AHIA Professional Practices Committee Minutes

Tuesday, November 29, 2011

Page 1 of 4

/ 2011Professional PracticesCommittee
November 29, 2011
11:00 am (eastern)
Minutes

Present:Dan Clayton, Carolyn Ballard,Kyle Brewster,Lori Chapin,Anna Cuson,Carolyn Golden, Jason McKinney,Victoria Tang, Linda Pocsik and Michelle Cunningham

Absent:Regine Gnagoand Kelly Nueske
Agenda Item / Summary of Discussion and Decisions
Call to Order / The meeting was convened at 11:01 am (EST).Dan welcomed Jason McKinney as the newest member of the committee and requested a brief background on his interest in the committee’s activities. Jason reported that he is most interested in developing and sharing risk management resources. Dan recapped the October meeting and asked if members had difficulty accessing the committee only website at Members commented that they had no issue with the website.
Dan presented the minutes from the October 30, 2011 meeting. MSC to approve the October 2011committee meeting minutes as presented.
Dan then proceeded to the business of the agenda.
Discuss Categorization of Information(Hospital Areas, Insurance, Government, Audit Process, and Document Types) / Dan discussed the importance of categorization in AHIA’sAudit Libraryinfrastructure to ensure that committee members are operating off the same structure when the information gathering process begins. Dan referenced the “Hospital Areas Categorization Example” spreadsheet. Dan reviewed the categories utilized by his hospital system and how they manage classifications. He requested feedback from the committee on types of classification.The committee agreed that the document is organized effectively.
Dan requested input from members with government and insurance experience. No suggestions were offered. Dan requested that between now and the next meeting that committee members research the insurance perceptive. It was recommended that we enlist someone outside the committee to help with this project.
ACTION ITEM:Michelle will send Dan the list of current AHIA members affiliated with insurance providers. This list will include titles. Dan will qualify the top prospects and Michelle will reach out to request assistance in defining insurance topics.
Discuss Emerging Issues and other industry priorities
Outline a mock member survey on these topics / Dan discussed surveyingAHIA’s membership to determine priority emerging issues for which the members desire more information. He presented the 2011 Emerging Issues document for review and comment:
1 / Healthcare Reform
Medical Loss Ratio
Insurance Exchanges, Medicaid Changes
State Legal Challenges
Constitutionality, and Presidential Election
New Reporting expectations and needs; Quality expansion, Labor costs, RAC response, data on request, productivity and cost data
Compliance; growing authority at the Federal Level
Managed Care; greater number of factors impact payment, productivity,
2 / Clinical Process Change Management;
ICD-10 implementation
EMR Implementation
Low quality of care requiring response
Education of Clinical Staff on new systems and processes
3 / Tax Exempt Status
4 / Patient Privacy in a Mobil Technology World
HIPAA Compliance
Protecting Data required by EHR entities, liability
5 / Financial Management of Costs
Knowing service line costs in difficult economy
Aligning Government reimbursement with budget of service lines
In addition to the above topics, the Committee discussed the inclusion of meaningful use, Stark Act, RAC, Medicaid, Physician practice acquisitions, data mining, best practice risk assessments and healthcare reform.
ACTION ITEM:Dan will prepare a survey template and Carolyn Ballard, Jason McKinney and Regine Gnago will work on a draft survey questions.
Dan reported that he has received the content infrastructure for the Audit Library. He requested assistance in reviewing the Audit Library. It was recommended that the Library be broken out into parts.
ACTION ITEM: Dan requested that the committee members send their top 3 to 5 expertise areas to him via email and Audit Library review assignments will be made.
Subcommittee assignments / Assignments are TABLED until January. Dan encouraged the committee to determine which subcommittee they are most interested in. Descriptions follow:
  • Audit Library – managing submissions and content on AHIA’s online Audit Library - contribute to its quality by identifying gaps in this knowledge base, screening submissions, and awarding prizes for best contributions.
  • Subject Leadership Program - a new initiative to identify members with a depth of knowledge and experience in a subject area of importance to auditors in the healthcare industry. These unique individuals will be called upon to help AHIA strengthen members' skills. Subject Matter Leaders (SML) will be formally identified and asked to, for example, promote conversation about their subject (in the List Serve and on LinkedIn), promote contribution of quality materials to the Audit Library, contribute to or solicit submission of New Perspectives articles, E-News articles, and educational programs. Right now, you can contribute to the development and maintenance of this program. Tasks to be completed include:
-Infrastructure development
-Identification of desired SML skills/knowledge
-Identification of individuals to be designated as SML
-Skills database maintenance
  • Emerging Issues – Indentify and disseminate information on trends shaping healthcare and healthcare internal auditing that will guide AHIA's strategies and give direction to the content of AHIA's education and publications.

Other Business / Lori requested follow-up information on Audit Library contributor incentives. Dan discussed that he is interested in providing guidelines on copy write infringement, etc… to facilitate and encourage submissionsby removing the “fear factor.” Michelle reported that Dan will be meeting with the AHIA Technology Chair on December 7 to facilitate the transition of the Audit Library to the PPC committee and to give Dan background on past processes and incentives offered. An incentive program and or award have been budgeted for 2012.
Adjourn / The meeting was adjourned at 12:04 pm (EST).
Next Meeting / Monday, January 9, 2012 – 11:00 am (EST)
Action Items
Who / Task / Due Date
Michelle / Send Dan the list of those members affiliated with insurance providers, including titles, to determine who we can reach out to for input on defining insurance topics/emerging issues / December 5
Committee / Send Dan 3 to 5 top expertise/interest areas using the Hospital Areas Categorization Example list and email to Dan / December 5
Dan / Qualify AHIA members affiliated with insurance provides and inform Michelle / January 2
Dan / Create member survey template/guidance and disseminate to Carolyn B., Jason and Regine / December 5
Dan / Send out audit library review assignments with library content listing / December 9
Michelle / Reach out to AHIA members as specified by Dan to gather input on defining insurance categorization, topics and emerging issues / January 8
Carolyn Ballard, Jason McKinney and Regine Gnago / Develop member survey questions for committee review to cover emerging issues, content needs of members, and member skills / January 8
Committee / Determine which Subcommittee you have the most interest in serving / January 8