay: Effective Communication for Your Organization is Key By: David C. Tolley, JD, MA Many healthcare organizations are increasingly focused on data privacy, and the same goes for regulators. In the not too distant past, regulators would allow leeway for non-compliance with highly technical and complex state and federal data security laws. The most recent settlement agreements entered into between healthcare organizations and the United States Department of Health and Human Services Office for Civil Rights (вЂњOCRвЂќ) demonstrate that non-compliance вЂ“ big or small вЂ“ will no longer be easily excused. Highlights from Recent Enforcement Activity Just a few of the recent examples include: вЂў $800,000 settlement paid on June 23, 2014 by Parkview Health System of Indiana after leaving paper records unsecured and in boxes in a physicianвЂ™s home driveway. вЂў $1,725,220 settlement paid on April 21, 2014 (continued on page 14) Issue 6 MM ISSUE 6_.cs5.5 .indd 13 13 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (Privacy Regulators - continued from page 13) by Concentra Health Services stemming from the loss of an unencrypted laptop and an alleged history of internal findings suggesting risks based on lack of encryption of electronic devices. OCR of the entityвЂ™s HIPAA compliance program following theft of an unencrypted thumb drive containing the ePHI of approximately 2,200 individuals from a staff memberвЂ™s vehicle. вЂў $250,000 settlement paid on April 14, 2014 by QCA Health Plan, Inc. of Arkansas (вЂњQCAвЂќ) as a result of a lost, unencrypted laptop and suggestions by OCR that QCA had failed to comply over a number of years with HIPAA requirements. вЂў $1,215,780 settlement on August 7, 2013 paid by Affinity Health Plan, Inc. when an investigation by OCR indicated that Affinity impermissibly disclosed the PHI of up to 344,579 individuals when it returned multiple photocopiers to a leasing agent without erasing the data contained on the copiersвЂ™ hard drives. вЂў $215,000 settlement paid on March 6, 2014 by Skagit County, Washington as a result of inadvertent placement of patient information of 1,581 individuals on a publically available web server. вЂў $150,000 settlement paid on December 24, 2013 by Adult & Pediatric Dermatology, P.C. of Massachusetts following an investigation by вЂў $275,000 settlement on June 6, 2013 paid by Shasta Regional Medical Center when OCR determined that senior medical center officials disclosed PHI to multiple media outlets, without valid authorization (and without sanction) on at least three occasions. (continued on page 15) healthcare financing. TD Bank provides innovative financial solutions to address the unique needs of the healthcare industry. вЂў вЂў вЂў вЂў Fixed and Variable Rate Refinancing Direct Purchase Bond Financing Letters of Credit Project Financing вЂў вЂў вЂў вЂў Operations Financing Capital and Operating Leases Comprehensive Cash Management Services Standby Bond Services PUt the POWer Of tD BanK tO WOrK fOr YOU. Contact Alta Fleming at 617-310-0927 or connect to www.tdbank.com. TD Bank, N.A. | Some fees and restrictions may apply. Loans subject to credit approval. Equal Opportunity Lender 14 MM ISSUE 6_.cs5.5 .indd 14 Mass Media 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (Privacy Regulators - continued from page 14) Are There Any New Lessons to Learn? Maybe OneвЂ¦ What lessons can we learn from these settlements and others? Perhaps the only real lesson is that regulators are serious, and a broad commitment to compliance in a way that fills as many gaps in compliance as possible should be the goal for any organization. But most organizations have known this for some time. Furthermore, most of the themes are not new. For example, three of the seven settlements noted above resulted from theft or loss of a portable electronic device containing unencrypted patient data. While difficult to implement, entities have known for some time that they should have as a goal strong media control procedures along with entity-wide encryption of portable devices. Furthermore, OCR has made clear on a number of occasions that it expects organizations to undertake periodic internal security risk assessments followed by concrete steps by the organization to address potential gaps in security. Issue 6 MM ISSUE 6_.cs5.5 .indd 15 There is perhaps one lesson that is new when it comes to privacy: organizations cannot overestimate the importance of effective communication with the regulators who come knocking. Most organizations that receive a subpoena or other inquiry from the Department of Justice recognize the immediate seriousness of the inquiry and respond accordingly вЂ“ a well-managed, thoughtful response goes a long way. However, until very recently, privacy regulators at the state and federal level have seldom demonstrated an appetite for imposing penalties for non-compliance like their other law enforcement counterparts. Even seasoned professionals may be inclined towards a more routine and informal approach with these regulators. In our experience, approaching these regulators with an appreciation for the significant power they now wield and the seriousness with which they take their charge goes a long way and can lead to better outcomes for your organization. If you receive a letter or verbal inquiry from a privacy (continued on page 16) 15 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (Privacy Regulators - continued from page 15) regulator, you should consider the following: вЂў There is nothing wrong with having discussions with regulators about a reported breach or your compliance infrastructure. However, given that enforcement activity usually arises from follow up questions posed in the aftermath of a reported breach (and the findings that result), you should ensure coordination among compliance, legal and other executive groups to ensure an accurate and effective response by your organization. Avoid piecemeal responses without appropriate consultation among stakeholders. вЂў Consider utilizing internal or external counsel to oversee and facilitate responses to regulators so that you can use every communication with a regulator as an opportunity for effective advocacy. Advocacy is, of course, a broad concept. Often, cooperation with regulators is key to good advocacy вЂ“ you are almost always well-served by forming a good working relationship with your 16 MM ISSUE 6_.cs5.5 .indd 16 regulators. In addition, your ability to advocate effectively often depends on a solid understanding of the underlying facts вЂ“ taking the time to understand any underlying circumstances usually pays off handsomely whether because it helps you secure a better result for your organization or because it helps you calibrate your strategy quickly and avoid taking positions that you cannot later support with evidence. Last, there is no substitute for being willing to tell your story in a way that presents (and emphasizes) the strengths of your organization and acknowledges any weaknesses in proportion to your strengths. вќЏ David Tolley recently joined the Boston office of Latham & Watkins LLP where he focuses on representing healthcare providers, health plans and life sciences companies in compliance and regulatory enforcement matters. He can be reached at david.tolley@lw.com or (617) 880-4610. Mass Media 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT Reducing Unwarranted Variation In Care By: Kenneth Kaufman, James W. Blake, and Mark E. Grube For more than two decades, researchers at The Dartmouth Institute have been documenting the lack of correlation between the amount of spending and the quality of care received by Medicare patients.1 More care at higher costs does not necessarily result in better outcomes; in fact, the opposite often is true. Their findings point to three types of inappropriate care variation as key drivers of poor outcomes and high costsвЂ”overuse of supply-sensitive care (admitting patients with chronic illnesses to a hospital or ICU), misuse of preference-sensitive care (orthopedic prostheses or stents), and under- use of effective care (beta blockers for patients with heart attacks).2 Total excess costs (вЂњwasteвЂќ) are estimated to be nearly $800 billion.3 Issues Some physician-led organizations (Intermountain, Geisinger, Mayo, among others) have been delivering strong performance results through use of guidelines that eliminate unwarranted variation in (continued on page 18) The vision to dream big. At Siemens, we are devoted to bringing you the science you need to dream bigвЂ”redefine early detection, develop innovative treatments, deliver truly personalized care. We are dedicated to improving the health and well-being of patients. And weвЂ™re committed to helping you every step of the way. Siemens is proud to sponsor the 2012-2013 HFMA Massachusetts-Rhode Island Chapter Sponsorship program. www.usa.siemens.com/healthcare 1-888-826-9702 Answers for life. В© 2012 Siemens Medical Solutions USA, Inc. All rights reserved. Issue 6 MM ISSUE 6_.cs5.5 .indd 17 17 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (Reducing Unwarranted Variation In Care - continued from page 17) practice. Yet despite their success and the scope and longevity of the Dartmouth evidence, many organizations are not tackling the important goal of eliminating inappropriate clinical variation. Difficult issues, including politics, trust, and behavior change, are likely preventing progress. Physician autonomy has been central to the nationвЂ™s care model: one physician taking care of one patient for one episode of care in one facility of the physicianвЂ™s choosing. Although acknowledged as the most influential element of healthcare,4 physician practice traditionally has been a вЂњhands-offвЂќ area for leadership teams. Hospital leaders have focused on providing the very best facilities, equipment, and nursing staff so that doctors can do what they do best. In many organizations, physicians have been entirely in charge of making choices about how to provide care, define appropriate measures of quality, and monitor performance. Hospital leaders have been cautious about treading in the clinical domainвЂ”particularly with high-admitting physicians in high-revenue servicesвЂ” out of concern those physicians would take their patients elsewhere. This cannot continue. The point is that what physicians do matters to achieving Triple-Aim objectives, with which patients, hospitals, and payers are critical stakeholders. Full engagement of physicians, using proven best practices and facilitated by the organizations in which they operate, will be required to eliminate care variation. Information overload is also a significant issue. The unprecedented amount of clinical and biomedical information released each day can strain a systemвЂ™s ability to identify and rapidly diffuse evidence-based practices. Some studies suggest that just 10 to 20 percent of clinical decisions are adequately informed by formal evidence gained from clinical research.5 Clinical practice guidelines must be deemed trustworthy to stand a chance of being used. Recognizing this fact, Congress charged the Institute of Medicine (IOM) in 2008 with creating standards for developing practice guidelines and criteria by which they should be evaluated.6 Strategies From day one in every organization, physician leadership will be required to assess and implement guidelines. Physician leaders will be most effective in increasing physician buy-in. They are best equipped to identify sources of unwarranted variation and operational deficiencies that may be driving utilization and costs. Physicians should lead all guideline development and best-practice initiatives. Many hospitals and health systems do not have such leadership at this time. They will need to develop it. Cultural change is needed to build positive physician relationships, along with physician leadership development at all levels. To increase collaboration and commitment to best practices and care standardization organization-wide, Virginia Mason Medical Center (VMMC) developed a вЂњcompactвЂќ outlining the mutual responsibilities of the organization and its physicians.7 Physicians sign an agreement to вЂњimplement VMMC-accepted clinical standards of careвЂќ as part of the вЂњtake ownershipвЂќ section of physician responsibilities. VMMC leaders agree to вЂњprovide information and tools necessary to improve practiceвЂќ as part of the вЂњeducateвЂќ section of leadership responsibilities. A data-driven approach will be critical to physician participation in reducing care variation. Credible data have the power to change behavior. Physicians who receive trustworthy data with evidence of wide, unwarranted variation in their own careвЂ”whether related to quality, outcomes, and/or costвЂ”typically need no further inducement to bring their practices in line with their colleagues. A recent analysis of a consortium of physician groups in Wisconsin indicated that public reporting of data also can enhance physician performance in many measures, such as cholesterol control and breast cancer screening.8 An organization-wide approach to reducing clinical variation must be supported by a commitment to defining, collecting, analyzing, and monitoring key data related to quality, outcomes, access, and cost. These data provide benchmarks for clinical guidelines (continued on page 19) 18 MM ISSUE 6_.cs5.5 .indd 18 Mass Media 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (Reducing Unwarranted Variation In Care - continued from page 18) and protocols, and pertinent information to guide future revisions based on new analytical findings. Building a sustainable program of practice standardization can be taken one piece at a time. That piece may focus on an individual diagnosis-related group (DRG), use of a certain drug or device, an office visit, a specific test, a condition, a work process, a clinical program, or some other element of patient care. Choice of which piece to tackle first can be based on its likelihood of early success, which will build the trust and commitment needed for further improvement efforts. Reducing unwarranted variation in major joint replacement and other elective procedures has been an area of focus nationally due to current and projected use and cost, and therefore present one place to start. Claims data for selected high-cost DRGs can be particularly helpful in this regard. Five high-performing health systems recently reported on their study of total knee replacement. They selected the subject based on the wide variation in knee replacement rates and results among Medicare patients by location.9 They looked at surgery times, hospital lengths of stay, discharge dispositions, and complication rates from a sample of nearly 11,000 total knee replacements in their organizations.10 The systems found that surgeons who performed a higher number of total knee replacements each year tended to have shorter lengths of stay, shorter operating times, and fewer complications. Certain clinical practices eliminated variation to drive these positive results (see sidebar). Sidebar: Total Knee Surgery Best Practices вЂў Care coordination and medical co-management: A multispecialty preoperative evaluation of potential arthroplasty candidates and co-managed inpatient stays by anesthesia, internal medicine, (continued on page 22) Finding answers for вЂњnow what?вЂќ Moments of clarity. TheyвЂ™re in demand post-health reform. At PwC, weвЂ™re providing insight into the issues and challenges that organizations are now facing. WeвЂ™re ready to work with you, and develop the strategies that youвЂ™ll need to comply with new requirements and regulations so you can prosper. www.pwc.com/healthreform В© 2013 PwC. All rights reserved. вЂњPwCвЂќ refers to PricewaterhouseCoopers LLP, a Delaware limited liability partnership, which is a member firm of PricewaterhouseCoopers International Limited, each member firm of which is a separate legal entity. This document is for general information purposes only, and should not be used as a substitute for consultation with professional advisors. Issue 6 MM ISSUE 6_.cs5.5 .indd 19 19 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT HFMA Region 1 Annual Healthcare Conference HFMA held its Region 1 Annual Healthcare roads, Choosing the Right PathвЂќ and the tracks, Conference on May 14 вЂ“ 15, 2014. The confer- speakers and even dГ©cor lived up to its name. ence was again held at the Mohegan Sun Resort in Uncasville, Connecticut and was attended by over 450 attendees and exhibiting sponsors. Region 1 consists of the New England HFMA chapters: Connecticut, Maine, MassachusettsвЂ“Rhode Island, and New HampshireвЂ“Vermont. The conference had many great speakers on both days and throughout the seminars. Some high lights included a Keynote Address given by Donald M. Berwick, MD, Former Administrator for the Center for Medicare and Medicaid Services and Founding CEO of the Institute for Healthcare Improvement and a Capstone The conference included three tracks: Reve- Address given by Fred Lee, Author, If Disney nue Management, Payment/Reimbursement/ Ran Your Hospital вЂ“9 ВЅ Things You Would Do Regulation and Leadership, Innovation and Differently. The first day featured a network- Managing Change. ing reception where attendees mingled and The conference theme was вЂњAt the Cross- networked for two hours. Raffle prizes and a free (continued on page 21) Over 400 attendees listen to the Keynote Address delivered by Donald Berwick, MD. 20 MM ISSUE 6_.cs5.5 .indd 20 Mass Media 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (continued from page 20) 2015 Conference voucher were awarded at the conclusion of the second day. Thank you to the wonderful volunteers and sponsors who help make this event a Questions from the audience. success! Anecdotal feedback on the conference sessions from individual members was very favorable. Formal survey data will be used to develop next yearвЂ™s conference. We continue to strive to bring you the best conference each year and hope you will be able to join us again next year. Speakers Kathleen Maher from e4e, and Neville Zar from Deloitte pause for a photo before their afternoon session on ICD-10. Chapter President Deb Wilson, CPA and PresidentElect Tim Hogan, FHFMA, CPA enjoying the first day of the conference. MM ISSUE 6_.cs5.5 .indd 21 Region 1 volunteer and Chapter Committee Co-Chair Jennifer Samaras from Patient Funding Alternatives pictured with speaker Jennifer Tosto, Esq. from Convergent Revenue Cycle Management, Inc. R to L вЂ“ Region 1 Coordinator, Marvin Berkowitz from BHC Consulting, Capstone Speaker Free Lee author of If Disney Ran Your Hospital вЂ“ 9 ВЅ Things You Would Do Differently, and Karen Kinsella of Bank of America Merrill Lynch. Photos courtesy of Tony Slabacheski, Sutherland Global Keynote Speaker Donald Berwick, MD, Former Administrator for the Center for Medicare and Medicaid Services and Founding CEO of the Institute for Healthcare Improvement pictured with the Opening Speaker HFMA NationalвЂ™s Chair-Elect Kari Cornicelli, FHFMA, CPA. 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (Reducing Unwarranted Variation In Care - continued from page 19) and orthopedic surgery (rather than exclusive management by the latter) led to the lowest hospital complication rates. вЂў Dedicated operating room teams: Matching total knee replacement surgeons with a team of specialized arthroplasty scrub nurses and technicians resulted in the fastest operations and lowest complication rates due to staff familiarity with technologies, machinery, and instruments specific to knee arthroplasty. Source: Tomek, I.M., et al.: вЂњInnovation Profile: A Collaborative of Leading Health Systems Finds Wide Variations in Total Knee Replacement Delivery and Takes Steps to Improve Value.вЂќ Health Affairs 31(6): 1329-1338, June 2012. Not all organizations have the resources to conduct these kinds of studies, or immediately apply best practices appropriate for high-performing organizations. But serious work on eliminating unwarranted variation can and must get under way in all hospitals and health systems. Removing variation through practice standardization is an iterative process and a job thatвЂ™s never done; its potential for improving care and costs is enormous. вќЏ Excerpted with permission from Kaufman Hall Point of View: Five Hard Things Hospital Leaders Must Do to Transform U.S. Healthcare, July 2013. Copyright 2013 Kaufman, Hall & Associates, Inc. Kenneth Kaufman is Managing Director and Chair, and James W. Blake and Mark E. Grube are Managing Directors, Kaufman Hall, Skokie, IL, www.kaufmanhall.com. References (Endnotes) 1 The Dartmouth Atlas of Health Care (http://www. dartmouthatlas.org/) 2 Dartmouth Atlas Project Topic Briefs: Effective Care, Preference-Sensitive Care, and Supply-Sensitive Care; Jan. 15, 2007. 3 Institute of Medicine (Smith, M., et al., Editors): Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: The National Academies Press, 2012, p. 3-10 (http:// www.iom.edu/Reports/2012/Best-Care-at-Lower-CostThe-Path-to-Continuously-Learning-Health-Carein-America.aspx); and Farrell, D., et al.: Accounting for the Cost of US Health Care: A New Look at Why (continued on page 23) 22 MM ISSUE 6_.cs5.5 .indd 22 Mass Media 8/29/14 5:07 PM PHYSICIAN PRACTICE MANAGEMENT (Reducing Unwarranted Variation In Care - continued from page 22) Americans Spend More. Washington, DC: McKinsey Global Institute, Dec. 2008. (http://www.mckinsey.com/ insights/health_systems/accounting_for_the_cost_of_ us_health_care) 4 Fuchs, V. and Milstein, A.: вЂњThe $640 Billion QuestionвЂ”Why Does Cost-Effective Care Diffuse so Slowly?вЂќ NEJM, 364(21): 1985-1987, May 26, 2011. (http://www. nejm.org/doi/full/10.1056/NEJMp1104675) 5 Institute of Medicine (Smith, M., et al., Editors), 2012, p. 6-1. 6 Ransohoff, D.F., Pignone, M., Sox, H.C.: вЂњHow to Decide Whether a Clinical Practice Guideline Is Trustworthy.вЂќ JAMA 309(2): 139-140, Jan. 9, 2013. 7 Association of American Medical Colleges: AAMC Readiness for Reform: Applying LEAN Methodology to Lead Quality and Transform HealthcareвЂ”Virginia Issue 6 MM ISSUE 6_.cs5.5 .indd 23 Mason Medical Center, 2010. (https://www.aamc.org/ download/278946/data/virginiamasoncasestudy.pdf) 8 Lamb, G.C., Smith, M.A., Weeks, W.B., et al.: вЂњPublicly Reported Quality-of-Care Measures Influenced Wisconsin Physician Groups to Improve Performance.вЂќ Health Affairs 32(3): 536-543, March 5, 2013. (http://www.commonwealthfund.org/Publications/ In-the-Literature/2013/Mar/Publicly-Reported-Qualityof-Care-Measures-Wisconsin.aspx) 9 Tomek, I.M., et al.: вЂњInnovation Profile: A Collaborative of Leading Health Systems Finds Wide Variations in Total Knee Replacement Delivery and Takes Steps to Improve Value.вЂќ Health Affairs 31(6): 13291338, June 2012. 10 Tomek et al. (2012). 23 8/29/14 5:07 PM Annual Social & Awards Night PHYSICIAN PRACTICE MANAGEMENT HFMA Massachusetts-Rhode Island Chapter May 22, 2014 Many members of the Massachusetts-Rhode Island Chapter of HFMA gathered on the evening of May 22nd for our Annual Social and Awards Night. This year, well over 160 members and guests enjoyed a delightful evening of wine, food, and award presentations. The event was heldВ at the wonderful Downtown Harvard Club located on the 38th floor of 100 Federal Street in Boston - a fabulous location with panoramic views of the city and harbor.В Early in the evening, we wereВ introduced to Cote Mas Cremant de Limoux Brut, served during appetizers and socializing. Once seated, we were thenВ treated to superb French vineyard wines throughout our four course dinner and dessert.В The wines were all introducedВ by Margaux Arbo from Diva Wine, a national wine expert, who carefully explained the origins and processing of each wine. The wines complimented the outstanding four course dinner prepared by Executive Chef Damien Zedower and his staff of the Harvard Club. We toasted frequently, laughed, talked, and dined...all of the activities Chapter Past President Michael Connelly, CPA from Huggins Hospital and his daughter Meghan and his wife Kelli Connelly. Wine dinner event organizer Garrett Gillespie from CVS Caremark and Chapter President Deborah Wilson, CPA from Lawrence General Hospital. (continued on page 25) Winner of this yearвЂ™s Hernan Award Daniel Phillips from Phillips, DiPisa & Associates and his wife Cathy Phillips. 24 MM ISSUE 6_.cs5.5 .indd 24 Chapter Past President Gail Schlesinger, CPA of Steward Health Care and her husband Bob Schlesinger. Mass Media 8/29/14 5:07 PM Annual Social & Awards Night - continued from page 24) Chapter Life Membership recipient Allen Krause and his wife Sharon Krause. Issue 6 MM ISSUE 6_.cs5.5 .indd 25 Medal of Honor winners L to R Stephen Guimond, Cape Healthcare Finance, LLC, John Shaver, FHFMA, Noble Hospital, and Jeffrey Heidt, Esq., Verrill Dana LLP. Photos courtesy of Tony Slabacheski, Sutherland Global for whichMANAGEMENT we can thank Ms. Arbo, Chef Zedower and, which are near and dear to HFMA members! PHYSICIAN PRACTICE of course, our wonderful sponsors. A special thanks Roger Boucher, outgoing Massachusetts-Rhode to Garrett Gillespie for organizing this enjoyable event. Island Chapter President, and Deborah Wilson, Our Annual Social and Awards event is a wonderful our current President, presented the gold, opportunity to network, socialize with friends, partake of silver and bronze service awards to the award fine food and fine wine. recipients. A delightful evening was had by all, 25 8/29/14 5:08 PM PHYSICIAN PRACTICE MANAGEMENT Schedule M, Noncash Contributions and Gift-In-Kind Valuations By: Karen L. Henderson, CPA and Haley Shulman, CPA Federal Form 990, Schedule M, Noncash Contribu- tions, is used by tax-exempt organizations that are required to report noncash contributions received during the year. If a tax-exempt organization receives more than $25,000 of noncash contributions or receives contributions of art, historical treasures or qualified conservation contributions during the year, it is required to complete Schedule M when filing the Form 990. Noncash contributions, also often known as gifts-inkind (or in-kind donations), is a type of charitable giving in which goods and services are provided to a tax-exempt organization in lieu of donating money. Often times, these donated goods and services are items that the organization would have had to purchase had the items not been donated. Examples of in-kind gifts include food, clothing, medicine, equipment and various services. Prior to determining the value of the donation an organization needs to determine if the item may be used in carrying out their mission. If an organization determines that the items cannot be used or sold, then the organization should treat the transaction as if it did not occur and not account for the donation. Many tax-exempt organizations, especially foundations, are dependent on the support which is donated to the organization during the year. While cash contributions are typically a large part of the support these organizations receive, gifts-in-kind are also frequently (continued on page 27) Moving from paper to electronic with our HealthLogic revenue cycle solutions helps take the pain out of patient payments. ItвЂ™s how forward-thinking hospitals operate more efficiently every day. baml.com/healthcare The power of global connections For marketing disclaimer, visit bankofamerica.com/disclaimer 26 MM ISSUE 6_.cs5.5 .indd 26 Mass Media 8/29/14 5:08 PM PHYSICIAN PRACTICE MANAGEMENT (Schedule M вЂ“ continued from page 26) contributed. With the increase in the amount of in-kind gift donations many tax-exempt organizations are receiving, questions regarding the valuation and вЂњworthвЂќ of these types of gifts are on the rise. Organizations should also educate their employees regarding acceptance of gifts-in-kind by training them to understand the nature of the items that are received as well the donorвЂ™s intent for the gift-in-kind. Having this understanding is critical to correct financial reporting. Lastly, costs versus benefits must be considered. If the cost of obtaining a valuation of a gift-in-kind is greater than the value of receiving the gift in the first place, then perhaps the gift is not worth accepting. вќЏ Valuation/Measurement of Gifts-In-Kind Tax-exempt organizations are typically required to use fair market value to measure gift-in-kind contributions. Fair value is defined in FASB ASC Topic 820 as вЂњthe price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date.вЂќ About the Authors Karen L. Henderson, CPA, is a Tax Manager at WithumSmith+Brown, Certified Public Accountants and Consultants, and is a member of the firmвЂ™s Healthcare Services Group; In order to determine the fair market value, the organization must identify the вЂњprincipal exit market,вЂќ which is the market in which the organization could sell the asset or transfer the liability. Additionally, the organization must recognize that the donorвЂ™s market and the principal exit market of the tax-exempt organization are not the same. Therefore, generally donor provided values are not the same as fair market value. Hayley Shulman is a Senior Accountant. They can be reached at 973-898-9494 or by email at khenderson@withu.com or hshulman@withum.com. In these challenging economic times itвЂ™s Issue 6 MM ISSUE 6_.cs5.5 .indd 27 Solutions Oriented Providing the full range of highly eп¬Ђective accounts receivable management services exclusively to health care organizations in New England. вЂў Bad Debt Collection Account Recovery Services вЂў Pre-Collection вЂў Large Balances вЂў Third Party Follow Up вЂў Legal Services вЂў Probate / Estate Filings CORPORATE HEADQUARTERS 620 Main Street, Suite 2 East Greenwich, RI 02818 Phone 401.398.8310 Fax 401.398.8314 Email info@arsnewengland.c Website www.arsnewengland Solutions Oriented ns On ritee nd ted SolutiSoonlustioO rie Solutions Oriented Account Recovery Services been more important or diп¬ѓcult to be Lastly, the organization must consider any legal restriccessful with your bad debt collections eп¬Ђor ThatвЂ™s why you need ARS! tions that may be placed on the gift-in-kind, which At Account Recovery Services, times weвЂ™re fo In these challenging economic on service and п¬‚exibility! 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At Account For Providing the full range of organizations highly eп¬Ђective if accepting the giftServices will the organization to determine Account Recovery over 35 years,Services, ARS has specialized i Recovery weвЂ™r been more important or diп¬ѓcult to be sucп¬Ѓeld of medical collections. This exper receivable management services exclusively to on service and п¬‚exibility! 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ARS client is an ability вЂў Third Party Follow Up a little help i Contact us today to learn more! on вЂўservice and п¬‚exibility! Whether you need Pre-Collection Bad Debt Collection from an challenging вЂњa-la-carteвЂќ menu times of ou gift-in-kind. If applicable, aвЂў valuation relative to the вЂў Legal Services In these economic itвЂ™s range of servic a little help in one speciп¬Ѓc area, oroп¬Ђerings. a full Account Recovery Services been more important or diп¬ѓcult to b вЂў Pre-Collection вЂў Large Balances вЂў Probate / Estate Filings item needs to be fair market value of the donated accounts rece range of services to support your total medical cessful bad debt collections eп¬Ђo For overwith 35 your years, ARS has specializ Providing the full range of highly eп¬Ђective accounts вЂў Large prepared by a professional. This is Balances the responsibility of accounts receivables the advantage of being an Ae вЂў Third Party Follow Upeп¬Ђorts, п¬Ѓeld of medical collections. This receivable management services exclusively to ThatвЂ™s why you need ARS! In these challeging economic times itвЂ™s never been more of being andifficult ARS select вЂў Third Party Up health care organizations in Newclient England. is an ability tocombined the donor and not the organization. InFollow acknowledging with exceptional custom from an вЂњa-la At Account Recovery Services, weвЂ™re fo important or to be successful with your bad debt вЂў Legal Services from an Debt вЂњa-la-carteвЂќ menu of our and service solutions oriented approach collections on our service and п¬‚exibility! 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This experience, of being an ARS client is an ability to Party Follow Up area, orвЂў aThird range of services to support your total medical receivables to cash than othes from menu any of our combined with combined with efforts, exceptional customer service вЂў Legal Services accounts receivables the advantage of being an ARSan вЂњa-la-carteвЂќ industry. oп¬Ђerings. client our isвЂў Probate ansolutions ability to Filings select from anapproach вЂњa-la-carteвЂќ menu ofthe our / Estate and oriented with Conclusion and our soluti service offerings. Contact us 35 today to ARS learnhas more! For over years, specialized debtor client has made Account Recovery CORPORATE HEADQU debtor client of medical collections. This expe Contributions, either cash or noncash, are often large For over 35 years, ARS has specialized in the field of п¬Ѓeld medical 620 Main Street, Suite Services more eп¬ѓcient eп¬Ђective in combined with exceptional customer collections. This experience, combined and with exceptional customer East Greenwich, RI 028 Services mor sources of revenue for tax-exempt organizations. It is and our solutions oriented approach w service and our solutions approach with the debtor client Phone 401.398.8310 liquidating past oriented due accounts and turning FaxAccount 401.398.8314Re has made Account Recovery Services more efficient and effective liquidating pa debtor client has made important that organizations understand the effects of receivables to cash than any others in the Email info@arsnewen in liquidating past due accounts and turning receivablesServices to cash more eп¬ѓcientWebsite andwww.arsnew eп¬Ђecti receivables to industry. accepting these gifts. Tax-exempt organizations should than any others in the industry. liquidating past due accounts and tu industry. receivables to cash than any others Contact us us today to learn have a policy for assessing gifts-in-kind prior to their Contact today tomore! learn more! industry. CORPORATE HEADQUARTERS Contact us toda acceptance of them. It is also important to note that 620 Main Street, Suite 2 Contact us today to learn more! East Greenwich, RI 02818 CORPORATE HEADQUARTE prior to the acceptance of any gifts-in-kind the organiPhone 401.398.8310 620 Main Street, Suite 2 East Greenwich, RI 02818 Fax 401.398.8314 zation should determine that such item can be used in Phone 401.398.8310 Email info@arsnewengland.com Fax 401.398.8314 Website www.arsnewengland.com Email info@arsnewengland carrying out their charitable mission. Website www.arsnewengla MM ADS .25 page.indd 2 27 10/2/12 2:56 PM 8/29/14 5:08 PM U.S. POSTAGE PAID LEOMINSTER, MA PERMIT NO. 17 HFMA MassachusettsRhode Island Chapter PRSRT STD U.S. POSTAGE PAID LEOMINSTER, MA PERMIT NO. 17 411 Waverley Oaks Road, Suite 331B Waltham, MA 02452 NON-PROFIT ORG. U.S. POSTAGE PAID LEOMINSTER, MA PERMIT NO. 17 PRESORTED BOUND PRINTED MATTER U.S. POSTAGE PAID LEOMINSTER, MA PERMIT NO. 17 PRSRT BPM U.S. POSTAGE PAID LEOMINSTER, MA PERMIT NO. 17 2014 - 2015 Program & Special Event Schedule Date Event 10-17-2014 Accounting & Regulatory Update 11-20-2014 Capital Finance Program 12-12-2014 Compliance Update 01-23-2015 Revenue Cycle Meeting 03-20-2015 Enterprise Performance Management & Practice Management Joint Meeting 05-18-2015 - Region 1 Conference 05-20-2015 06-05-2015 Managed Care Program Location Coordinator(s) Sheraton Ferncroft Framingham, MA Michael McCollister Boston Convention & Event Center Boston, MA Jeffrey Dykens, CPA & Karen Kinsella Doubletree Hotel Westborough, MA Matthew Smith, CHFP Gillette Stadium Foxboro, MA Jennifer Samaras & William Wyman, FHFMA Four Points Sheraton Norwood, MA Roger Price, Stephen Saudek & Annamarie Monks Mohegan Sun Uncasville, CT Region 1 Four Points Sheraton Norwood, MA Jan Costa & James Donohue, MBA Educat i on/ Prog ram Admi n i st r a t i o n C o m m i t t e e, C h a i r: T i m o t hy H og a n , J D, F H F M A , C H C , H a r va r d Va n g u ard Medical Associates & Atrius Health NOTE: Please keep in mind that the themes listed for the programs are general. The programs themselves address current issues pertaining to these themes. MM ISSUE 6_.cs5.5 .indd 28 8/29/14 5:08 PM USE T USE T USE T U OR T MAT