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® VOLUME 6, ISSUE 7 JULY 2011 ACOs: Will There be Savings to be Shared? By Stephen Rose in the past, the premise of ACOs join the mad scramble to compre- Health Care Attorney and Owner is that they will improve the health hend the requirements and prepare Garvey Schubert Barer of the population; enhance the pa- to meet the quality and savings tient experience of care (including requirements or be faced with the quality, access, and reliability); very real possibility of not having and reduce, or at least control, the a seat in this regulatory game of per capita cost of care.2 The “sav- musical chairs. ings” created by ACOs participat- ing in the Medicare Shared Sav- Providers Begin to Express Con- ings Program will then be “shared” cerns between the federal government and the ACO. The Shared Sav- More recently, health care pro- ings Program is only one of sev- viders and provider organiza- eral programs envisioned by the tions have started the process of Affordable Care Act (“PPACA”): Please see> ACOs, P4 The Affordable Care Act Overview includes a number of provi- Inside This Issue After months of anticipation and sions designed to improve ACOs: Will There be Savings 1 the quality of Medicare ser- to be Shared? speculation the Centers for Medi- care and Medicaid Services issued vices, support innovation Healthcare Facilities: and the establishment of Providence Regional Medical proposed rules relating to a volun- 8 Center Everett Opens $460 tary Shared Savings Program for new payment models in the Million State-of-the-Art Tower Medicare providers and suppliers program, better align Medi- participating in Accountable Care care payments with provider Healthcare Administration: costs, strengthen program Accountable Care Organizations (ACOs).1 Under Organizations: The Future 10 the Shared Savings Program, pro- integrity within Medicare, of Quality Healthcare? viders and suppliers will continue and put Medicare on a firmer financial footing.3 Healthcare Law: Legal to receive traditional Medicare Challenges to Medicaid Rate fee-for-service payments under 12 Reductions Frustrated by Parts A and B, and be eligible for Immediately after the publica- Proposed Federal Rules additional payments if specified tion of the proposed regulations various commentators warned that Career Opportunities 15 quality and savings requirements are met. those who wanted to participate Plan and Hospital Financial and meet the ACO implementation Information Available at As with other healthcare initiatives date of January 2012 had better www.wahcnews.com ® Letter from the Publisher and Editor Publisher and Editor David Peel Dear Reader, Managing Director The volume of online job postings can indicate the Elizabeth Peel strength of the economy. However, it can also be Contributing Editor misleading. Nora Haile I review The Conference Board’s Help Wanted Advertising Online (HWOL)™ report each month to see how Jennifer Sharp postings are trending. The number of postings on Business Address 631 8th Avenue Healthcare News web sites are at all-time highs so Kirkland, WA 98033 it didn’t surprise when HWOL reported online post- Contact Information ings rose 148,800 during May 2011 when compared Phone: 425-577-1334 to April 2011. The hottest categories have fewer un- Fax: 425-242-0452 employed persons than online ads. Computer and E-mail: firstname.lastname@example.org math science (.23) and healthcare practitioners and technical (.37) categories Web: wahcnews.com have the highest demand when comparing unemployed persons to online ads. TO GET YOUR COPY However, while healthcare and computer/math science jobs go begging, post- If you would like to be added to the dis- ings in other industries are scarce. This probably explains why the U.S. De- tribution, go to our web site at wahcnews. com, click on the “subscribe” tab at the top partment of Labor has been reporting initial claims for unemployment insur- of the page and enter all information re- ance above 400,000 for the past few months. quested. Be sure to let us know whether you want the hard copy or the web version. For the foreseeable future, there will be high demand in some industries while LETTERS TO THE EDITOR others languish. Expect healthcare workers to continue to be in short supply If you have questions or suggestions re- so make sure your recruiting budgets are adequately funded. garding the News and its contents, please reply to email@example.com. David Peel, Publisher and Editor Washington Healthcare News 2011 Editorial Calendar Month and Year Theme of Edition Space Reservation Distribution Date January 2011 Hospitals December 1, 2010 December 27, 2010 February 2011 ASCs January 4, 2011 January 24, 2011 March 2011 Hospitals February 1, 2011 February 21, 2011 April 2011 Insurance March 1, 2011 March 21, 2011 May 2011 Clinics April 1, 2011 April 18, 2011 June 2011 Human Resources May 2, 2011 May 23, 2011 July 2011 Hospitals June 1, 2011 June 20, 2011 August 2011 Hospitals July 5, 2011 July 18, 2011 September 2011 Clinics August 1, 2011 August 22, 2011 October 2011 Human Resources September 1, 2011 September 19, 2011 November 2011 Hospitals October 3, 2011 October 24, 2011 December 2011 Clinics November 1, 2011 November 21, 2011 -2- HEALTHCARE MANAGEMENT ADMINISTRATORS SERVICE SAVINGS AND HMA is committed to maximizing health plan value by lowering claims costs and providing superior customer service. For the best of both Service and Savings, contact us today: Oregon Washington Melody Ortiz Brooke Vassar 503.808.9287 x6213 425.289.5227 firstname.lastname@example.org • www.accesshma.com Committed to Value HEALTHCARE MANAGEMENT ADMINISTRATORS < ACOs, from P1 whether applicants will be partment of Justice are substantial able to achieve success.4 and add another disincentive to drilling down through the regula- participation. tions. Questions are being raised The letter from the Cleveland Clin- regarding whether it is possible to ic then goes on to list seven more Other provider organizations have increase quality of care to a larger pages of, what the Clinic terms, commented that the proposed population of recipients while si- “recommendation[s] to improve regulations do not allow a gradual multaneously lowering costs or at the proposed rule.”5 transition that would allow provid- least lowering the growth in overall ers new to care coordination ample expenditures. Thus far there is not The Medical Group Management time to build the infrastructure one “cookie-cutter” model for an Association (“MGMA”) recently needed to function successfully as ACO. The nuts and bolts of what commented that the Shared Sav- an ACO or within an ACO. Rath- an ACO could look like have been ings Program detailed in the pro- er, they state that the proposed well chronicled by others and will posed regulations “. . . may not be regulations demand that all ACO not be reiterated here. Without en- viable as a national strategy unless “participants quickly move to dorsing or criticizing the positions significant program policies are taking on downside risk.”7 CMS taken, this article focuses on some modified when final rules are pro- acknowledges that requiring all of the concerns raised by providers mulgated.6 As an overall observa- ACOs to take this risk “. . . would and provider organizations. tion MGMA notes that the ACO likely inhibit the participation of model is a hybrid business model some interested entities.”8 How- As a general statement, it appears somewhere between the traditional ever, CMS believes that requir- that most health care providers fee for service model and a capi- ing participating ACOs to take on support the concept and goals of tation or similar “all-risk” model. downside risk quickly is best for ACOs but believe that the pro- MGMA comments that ACOs pur- the program because “. . . payment posed regulations impose signifi- port to provide the best of both models where ACOs bear a degree cant impediments to successfully ends of the spectrum: cost control of financial risk have the potential participating in a Shared Savings and cost certainty from the gov- to induce more meaningful system- Program. ernment’s perspective as a payer atic change in providers’ and sup- and patient and provider freedom pliers’ behavior.”9 The debate here For example, the Cleveland Clinic of choice. MGMA wonders out is not whether ACOs should take expressed its disappointment with loud whether Medicare (and each on downside risk but how soon in the proposed rules, stating that: of its stakeholders) can “have its their lifecycle that risk should be cake and eat it too” using the ACO borne. Many providers believe Rather than providing a model. that if ACOs take on too much risk broad framework that focus- too soon the ACO may be forced es on results as the key crite- Four specific areas of concern out of business. ria of success, the Proposed raised by MGMA are: (1) The Rule is replete with (1) pre- complexity of the ACO program Complaints have been registered scriptive requirements that creates a bias against participa- regarding how CMS will calcu- have little or nothing to do tion; (2) The cost of ACO devel- late the expenditure benchmark with outcomes, and (2) many opment and ongoing operations for ACOs. The benchmark will detailed governance and re- are too high relative to the po- be unique to each ACO. CMS porting requirements that tential financial benefits; (3) The will base the benchmark on esti- create significant adminis- potential financial benefits are mated Part A and B expenditures trative burdens. Further, too small and too uncertain; and for ACO beneficiaries. Some pro- we have concluded that the (4) The regulatory risks under the vider groups have argued that a shared savings component related joint notices concerning better approach would use blended (Shared Savings) is struc- ACOs issued by CMS, the Office regional and national expenditures tured in such a way that cre- of Inspector General, the Federal ates real uncertainty about Trade Commission, and the De- Please see> ACOs, P6 -4- Chris Apgar, CISSP President Phone: 503-977-9432 Fax: 503-245-2626 Mobile: 503-816-8555 E-mail: email@example.com Quality Compliance Resources Apgar & Associates, LLC offers the highest quality service assisting health- care organizations establish sound privacy and security programs, meet regulatory requirements, address legal and regulatory issues and assist in planning deployment of health information technology, electronic health records, personal health records and health information exchange plan- ning. Check out Apgar & Associates, LLC’s web sites for a full list of ser- 10730 SW 62nd Place Portland, OR 97219 vices offered. http://www.apgarandassoc.com Check out enhanced virtual compliance officer services for organizations of all sizes < ACOs, from P4 to create a benchmark. Conclusion As with any potential decision, health care providers must assess the pros and cons associated with joining or creating an ACO or re- fusing to do so. ACOs have been heavily promoted as a panacea for control of health care spending while increasing health outcomes; a world view that is yet to be prov- en. However, some of the criti- cism may be equally flawed. A decision whether to participate in the Shared Savings Program and the provider’s selection of an ACO to join, are weighty decisions that require a careful consideration with a full appreciation of both the costs and the benefits evaluated in the context of your specific situa- tion. Time to bring in outside help? Stephen Rose has more than 25 The Consultant Marketplace, years representing healthcare pro- located on the Washington Healthcare News web site, is viders in matters relating to Medi- where over 50 companies that care/Medicaid reimbursements, specialize in providing services government audits, and corpo- or products to healthcare rate compliance plans. He can be organizations are found. reached at firstname.lastname@example.org or To learn more, visit 206.816.1375. wahcnews.com/consultant 1 76 Fed. Reg. 19528-19654 (April 7, 2011). 2 Id. at 19531. 3 Id. at 19530. 4 Letter from Delos M. Cosgrove, President and CEO, Cleveland Clinic to Donald Ber- wick, M.D., Administrator, CMS (May 26, 2011) (http://www.medcitynews.com/wordpress/ wp-content/uploads/Cleveland-Clinic-ACO- letter.pdf). 5 Id. 6 Letter from William F. Jessee, M.D. for MGMA to Donald Berwick, M.D., Admin- istrator, CMS (June 1, 2011) (http://www. mgma.com/WorkArea/DownloadAsset. aspx?id=1366447). 7 76 Fed. Reg. at p. 19618 (April 7, 2011). ® 8 Id. 9 Id. -6- Over 33,000 healthcare leaders receive Healthcare News publications each month. As a healthcare organization, doesn’t it make sense to target recruiting efforts to the people most qualified to fill your jobs? To learn about ways the Washington Healthcare News can help recruit your new leaders contact David Peel at 425-577-1334 or email@example.com ® Healthcare Facilities Washington Healthcare News | July 2011 | wahcnews.com Providence Regional Medical Center Everett Opens $460 Million State-of-the-Art Tower By David Brooks comprehensive building project in to provide first-class health care in Chief Executive Officer our hospital’s 150-year history. our growing community. Providence Regional Medical Center Everett The 12-story Marshall and Kather- The new tower was designed Providence Regional Medical ine Cymbaluk Medical Tower, one around Providence’s patient-and Center in Everett will take its of the largest private investment family-centered care philosophy, award-winning healthcare to the projects ever in Snohomish Coun- with comfort, privacy and con- next level June 14 when it opens a ty, is the centerpiece of a compre- venience in mind. By combining new $460 million, state-of-the-art hensive plan to ensure Providence cutting-edge technology with pa- medical tower, the largest and most Regional remains well equipped tient-centric care, Providence aims Providence Regional Medical Center Everett’s 12-Story Marshall and Katherine Cymbaluk Medical Tower -8- Volume 6, Issue 7 to set a new standard for the way members to stay with them. features family lounges with inter- patients and their families experi- net access, and the surgery waiting Of equal importance, the tower is ence hospital care in America. areas provide a kitchen, playroom designed to be a calming, healing The facility, which houses many and resource center for all. environment for patients, family Providence services, features $60 members and visitors alike. The The doctors, nurses and other million in the latest medical equip- building brings nature and the caregivers at our new tower will ment and is designed to adapt to outdoors inside, with features that provide the industry-leading care technology as it evolves in the fu- include a two-story atrium lobby, Providence is known for – but ture. It dedicates an entire floor - patient rooms with sweeping views we expect our warm, welcoming larger than an NFL football field on all sides of the building and a approach to serving patients and - to emergency services, which in- rooftop viewing garden with native their families is what will truly set cludes 79 private treatment rooms plants, grasses and trees. It also us apart. including four trauma rooms. CT vertical and X-ray services are also located within the department to provide quick access to imaging capabili- ties. More than $20 million in diagnos- tic imaging equipment, including two MRI scanning machines and four CT scanners, are housed on the diagnostic imaging floor. The department has a unique design that will accommodate both inpa- tient and outpatient imaging needs. Electronic medical records allow doctors and staff from multiple or- ganizations to share information in real time, which speeds diagnosis Legal strategies for the and treatment. healthcare challenges ahead. Two floors of the tower are dedi- cated to both surgical and interven- tional procedures and two floors Your healthcare business is operating in an increasingly complex environment. Miller Nash’s team of healthcare attorneys has the will house 48 patient rooms dedi- knowledge and depth of experience to successfully address the cated to intensive care, which in- unprecedented challenges and expanding responsibilities you face. clude six dialysis stations. Each of the top three floors has 56 patient Please contact Bob Walerius | firstname.lastname@example.org rooms for medical or post-surgical Regulatory Compliance | Board Governance | Medical Staff | Fair Hearings patients. Mergers & Joint Ventures | Physician Recruitment & Contracting | HIPAA Privacy Laws We worked closely with our Pa- Health Information Technology | Physician Credentialing | Stark/Fraud & Abuse Litigation & Dispute Resolution Business Formation & Transactions tient and Family Advisory Coun- Labor and Employment | Real Estate cil when designing the tower and, as a result, incorporated several seattle elements not typically found at a washington hospital. For example, most rooms vancouver washington have a special ‘family zone’ area, portland oregon TEL 206.622.8484 complete with a sleeper sofa and central oregon storage area for patients’ family -9- Healthcare Administration Washington Healthcare News | July 2011 | wahcnews.com Accountable Care Organizations: The Future of Quality Healthcare? By Loy Maslen and process improvement) for an causing quality and outcomes to RN, BSN, NNP-BC, CPUM Associate assigned population of people; i.e. suffer. To combat these issues, a Quality Improvement and Education Consultant Medicare patients. recognized ACO will need to meet Derry Nolan & Associates, LLC indicators and data derived from The Center for Medicare and Med- five key areas: icaid Services (CMS) is asking healthcare providers to be account- 1. Patient and providers’ experi- able to the care provided. That in- ence of care (patient and staff cludes administration, governance, satisfaction scores) and implementation either within the scope of our roles or in our 2. Care coordination (informa- employment positions. It also en- tion sharing across the contin- compasses the obligation to report, uum of care) explain and be answerable for any resulting consequences. 3. Patient safety (reporting, anal- ysis and error prevention) Initiated by the goals of the Af- fordable Care Act to improve care 4. Preventive health (treatments while lowering its cost, ACOs to minimize illness and hospi- will help make quality a habit tal admissions) in healthcare. Those ACOs that meet required quality performance 5. At risk population, frail and el- Healthcare reform is about ac- standards have the potential to re- derly health (using proven care countability for care. As a nurse, ceive payments from the Medicare standards to assist with care should someone ask me if I pro- Shared Savings Program, which provision) vide quality care, I would answer, “promotes accountability for a pa- “Absolutely.” But if they ask me, tient population, coordinates items The overall quality performance “What is your data to support that and services under Parts A and B, score will be calculated on 65 claim of quality care?” Then I may and encourages investment in in- quality metrics within those five need to say, “I’ll be right back with frastructure and redesigned care defined key areas, equally weight- you on that.” processes for high quality and ef- ed. CMS will define the quality ficient service delivery.”1 performance benchmarks based on That’s where the ACO comes in. Medicare Fee-For-Service (FFS), ACOs are a type of payment and From an operational perspective, Medicare Advantage or ACO per- delivery reform model that begins as well as from a clinical one, the formance data over time. to tie provider reimbursements to ACO model makes sense. Today’s quality metrics (measures of qual- healthcare organizations are often Note that the ACO is eligible for ity indicators) and reductions in fraught with inefficient workflows monetary compensation only if it the total cost of care (performance and faulty communication habits, demonstrates to CMS that it has -10- Volume 6, Issue 7 fulfilled the required quality per- and quality outcomes. of costly wastes. formance elements and achieves the other regulatory performance Communication should be a simple Consider this: the products of criteria. Mature organizations ex- concept, particularly in healthcare. healthcare systems are services. ist that already meet the measures Patients talk to doctors, nurses Therefore, measuring healthcare required. Those organizations not and other staff members. Health- quality must extend beyond clini- only meet the clinical measures, care providers talk to each other. cal measures. Organizations must but are also likely made up of high Unfortunately, the barriers that also measure patient perceptions performance teams. frequently block understandable and experiences. So, although ser- exchanges create gaps. Those gaps vice quality is usually measured by Creating High Performance in quality communication limit five dimensions: Teams quality service to patients and staff alike. The natural progression? Pa- 1. Tangibles Healthcare is complex, so ap- tient and staff dissatisfaction and 2. Reliability proaching issues as a cohesive frustration. group working together to achieve 3. Responsiveness a goal allows for creativity, sharing Failure to address these commu- expertise, developing new skills, nication issues in healthcare leads 4. Assurance increasing personal autonomy and to inefficiency, ineffective and po- influencing decisions. Such teams tentially unsafe care, rework, a di- 5. Empathy can only come together through minished capacity for team perfor- eliminating barriers encountered in mance and unintended outcomes. We will add two more: everyday communications. Com- Simply improving and standard- 6. Accessibility munication excellence is the key izing parts of our communication to unlocking team performance strategies can eliminate these types Please see> Quality, P14 EVERYONE BENEFITS FROM SOUND LEGAL ADVICE OUR BREADTH OF EXPERIENCE keeps our clients focused on their mission—providing quality care to their patients. Serving health care clients for over 75 years, we provide sound and practical advice to health care professionals, clinics, and institutions in such areas as labor and employment, risk management, regulatory compliance and licensing, business transaction and litigation services. FOR MORE INFORMATION CONTACT MARY SPILLANE: 206.628.6656 SEATTLE . TACOMA . PORTLAND and afﬁliated ofﬁces in SHANGHAI . BEIJING . HONG KONG Practicing law with greater resolve™ -11- Healthcare Law Washington Healthcare News | July 2011 | wahcnews.com Legal Challenges to Medicaid Rate Reductions Frustrated by Proposed Federal Rules By Renee M. Howard “Section 30(A)” of the Medicaid Belshe, 103 F.3d 1491, 1497 (9th Shareholder Act, requires state Medicaid Plans Cir. 1997).3 Based on this require- Bennett Bigelow & Leedom, P.S. to utilize “methods and proce- ment, many health care provid- dures” that “assure that payments ers have successfully challenged are consistent with efficiency, budget-driven Medicaid rate re- economy, and quality of care and ductions on the basis that the state are sufficient to enlist enough pro- did not conduct a responsible cost viders so that care and services are study prior to developing a new available under the plan at least to rate (or that the study itself was the same extent that such care and inadequate), and that the provid- service are available to the gen- ers would be financially harmed if eral population in the geographic such rate went into effect. area.”2 These payment-related requirements are known as the The proposed rules would sub- “quality” and “access” standards. stantially alter this legal standard. Rather than require cost studies, In recent years, various types of the rules would allow states to con- providers have brought success- duct a more flexible access analy- ful legal challenges to Medicaid sis that examines three factors: (1) rate cuts that do not comply with enrollee needs; (2) availability of Providers who participate in Med- Section 30(A) quality and ac- care and providers; and (3) utili- icaid should familiarize them- cess requirements. While provid- zation of services. Clarifying that selves with proposed federal regu- ers cannot get money damages in the relationship of rates to provider lations published on May 6, 2011 these lawsuits, they have been able costs is no longer the primary fo- that, if adopted, would substantial- to block state Medicaid programs cus of an “access” analysis, CMS ly impede their ability to challenge from implementing rate cuts that noted: “Depending on State cir- Medicaid rate reductions in court. violate Section 30(A). cumstances, cost-based studies Interested parties may submit com- may not always be informative ments to the proposed rules, which Since 1997, federal courts in or necessary. In addition, because must be received by the Centers Washington and elsewhere in the many State payment rates are not for Medicare and Medicaid Ser- Ninth Circuit have required states, specifically calculated based on vices (“CMS”) no later than 5 pm in order to comply with Section provider cost considerations, it can EST on July 5, 2011.1 30(A), to conduct “responsible be burdensome and not particu- cost studies” to ensure Medicaid larly productive to rely solely on The proposed rules interpret a fed- rates will be “reasonably related” that one factor as a measure of ac- eral Medicaid law that limits how to provider costs, and to conduct cess.”4 Going a step further, CMS state Medicaid programs can set such cost studies prior to setting suggests that a Medicaid rate can payment rates. That law, known as the new rates. Orthopedic Hosp. v. satisfy Section 30(A) requirements -12- Volume 6, Issue 7 irrespective of the payment level: the proposed rules and consider has represented health care clients “If beneficiaries are able to gain submitting comments to ensure in litigation and government in- access to care . . . . then clearly the that the final rules provide mean- vestigations implicating the fed- standards of the Act have been met ingful protections against budget- eral False Claims Act, the federal regardless of other factors, includ- driven rate cuts. Anti-Kickback Statute and physi- ing payment levels.”5 cian self-referral (“Stark”) laws, Renee is experienced in represent- state Medicaid issues, and health The singular focus on “access” to ing a wide range of health care care licensing matters. Renee also Medicaid services is problematic providers and suppliers, includ- assists clients with internal inves- for providers such as hospitals, ing hospitals and health systems, tigations of allegations of fraud or which must provide some measure academic medical centers, physi- other noncompliance with state or of treatment to all who come to cians, imaging centers, and medi- federal health care laws, and re- the emergency department regard- cal suppliers and distributors. She Please see> Medicaid, P14 less of insurance status or payment rates. Indeed, the framework in the proposed rules was developed based on a study that focused on primary and specialty care provid- Health Insurance ers and services, and did not spe- cifically address hospital, ancil- Options and Advice from the lary, and long-term care services.6 The rules also do not address Sec- Local Experts at EmSpring. tion 30(A)’s second requirement that states must ensure “that pay- ments are consistent with efficien- cy, economy, and quality of care,” in addition to ensuring access to No worries: services. We know how they all fit. Finally, the proposed rules would make it difficult for providers to es- tablish that a state failed to satisfy Section 30(A) access requirements, as the rules give CMS discretion to deny a State Plan Amendment only where a state fails to conduct an access analysis altogether and not where the access review is method- KIRKlAnD .......(425) 818-0726 ologically unsound or reveals defi- 218 Main Street ciencies.7 For example, if a state’s YAKImA .......... (509) 575-6497 access review identifies access is- 3911 Castlevale Rd, Suite 2109 sues, instead of denying the State SPoKAnE ....... (877) 550-0088 Plan Amendment, the proposed 601 Main Street rules permit the state to submit a corrective action plan, and take up WWW.EmSPRIng.Com to twelve months to remediate the deficiency. Health Reimbursement Arrangements (HRA) | Health Savings Accounts (HSA) Given these issues, Medicaid pro- Dan Fisher | Sue Ferrari | Kathy Rheaume | Carol Wagar, CPA | Ed Haines viders should critically examine -13- < Medicaid, from P13 and other health care compliance Maxwell-Jolly, 572 F.3d 644 (9th Cir. 2009). 4 76 Fed. Reg. at 26344. matters. She can be reached at 5 Id. at 26350. sponding to Medicare, Medicaid email@example.com. 6 Medicaid and CHIP Payment and Access and third party payor audits. Renee Commission (MACPAC), Report to Congress regularly advises clients on Medi- 1 The proposed rules are available at http:// on Medicaid and CHIP (March 2011), Ch. 4, p,126, available at http://www.macpac. care and Medicaid reimbursement www.gpo.gov/fdsys/pkg/FR-2011-05-06/ gov/reports/MACPAC_March2011_web. and payment issues, structuring fi- pdf/2011-10681.pdf (76 Fed. Reg. 26342 pdf?attredirects=0&d=1. (May 6, 2011)). nancial relationships under fraud 2 42 U.S.C. § 1396a(a)(30)(A). 7 Proposed 42 C.F.R. § 447.204(b). and abuse and self-referral laws, 3 Holding reaffirmed in Indep. Living Ctr. v. < Quality, from P11 foundation for the high perfor- tions to improve teamwork and mance teams that will make qual- performance outcomes. She holds 7. Communication ity a habit. the firm belief that an ACO begins The high performance teams that with partnerships between pa- grow from achieving these mea- Loy Maslen, RN, BSN, NNP-BC, tient, family, providers and staff, sures experience bonus benefits: CPUM Associate, is a quality im- applying standard structure and job satisfaction and communica- provement and education consul- process to drive improved qual- tion improves, mutual respect tant with Derry, Nolan & Associ- ity outcomes while simultaneously grows. If your healthcare organi- ates, bringing over 30 years of decreasing costs and eliminating zation can build such high perfor- diverse healthcare experience to waste. Maslen can be reached at mance teams, you will naturally inpatient and outpatient organiza- firstname.lastname@example.org or (425) evolve to improved quality and tions. A TeamSTEPPS™ Master 774-4893. outcomes. Your healthcare organi- Trainer and VitalSmarts™ Crucial zation can meet ACO performance Conversations Master Trainer, 1 http://www.modernhealthcare.com/assets/ pdf/CH7349848.PDF, page 4, Section B. Stat- criteria. But first, we must begin Maslen helps clients learn effec- utory Basis for the Medicare Shared Savings to truly communicate, laying the tive evidence-based communica- Program. Time to bring in outside help? The Consultant Marketplace, located on the Washington Healthcare News web site, is where over 50 companies that specialize in providing services or products to healthcare organizations are found. Visit wahcnews.com/consultant to learn more. ® -14- Volume 6, Issue 7 Career Opportunities To advertise call 425-577–1334 Visit wahcnews.com to see all available jobs. Controller Healthcare Sales Executive (Wenatchee, WA) Director, Human Resources (Portland, OR) Jefferson Healthcare, in Port Townsend, Washington, is This position is primarily responsible for building and execut- The Controller will provide leadership for the Finance ing tactical and strategic sales plans for HMA’s Oregon terri- recruiting for a Director, Human Resources. Department and will maintain agency financial infor- tory. The Sales Executive must demonstrate a consistent fo- mation, prepare financial reports, maintain and bal- Jefferson Healthcare is a full service, publicly owned, 37 cus on achieving or surpassing goals and a proven record of ance accounting ledgers and provide direct oversight bed, self supporting acute care hospital. excellence. He or She must show a passion for continuous improvement, and demonstrate personal motivation, energy, of the Purchasing, Accounts Payable, Cash Receipts, The hospital has approximately 350 employees and four creativity and adaptability while pursuing goals. The Sales Ex- Payroll and General Ledger functions. The Controller clinics. ecutive should inspire others through their own vigorous drive is responsible for maintaining compliance with exter- to achieve, motivating groups by communicating a compelling Jefferson Healthcare has all of the standard acute care nal stakeholders by ensuring the accuracy and timeli- vision and translating that vision into clear, actionable goals services plus Cardiac Rehab, Chemotherapy, Pulmonary ness of required reporting. Rehab, Rehabilitation Services, Support Groups and a and objectives. They work closely and collaboratively with Cli- ent Services team members, and seek out and share the latest Surgical Center. CVCH is a dynamic community health center with information on successful industry and business practices. fully integrated EMR. Our services include Medical, The Director, Human Resources supervises a staff of five Successful Candidate will have: Experience selling products Dental and Behavioral Health services with our main employees. with complex funding arrangements including Administrative clinic in Wenatchee and a site in Chelan. We serve A Bachelor’s Degree in Human Resources is required. Five Services Only, ASC, minimum premium, prospective, and ret- 20,000+ people in a geographically stunning part of rospective financial arrangements is required. Familiarity with or more years of progressive Human Resources experience the world and are proud to be a progressive group industry trends in health care insurance, as well as federal in a healthcare facility as a Director or Assistant Director is and relevant state legislative and regulatory issues. Currently of mission-focused employees committed to serv- also required. licensed (in Life and Disability) and have a valid state driver’s ing the underserved. We are leaders in the Medical license with a good driving record and proof of auto insurance. Labor relations experience along with PHR or SPHR is Home Model, are Joint Commission accredited and preferred. Demonstrates selling skills such as call planning, needs identi- are routinely recognized as one of the highest quality fication, overcoming objections, closing, and follow-up. Works Community Health Centers in Washington. Jefferson Healthcare is very well managed in an idyllic effectively under short deadlines. Additional requirements ap- setting. ply. The successful candidate will have a Bachelor’s de- Healthcare Management Administrators (HMA) believes in For more information please contact: gree in Accounting with five years accounting and delivering superior value to our many self-funded Northwest supervisory experience. CPA preferred. Visit our George C. Deering clients by combining competitive rates with superior service. If website at www.cvch.org. President you would like to learn more about our organization, please E- Deering and Associates mail your resume, cover letter and salary history to: recruiter@ To apply, contact Sarah Wilkinson, HR, @ 509-664- (425) 264-0865 (Office) accesstpa.com Faxed resumes are welcome at 305/574- 3587 or email@example.com (888) 321-6016 (Toll Free) 0443. Be sure to visit our website at www.accesshma.com. PeaceHealth Dedicated to Exceptional Medicine and Compassionate Care Chelan Clinic Administrator (Chelan, WA) PHMG Clinical Practice Program Manager The Clinic Administrator will provide leadership at our Chelan Clinic and future clinic site in East Wenatchee PeaceHealth’s Lower Columbia Region, in Longview, Washington, includes St. John Medical to ensure effective day-to-day operations and su- Center, a 200-bed acute care and Level III trauma center community hospital, and PeaceHealth pervision of support staff. This position will work col- Medical Group, a multi-specialty physician practice. We are an integral part of a nationally recog- laboratively with CVCH managers to ensure that all nized not-for-profit health care system known for its innovations in patient-centered care, patient program goals are achieved in support of our mission safety, and health care technologies We currently are recruiting for a Clinical Practice Program to provide healthcare with compassion and respect Manager for our Primary Care Clinics within PeaceHealth Medical Group: for all. In this role, you will support our primary care clinics by managing the clinical practice program CVCH provides Medical, Dental, Behavioral Health, operations and staff performance on clinical-related policies and processes in conjunction with Diabetes Education and WIC services. We serve the Clinic Managers. Will also ensure compliance with all regulatory guidelines and facilitate the 20,000+ people in a geographically stunning part of development, implementation and evaluation of clinical best practices, as well as, collaborating the world and are proud to be a progressive group with clinic leadership on ensuring consistent delivery of patient care. of mission-focused employees committed to serving the underserved. Our center is Joint Commission Require a minimum of an AA degree in Nursing, strong clinic nursing experience, as well as proj- accredited and is routinely recognized as one of the ect management and process improvement experience. highest quality Community Health Centers in the state of Washington. With its ideal location just 40 miles north of Portland and a short drive from the beautiful Pacific Coast and several different mountain adventures, Longview is a small city with an urban flair. The ideal candidate will have a Master’s degree in Longview’s 37,000 friendly neighbors enjoy the pace and natural beauty of a family-first commu- Healthcare, MPH or MHA, with two years supervi- nity that benefits from the amenities of nearby Portland and Seattle. sory experience in healthcare. Bachelor’s Degree in Healthcare or related field with appropriate experi- We offer a competitive salary range and a comprehensive benefits plan. Interested candidates ence will be considered. may apply online via our website at www.peacehealth.org. Resumes may be submitted in addi- To learn more about CVCH, visit our website at www. tion to application, to: Lwishard@peacehealth.org: cvch.org. EOE To apply contact, Sarah Wilkinson, Human Resourc- es @ 509-664-3587 or firstname.lastname@example.org -15- Prsrt Std US Postage Paid Olympic Presort ®
"July 2011 Edition of the Washington Healthcare News"