Healthcare Happenings

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Healthcare Happenings April 1, 2015

Announcing: 2015-16 Show-Me Chapter Officers and Board of Directors

Inside this issue: President’s Message




Region 8 Update








Meet the officers & board members


Member news




Remember to renew your membership!! Also see page 5 for a special offer

Thank you to everyone that participated in our annual election, it was our highest response so far! We would like to announce the new slate of officers and directors for the 2015-16 HFMA year: President: President Elect Vice President Secretary Treasurer

Susan Duncan Josh Wilks Tina Gillespie Jennifer Doll Jean Nyberg


Bonnie Baker Adriana Iacob Lorrie Haden Shawn Harris Jim McMakin Kim Thompson

We also want to thank them for their dedication to our chapter. Great leaders and great members are what make the Show-Me Chapter so successful! If you would like to become more involved and volunteer to help on a committee, please contact Susan Duncan. Our leaders will be attending LTC in San Antonio later this month to collaborate with other chapter leaders and set goals for the upcoming year! Officer installation will be conducted at the Spring Conference in St. Louis May 13-15. Read more about your officers and board members on page 13.

Upcoming Events

May 13—15, 2015

Joint Spring Conference—River City Casino, St. Louis

June 22—25, 2015

ANI, Orlando, FL

July 29-31, 2015

Show-Me Chapter Summer Conference, Camden on the Lake, Lake Ozark, MO

August 26-28, 2015

Region 8 Conference, Minneapolis, MN

National HFMA On-Demand Webinar Listing

Register Online

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Healthcare Happenings

President’s Message — By Jon Branstetter

I am really proud of the recent success that the Show-Me of Missouri Chapter of HFMA has had. I want to thank everyone who participated in the recent membership satisfaction survey. The Show-Me of Missouri Chapter had a record 82% of its members who were very or extremely satisfied. Chapter leadership takes these surveys very seriously and uses the comments to help plan future education events and the strategic direction for the chapter. Based on the past surveys, we revamped our Chapter’s website this past year. Please take a chance to look at that website if you haven’t had the opportunity yet at Please let Kyle Lee or David Taylor know if you have any suggestions for the website. During this past quarter, we unveiled our first roadshow in Columbia on January 23rd. This was a great educational event where members listened to presentations by CliftonLarsonAllen on the physician revenue cycle, and Kim Duggan, MHA, providing a Medicaid update. It provided a great time for networking and to embarrass myself a little before my 40th birthday. We held a similar event on March 20th in Springfield. BKD provided a great presentation on industry updates and Kim Duggan once again presented on Medicaid and DSH updates. We want to thank CliftonLarsonAllen, BKD, and Kim Duggan, MHA, that made the educational part of these roadshows possible. Please give chapter leadership your ideas for future programs and roadshows.

Kim Duggan presenting at the Columbia networking event.

On March 17th, Shelly Hunter presented on behalf of the Show-Me Chapter for our annual Region 8 webinar discussing the journey to rebuild and the planning that went into building the new Mercy Hospital in Joplin. It is great to see the rebuilding effort in Joplin since the tornado hit almost 4 years ago. The hospital opened March 22, 2015. (cont on page 3)

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Healthcare Happenings

Susan Duncan and some of her leadership team will be attending the Annual Leadership Training Conference in San Antonio, Texas towards the end of April. The leadership training is a great opportunity to network and share ideas between HFMA chapters. It is one of the added benefits of being involved in chapter leadership. We are in the process of finalizing the Annual Joint Spring Conference. This year the Spring Conference will be at a new venue, River City Casino, in St. Louis on May 13th – 15th. Also, Southern Illinois will be joining the Greater St. Louis and Show-Me chapters in the conference this year. The link to register is included on page 1 of the newsletter in the upcoming events section. My term as President of the Show-Me Chapter is nearing an end. I want to thank all of the leadership and members of this chapter for making this another enjoyable and successful year. I hope everyone continues “Leading the Change” to make healthcare better for all of us. Jon Branstetter Show-Me Of Missouri 2014-2015 President

Happy 40th Birthday Jon!! Don’t forget: Renew your membership by June 1 HFMA’s Virtual conference is April 16—registration is FREE for members and you can earn CPE credits! Registration for the Spring Conference in St. Louis is now open—don’t miss this great event! If you would like to become more involved with the chapter—please contact Susan Duncan

Please contact Jennifer Ogden with suggestions, news items, or article submissions. [email protected]

Follow Show-Me on Linked In by clicking:

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Healthcare Happenings

Diamond Level Sponsor

Jean Nyberg

Page Here 5 Click to access our new photo gallery

Healthcare Happenings

Chapter Balanced Scorecard Update (3/11/15) Education hours

Actual 4,266.2 hours

Education hours per member

15.8 hours per member`


253 members


7.4% members certified

Goal 4,374 hours 97.5% of goal met so far 16.2 hours per member 97.5% of goal met so far 270 members 93% of goal met so far 8.2% members certified

2014-2015 Member-Get-A-Member Program - Share it! By sharing your experience of being an HFMA member with your staff, your peers, and others in your organization with an interest in healthcare finance, you make an investment in someone's future. For more information about the 2014-2015 Member-Get-A-Member program*, visit us online. This year, you could win:  HFMA Apparel Item, duffel bag, or smartphone accessory  $25, $100 or $150 Visa Prepaid Cards  Cash prizes of $1,000 or $2,500  Apple iPad Mini  Grand Prize of $5,000**

SPECIAL OFFER Members who join or reinstate in ShowMe Chapter during April 2015 with a membership through May 2016 will receive a complimentary registration to the Show-Me Summer Conference at the Lake of the Ozarks in July 2015! Also, members who get-a-member in April receive a complimentary registration to the Show-Me Summer Conference in July! (Please notify Kyle Lee when joining so we can assure your complimentary registrations are noted.)

Download applications to pass along to colleagues or hand out at networking events. Make sure your name and ID number appears in the "sponsor" area of the application in order to receive proper credit. Prospective recruits can join online at *This program runs through April 30, 2015.

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Healthcare Happenings

Region 8 Update By Tracy Packingham Wow, it’s hard to believe this is my final Regional Executive message and another HFMA year is almost complete. I would like to take this opportunity to say “Thank You” to all of the Region 8 Presidents – Darren, Amy, Troy, Rita, Tim, Sarah, Jon, Becky and Jim. It has been a privilege to work with and get to know all of you. It has been a phenomenal year to say the least. All the chapters in the region have met or exceeded goals and will be presented with National Awards at ANI this year in Orlando. It takes a TEAM to make this happen and we have an amazing group of dedicated individuals. CONGRATULATIONS to each of you! Stephanie Hultman and her TEAM have been working hard to bring yet another fantastic year in 2015/2016. Thank you Steph for all your support through this year; the region is in very good hands with you and Bill Fenske. Thank you for the continued support of all of our officers, directors, volunteers and members. Our chapters are truly exceptional. Region 8 ROCKS!!! Get involved and make this next chapter year even better. Thanks for the opportunity to serve as your Region 8 Regional Executive. This was truly a fabulous experience and look forward to working with the new leadership. Lastly, I would like to thank all of the chapter leaders who have made the Region 8 Mid America Summer Institutes a success. Don’t miss the conference this year, August 26-28 in Minneapolis, MN. Hope to see everyone there. My telephone number is 314-570-3580 and my email address is [email protected]. I welcome your questions and comments at anytime!!! Tracy Packingham Regional Executive HFMA Region 8

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Healthcare Happenings

Diamond Level Sponsor

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Healthcare Happenings

This year's conference theme is "Shaping the Future" and will take place at River City Hotel and Casino St. Louis, MO May 13 - 15, 2014 The conference will feature sessions for Finance and Revenue Cycle professionals dealing with changes in the volatile healthcare landscape many of which will be presented by Provider leaders, as well as sessions on Regulatory and Compliance! Register Online

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Solea Water Project - A St. Louis based organization that uses used shoes to build water wells in third world countries. We will host a used shoe drive and offer tickets for a grand prize and secondary give-a-ways for this shoe drive. ACO Update from Dr. Douglas Pogue of BJC Healthcare. CFO Panel populated by various hospital leaders on Shaping the Future Becky Welker of CHAN and Gregg Lepper of Greensfelder, Hemker & Gale speaking on 340 (b) Compliance ICD-10 Preparedness presented by Rose Dunn Update from the Washington Beltway presented by Kim Byas of American Hospital Association Building for the Future in Population Health Management presented by Tammy Kritzer of CliftonLarsonAllen (formerly of the Mayo Clinic) HFMA and Patient Financial Services Conversations Program presented by Sandy Wolfskill of HFMA An overview of the final 501r Regulation from BKD Plus MUCH MORE!

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Healthcare Happenings

Smartphone Apps: A Growing Trend in Medicine Lizabeth Brott, J.D., ProAssurance Regional Vice President, Risk Resource

A smartphone isn’t just a phone; it’s a miniature computer. We surf the web, email, play games, and use smartphones and other wireless devices as tools for work. This explosive growth in use has been aided by mobile applications (“apps”). Today physicians can monitor a patient’s vital signs, download patient schedules, access medical records, dictate office notes, and consult with other physicians without entering a clinical setting. Greater Access, New Risks As with any new medical device, there are risks to consider. Mobile devices “are considered one of the most vulnerable areas for [privacy] breaches.”1 This is in part due to security assessments that failed to address the use of mobile devices.2 The Health Information Technology for Economic and Clinical Health (HITECH) Act requires notification whenever a breach of unsecured protected health information (PHI) occurs.3 Additionally, the Department of Health and Human Services requires security of PHI on storage devices (hard drives), transmission media (cyberspace), and portable electronic media (e.g., smartphones).4 Reference guides, such as Epocrates, should not be a HIPAA risk. However, apps that transmit PHI could be intercepted by hackers or corrupted by a virus. Regardless of whether a physician’s mobile device is used to access, transmit, or store PHI, consider all HIPAA and HITECH requirements. HIPAA requires data security and proper destruction, and retention of PHI, when appropriate. What Can You Do? Review potential wireless apps to ensure security of PHI at all levels; Limit the type of app that can be used based upon the individual app’s level of security; Use encryption software that makes data unusable by intercepting parties; Develop a security policy addressing mobile devices and the types of apps that can be used, along with the appropriate use and destruction of PHI data; Develop an eDiscovery policy for retaining PHI in the event of litigation; seek assistance from your attorney or your medical professional liability carrier’s risk management staff; and Work closely with IT personnel to address all security issues. ___________________________________________________________________ 1

Dolan, P. “Large settlement for data breach sends message to lock up laptops and smartphones.” American Medical News, September 28, 2012, business/309289995/8/ (accessed August 27, 2013). 2, 3, 4 “Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules Under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information Nondiscrimination Act.

Copyright © 2015 ProAssurance Corporation This article is not intended to provide legal advice, and no attempt is made to suggest more or less appropriate medical conduct.

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Healthcare Happenings

Why is the King v. Burwell Case Important to Missouri? Andrew B. Wheeler, Vice President of Federal Finance, Missouri Hospital Association

Since the passage of the Affordable Care Act, opponents have worked to repeal and question its constitutionality. While the Supreme Court of the United States previously ruled that the ACA may require nearly all Americans to secure insurance, it ruled that states cannot be forced to expand Medicaid eligibility standards to 138 percent of federal poverty level. Since that time, 28 states and the District of Columbia have increased the eligibility standards to meet the ACA requirement. To date, Missouri has yet to expand Medicaid eligibility, leaving more population without insurance than those states who have expanded coverage. The ACA contains provisions to assist individuals without affordable coverage through Medicaid eligibility expansion and through the health insurance marketplace. Since Medicaid eligibility has not been expanded in Missouri, the only other ACA option is to purchase insurance through the health insurance marketplace. The Supreme Court is once again hearing a case which could have negative implications for those in Missouri who are now covered under the marketplace. The challengers are arguing that the text of the ACA only allows tax credits to be provided in state facilitated marketplaces. If the challengers are successful, this will leave those who have enrolled in a federally facilitated marketplace without tax credits, (cont on page 12)

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Healthcare Happenings

All FFM States


















Average Yearly Premium










Average Yearly Tax Credit










Average Premium after Tax Credit










Percent Premium Reduction due to Tax Credit










Percent Enrollee’s with Premium Assistance

(cont from page 11) allowing them to purchase affordable insurance. Since Missouri is a federally facilitated marketplace state, the loss of tax credits could result in many individuals forfeiting coverage. What is known is that more than 253,000 individuals in Missouri have enrolled in the marketplace. Of the enrollees, 88 percent are a receiving tax credits averaging $3,408 per year. Without these tax credits, Missouri’s marketplace enrollees would see their average monthly premium payment increase by 4.3 times their current payment. The loss of these tax credits would force Missouri’s marketplace enrollees to collectively incur a $761 million increase in premiums for 2015. If the challengers succeed, all providers in the state of Missouri will see an increase in the patients who are uninsured.

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Healthcare Happenings

Changes to HFMA’s CHFP Certification Program

HFMA’s strategic vision characterizes the current healthcare business environment as the transformation of care to achieve value. Providers, physicians, and payers are all confronted with new business challenges. The nature of the business environment and its impact on industry stakeholders supply both the demand for and elements of a new approach to the CHFP. New CHFP program features  A learning program designed to build comprehensive industry understanding and sharpen business skills;  Two-module structure: 1) Achieving Strategy: the Business of Healthcare 2) Operational Excellence: Healthcare Industry Stakeholder’s Business Challenges;  CHFP designation earned by successful completion of both modules; Online study materials created specifically to assist in mastering the business content. Why is the certification program changing? The healthcare reform environment has caused the industry’s key stakeholders—providers, payers and physicians—to fundamentally rethink existing business models. Care transformation is business transformation. The necessary success factor for finance professionals today: Change-oriented business acumen. The existing certification program focuses narrowly on applied finance and financial reporting and does not address the business environment. CHFP Program Important Dates: April 30, 2015 - Current CHFP exam registration ends You may register for the current CHFP exam prior to April 30. You have one year from the date of registration to schedule your exam. For example; if you register in March 2015 you will have until March 2016 to schedule your exam. Also, if you need to retake the exam, the current exam will be available to you for as long as you need (based on current registration, scheduling, and retake policy). May 1, 2015 - New CHFP program pre-registration available Pre-registration allows interested members to email HFMA. HFMA will email members as soon as the link to purchase and more information about the new program is available. June, 2015 - New CHFP program registration available. CHFP Program - Transition Groups For members who are currently pursuing certification and have begun actively pr epar ing for the exam, or have been through a chapter certification webinar series or practicum study group, HFMA encourages continuing with the current process. Current CHFP candidates can choose, at no additional cost, either to continue the traditional CHFP program or to wait until June 2015 to pursue the revised certification. These options are open to those who have:  Purchased the self-study course since January 2014, whether they have completed it or not.  Registered and paid for the CHFP exam via Castle since February 2014 (but not yet scheduled). Registered, paid for, and scheduled the CHFP exam via Castle since February 2014 (but not yet taken). Note: Members who may have been unsuccessful and are waiting to retake the current CHFP examination are not eligible. Candidates must choose one of these options by April 30, 2015 and notify Career Services at [email protected]. HFMA will provide the complete revised CHFP program (Modules 1 and 2) at no cost to all those who have purchased the CHFP self-study course and/or registered for the exam, as outlined above. For members interested in certification who have not yet begun preparing, HFMA encour ages that they wait and use the new materials available in summer 2015 to prepare for the new CHFP. Questions? Please contact careerservi[email protected] or call (800) 252-4362 and ask for career services.

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Healthcare Happenings

2015-16 Officers and Board of Directors Susan Duncan, Dir ector, Regional Rural Health Clinics for Ozarks Community Hospital is a life-long resident of Missouri. She earned her Bachelor of Science degree in Accounting from Drury University in Springfield. Susan joined HFMA in 2006 and has been an active member ever since. She has been married to her husband Richard for 35 years. They have two children and 2 grandchildren with number 3 arriving this summer. In her spare time, she loves to read and travel with her husband.

Josh Wilks, CPA, Principal with CliftonLarsonAllen (CLA) He leads the healthcare practice from the St. Louis office. Josh has a wife, Angela, and two daughters, Julie (8) and Alex (6). For fun he spends time coaching basketball, softball or attending his girl’s sporting events. He is a Cardinals fan and enjoys doing home improvement projects.

Tina Gillespie is the Chief Financial Officer at Northwest Medical Center in Albany. She received her B.S. in Finance from NMSU in 1990. Her experience includes banking and investments along with 12 years of Critical Access Hospital experience. In addition to revenue cycle, materials management and accounting supervision duties, she serves as the hospital risk manager. She lives on a farm outside of Albany with her husband Scott and miniature beagle, Missy. Tina enjoys camping and spending time with family, especially her granddaughter, Caroline.

Jennifer Doll, CPA, MBA, CHFP, is Controller of University of Missouri Health Care (MU Health Care) and the Senior Director of Finance for the University of Missouri Columbia School of Medicine. Having held the role of Controller for MU Health Care, since February 2007, Jennifer took on the additional role within the School of Medicine in October, 2014. Jennifer is also active in her community through involvement with local Parent Teacher Student Associations, and a community swimming association.

Jean Nyberg, CPA, is a member of BKD National Health Care Group, Jean provides audit and consulting services to health care providers, primarily health systems. Her years of experience include managing audits and assisting with accounting and reporting issues. She also prepares Medicare and Medicaid cost reports and analyzes reimbursement strategies and opportunities for hospitals. She is a member of the American Institute of CPAs, Missouri Society of Certified Public Accountants and Healthcare Financial Management Association.

Shawn Harris, CPA, is originally from Springfield and attended MSU, earning a bachelors and masters in Accounting. He has served Mercy for 18 years in a number of roles from budget & reimbursement, hospital controller, and currently Director of Finance of the Mercy Central Communities. Additionally, Shawn is an adjunct faculty for MSU. He and his wife Whitney are the proud parents of a son, who attends MSU and plays football and a daughter who is nearing graduation from high school and participates in the marching band.

Lorrie Haden, Dir ector MCG Revenue Management She has been in the HealthCare field for over 25 years working somewhere within the realm of the Revenue Cycle. She is busy trying to get her last two kids through high school and attending basketball and swimming events. They added a new addition to their family – her first grandson Larec. She and her husband enjoy riding Harleys, watching Nebraska Football (GO BIG RED) and hanging with the family

Bonnie Baker, Pr esident, Hawthorn Recovery Services, Inc. She started her own company six years ago specializing in mainly collections for medical providers. Prior to starting her own company, she worked as a computer programmer and worked her way into management learning all aspects of the business along the way. She enjoys the challenges of associated with her position and is active within HFMA.

Kim Thompson, VP Finance and CFO at Ozarks Medical Center in West Plains, Missouri. Kim has more than 30 years of accounting experience, including 13 years in health care. She is a member of the senior administrative team making strategic and operational decisions for the organization. Kim enjoys water sports-skiing and boating, travel, reading and gardening.

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Healthcare Happenings

The NEW Mercy Joplin

The doors opened March 22, 2015!

Tamara Ball Supervisor Lincoln County Memorial Hospital

New Members

Nicole Smith West Plains, MO LeeAnn Miles Interim CFO Harrison County Community Hospital Tiffany Holiman BKD, LLP Springfield, MO Christina Clifford Patient Accounts Support Coordinator Freeman Health System John Chastain Corporate Director of Budgeting CoxHealth System Gary Kuykendall Director of Revenue Cycle and Admin Applications Freeman Health System

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Healthcare Happenings