For Case Management and
Transitions of Care Professionals

1: OPENING SESSION: Journey to Value-Based Care

Sunday, November 5, 2017
2:00 PM - 3:00 PM

Brent Myers, MD, MPH
Chief Medical Officer & Executive Vice President of Medical Operations
Evolution Health·Raleigh, NC

ABSTRACT:

The quest to provide value-based health care has led to improvements and innovations, but barriers still exist to fully implement desired changes. Given the uncertainty surrounding current National health care policy, what are the key foundational elements that have been established as well as creative opportunities to improve and transform care delivery?

This session will highlight lessons learned, common challenges, solutions, and accomplishments within a value-based care environment. Main considerations in planning to provide quality, affordable, and accessible care to patient communities will also be discussed.


LEARNING OBJECTIVES:

  1. Identify achievements and opportunities with value-based care within the current healthcare environment
  2. Apply lessons learned to improve and transform processes
  3. Create an action plan to address internal opportunities to improve care

2B: Redesigning Care to Improve Outcomes

Sunday, November 5, 2017
3:15 PM - 3:45 PM

Ana Mola, PhD, RN, ANP-BC, MAACVPR
Director of Care Transitions & Population Health Management
NYU Langone Medical Center ·New York, NY

ABSTRACT:

How can hospitals and systems build on their existing infrastructure and apply experience with Bundled Payments to realign incentives to improve care coordination and maximize quality and efficiency?  In this presentation, a healthcare system with 66% of patient revenues incentivized through value-based arrangements will share their journey to achieve these goals.

Foundational elements will be reviewed including: technology, people, and a value-based culture.


LEARNING OBJECTIVES:

  1. Describe the BPCI care redesign changes and adaptation in care coordination resources
  2. Explain the lessons learned as well as the opportunities in designing, implementing and evaluating a BPCI care redesign
  3. Review the BPCI quality and cost metrics trended for formative evaluation

3B: Incorporating Organizational Strategy Into Operations

Sunday, November 5, 2017
4:00 PM - 5:00 PM

Elizabeth Fletcher
Vice President of Strategic Planning & Business Development
Spartanburg Regional Healthcare System·Spartanburg, SC

ABSTRACT:

Case management departments provide an important link to their organization's mission, goals, and strategies. It is important for case management leaders to understand their organizational strategic plan and the role case management plays.  This session will focus on how to take your organization’s high-level strategic plan and determine key points of integration with your departmental operational plan.  Strategies to identify competing priorities, sequence actions and operationalize strategic goals into milestones to be achieved within your department will be shared. 


LEARNING OBJECTIVES:

  1. Describe the differences and synergies between strategies and goals
  2. Determine and plan for priorities, action steps and operations to achieve a strategic vision
  3. Develop an operational plan to achieve results

4: SUNRISE SESSION: Physician Advisor - Case Management Process Overview

Monday, November 6, 2017
7:00 AM - 8:00 AM

Nicholaos Bellos, MD, FIDSA, FACP
AVP Medical Operations PMI
Tenet Health Care·Dallas, TX

ABSTRACT:

The physician advisor role and its interface with the case management team is increasingly becoming more well defined, even as the role continues to evolve. Leveraging this role for success requires an understanding of the tradition function of the PA and areas of influence, as well as the opportunities that lie ahead in today's rapidly changing healthcare environment.


LEARNING OBJECTIVES:

  1. Describe the role, scope and areas of influence for the physician advisor role
  2. Discuss the necessary skill set and qualities associated with an effective physician advisor
  3. Provide an overview of when physician advisor intervention occurs, and opportunities for greater impact on the effectiveness of the case management process

5: GENERAL SESSION: ICD-10-CM's Impact on CMS's Readmission Initiatives - Getting That O to E Right

Monday, November 6, 2017
8:00 AM - 9:00 AM

James Kennedy, MD, CCS, CCDS, CDIP
President
CDIMD - Physician Champions·Smyrna, TN

ABSTRACT:

Right or wrong, case management departments and their discharge planning processes are held accountable by hospital leadership for readmission rates, especially those measured by CMS and, in some states, Medicaid.  While most hospitals have an ICD-10-CM clinical documentation integrity workflow, many focus just on the documentation and coding affecting the facility’s DRGs without knowing what additional documentation affects readmission measures. 

This session will orient the audience in how CMS and some states use ICD-10-CM and other billing data to categorize and gauge the potential risk of readmissions and offer solutions as to how case managers in concert with their quality and coding teams can develop systems that integrate these principles with other workflows


LEARNING OBJECTIVES:

  1. Review the fundamentals of ICD-10-CM-based readmission measures with an emphasis upon the CMS and 3M Potentially Preventable Readmission models
  2. Outline ICD-10-CM documentation and coding principles inherent to readmission risk in pneumonia, heart failure, myocardial infarction, stroke, COPD, and others with an emphasis upon cohort selection, exclusion criteria, and risk adjustment
  3. Suggest a management action plan that engages all invested entities in documentation and coding integrity applicable to the subject matter

6B: Effective Strategies to Foster Engagement

Monday, November 6, 2017
9:15 AM - 10:15 AM

Rod Brace, PhD
SVP, Regional President & Chief Learning Officer
Memorial Hermann Health System ·Houston, TX

ABSTRACT:

There are many components that define an exceptional hospital or healthcare system and engagement is a vital ingredient to tie it all together. When engaged and aligned with the same mission, patient care is enhanced, processes flow and organizational performance improves. During this session, strategies to promote employee engagement and development will be explored.


LEARNING OBJECTIVES:

  1. Discuss the main components of an effective engagement strategy
  2. Support employee development and promote retention through mentorship, multigenerational workforce awareness, and staff recognition
  3. Implement daily leadership rounding & approaches to improve organizational performance

7B: Developing Executive Presence: Building Future Leaders

Monday, November 6, 2017
11:15 AM - 12:15 PM

Sally Stamp, RN, MC, BCC
Coach
Gifted Leaders, LLC·Phoenix, AZ

ABSTRACT:

Leadership today goes beyond technical expertise in our professional discipline.  It requires awareness of individual strengths and a willingness to challenge historical leadership models of "command and control" that create silos and barriers to collaboration and shared decision-making.  This session will explore the elements of executive presence and equip emerging and established leaders with guidelines for developing and expanding this critical leadership attribute.


LEARNING OBJECTIVES:

  1. Develop a definition of executive presence in the context of case management
  2. Increase understanding of shared leadership that considers individual strengths and talents
  3. Consider ways to manage increased workloads with decreased resources in a high-stress environment
  4. Commit to an individual action plan to further develop individual executive presence

10AB: Legislative and Regulatory Update

Monday, November 6, 2017
2:15 PM - 3:15 PM

Nicholaos Bellos, MD, FIDSA, FACP
AVP Medical Operations PMI
Tenet Health Care ·Dallas, TX

ABSTRACT:

Update on relevant legislative and regulatory considerations that impact clinicians, patients and families, and the case management process.


10C: Multi-Site System Integration: Aligning Cultures and Organizations (OPEN TO MULTI-SITE ORGANIZATION LEADERS)

Monday, November 6, 2017
2:15 PM - 3:15 PM

Julie Mirkin, RN, MA, Wharton Fellow
Vice President·Care Coordination
NewYork-Presbyterian Health System·New York, NY

ABSTRACT:

This closed, two-part session including a presentation and panel discussion, is designed for case management leaders who have system responsibility for multiple hospitals and/or health system functions. System leaders are accountable for strategically defined priorities and outcomes that must be achieved through operational execution. This interactive session will provide leaders with practical strategies for navigating alignment challenges, balancing site and system priorities, and incorporating system-level initiatives into daily case management operations.


LEARNING OBJECTIVES:

  1. Describe effective techniques for standardizing case management functions in the following domains: mission, culture, philosophy, operations and human resources
  2. Discuss optimal strategies for balancing and aligning site and system priorities to achieve goals set at the corporate level
  3. Identify tactics to incorporate system-level initiatives into case management operations through accountability structures

11B: An Innovative Approach to Care Coordination

Monday, November 6, 2017
3:30 PM - 4:30 PM

Stephen Crouch, MD, FACEP
Medical Director, Care Management
Advocate Health Care ·Downers Grove, IL

Marlene Bober, RN, MS
Vice President, Acute Enterprise Care Management
Advocate Health Care ·Downers Grove, IL

ABSTRACT:

Aligning programs, while redefining roles and services to address care gaps and provide integrated care can be a daunting task.  Presenters will share their programmatic approach and lessons learned in developing an innovative care coordination model to meet patient/family needs and provide access to cost effective, multi-site quality care.   


LEARNING OBJECTIVES:

  1. Examine and compare integrated health system services
  2. Apply strategies to align programs and processes to impact outcomes
  3. Identify programs and services that can be applied within your care delivery system

11C: Multi-Site System Integration: Aligning Cultures and Organizations (OPEN TO MULTI-SITE ORGANIZATION LEADERS)

Monday, November 6, 2017
3:30 PM - 4:30 PM

MODERATOR: Julie Mirkin, RN, MA, Wharton Fellow
Vice President·Care Coordination
NewYork-Presbyterian Health System·New York, NY

Linda Van Allen, RN, BSN, PHN, CPUM, ACM-RN
Vice President, Performance Excellence
Tenet Health Care·Dallas, TX

Patricia Metzger, RN, BSN, MSA, ACM-RN
Division Vice President·Case Management
CHI St. Lukes' Health System·Houston, TX

Helen Zughni, RN
Assistant Vice President of Case Management
Hospital Corporation of America Healthcare System·Nashville, TN

ABSTRACT:

This closed, two-part session including a presentation and panel discussion, is designed for case management leaders who have system responsibility for multiple hospitals and/or health system functions. System leaders are accountable for strategically defined priorities and outcomes that must be achieved through operational execution. This interactive session will provide leaders with practical strategies for navigating alignment challenges, balancing site and system priorities, and incorporating system-level initiatives into daily case management operations.


LEARNING OBJECTIVES:

  1. Describe effective techniques for standardizing case management functions in the following domains: mission, culture, philosophy, operations and human resources
  2. Discuss optimal strategies for balancing and aligning site and system priorities to achieve goals set at the corporate level
  3. Identify tactics to incorporate system-level initiatives into case management operations through accountability structures

12: SUNRISE SESSION: Communicating the Physician Advisor Role - I'm Here to Help

Tuesday, November 7, 2017
7:00 AM - 8:00 AM

Robert T. Grant, MD, MSc, FACS
Physician Advisor and Chairman Utilization Management Committee
NewYork-Presbyterian·New York, NY

Lory David Wiviott, MD
Chairman of Medicine & Medical Director
California Pacific Medical Center·San Francisco, CA

ABSTRACT:

The Physician Advisor is a critical team member, regardless of hospital system size.  Training and orientation to the physician advisor role, for case management team members, physician peers and others across the enterprise, increases the effectiveness of the role. The importance of this communication, and its impact on patient experience and cost of care, will be discussed in this session.


LEARNING OBJECTIVES:

  1. Describe training sessions used to explain the role of the Physician Advisor
  2. Describe how PA can improve CM-MD communication through structured mentoring sessions with CM’s
  3. Recognize the PA’s potential impact on patient discharge experience HCAHPS and Value-Based Purchasing

13B: Case Management Leader and Physician Strategic Alliances

Tuesday, November 7, 2017
8:00 AM - 9:00 AM

Larry Weems, MD
Hospitalist
Novant Health Inpatient Care Specialists·Huntersville, NC

Robert Barnabei, MD
Family Medicine Doctor
Novant Health Prosperity Family Physicians·Charlotte, NC

Stacy Wright, MSW, LCSW, MHA, MBA, ACM-SW
Corporate Director Case Management, Greater Charlotte
Novant Health·Charlotte, NC

ABSTRACT:

Case Management department structures, functions, leadership roles, and operations are undergoing change to align with healthcare delivery systems. Evolving care management models and related services within and beyond hospital walls present new opportunities to re-evaluate roles, eliminate silos and create points of collaboration.  Panelists in this session will review common themes and present interdisciplinary collaborative approaches that can lead to mutually beneficial strategic alliances to meet challenges. 


LEARNING OBJECTIVES:

  1. Discuss common challenges within the evolving health care environment
  2. Examine common ground for collaboration among Case Managers and physicians
  3. Identify models and roles within strategic alliances

14B: Resiliency

Tuesday, November 7, 2017
9:15 AM - 10:15 AM

Keith R. Doram, MD, MBA, FACP
Corporate Chief Medical Officer
Adventist Health Central Valley Network·Roseville, CA

ABSTRACT:

The ability to react, re-energize, recoil , and address challenges as one's career unfolds is a common theme for emerging and established leaders. During this session, the speaker will share their experience working with PTSD clients and provide examples that can be applied within workplace situations. Attendees will be equipped with tools and strategies to identify and overcome adversity within their teams.


LEARNING OBJECTIVES:

  1. Discuss healthcare inequities among populations and barriers to access care
  2. Examine the impact on healthcare outcomes nationally
  3. Apply strategies to address inequities and improve healthcare outcomes

15: CLOSING SESSION: Health Care Equity

Tuesday, November 7, 2017
10:30 AM - 11:30 AM

Anurag Gupta, MPhil, JD
Founder & CEO
Be More America ·Brooklyn, NY

ABSTRACT:

Providing access to high-quality, effective and efficient health care for society's most vulnerable populations is both an area of focus and a challenge facing healthcare systems nationally. During this interactive session, health determinants and common barriers will be explored. Evidenced based policies and approaches will be applied to address barriers and examine infrastructures to empower affected populations.


LEARNING OBJECTIVES:

  1. Description of healthcare inequities among populations and barriers to access care
  2. Discussion of the impact on patients' healthcare outcomes
  3. Strategies to address inequities and improve healthcare outcomes


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