Coffee with Coker

As healthcare business consultants, we are committed to helping healthcare organizations and professionals navigate the healthcare industry. Our discussion will focus on current events in the healthcare industry and how leaders in healthcare organizations can effectively overcome challenges.

Episode 77: New Opportunities with Telehealth Leadership Positions 11/19/2020

Episode 76: Beyond EHR: Using Technology to Meet Growing Demands and Deliver Better Patient Care 11/05/2020

Episode 76: Beyond EHR: Using Technology to Meet Growing Demands and Deliver Better Patient Care Jeffery Daigrepont joins Mark Reiboldt to discuss Coker’s latest book, Beyond EHR. Today, it is not uncommon for practices and hospitals to be on their second or third EHR or contemplating a transition from the traditional on-premise model to a cloud-based system. As a follow-up to Complete Guide and Toolkit to Successful EHR Adoption (©2011 HIMSS), this book builds on the best practices of the first edition, fast-forwarding to the latest innovations that are currently leveraged and adopted by providers and hospitals. Contact Information Subscribe to our feed in , , , or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. Please email us: Connect with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Like us on Facebook: Episode Synopsis In this new book, we examine the role that artificial intelligence (AI) is now playing in and around EHR technology. We also address the advances in analytics and deep learning (also known as deep structured or hierarchical learning) and explain this topic in practical ways for even the most novice reader to comprehend and apply. The book also covers the challenges of EHR to EHR migrations and data conversions, including the unethical practice of data blocking some vendors use as a tactic to hold data hostage. Further, we explore innovations related to interoperability, cloud computing, cybersecurity, and electronic patient/consumer engagement. Finally, this book will deal with what to do with aging technology and databases, which is an issue rarely considered in any of the early publications on healthcare technology. What is the proper way to retire a legacy system, and what are the legal obligations of data archiving? Extras /episode/index/show/coffeewithcoker/id/16571792

Episode 75: How to Succeed in the Business of Medicine 10/14/2020

Episode 74: Practicing in a Pandemic: Technological Innovation from the Ground Up with Modernizing Medicine 10/01/2020

Episode 73: Affiliation Options for Physicians: Current and Future Strategies 09/17/2020

Episode 72: Impact of 2021 Fee Schedule Changes on Physician Compensation 09/03/2020

Episode 72: Impact of 2021 Fee Schedule Changes on Physician Compensation Justin Chamblee, Alex Kirkland, and Amit Vaishampayan join Mark Reiboldt to discuss the proposed changes to the Medicare Physician Fee Schedule (MPFS). There are three noteworthy changes proposed, including evaluation and management (E/M) coding and payment changes, permanent telehealth changes implemented in response to the pandemic, and updates to the Quality Payment Program (QPP). Contact Information Subscribe to our feed in , , , or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. Please email us: Connect with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Like us on Facebook: Episode Synopsis E/M Coding and Payment Changes Due to increasing RVU amounts, the statutory budget neutrality mandate comes into play to reduce the conversion factor by $3.83 to $32.2605 to prevent an increase in healthcare costs. The Budget Neutrality Act requires that increases or decreases in RVUs may not cause the value of expenditures for the year to change more than $20 million in the absence of changes. If this threshold is exceeded, adjustments are made to preserve budget neutrality. Telehealth Changes The Centers for Medicare and Medicaid Services (CMS) are adding several telehealth CPT codes that are similar to existing consultations and office visits. They also added temporary codes during the pandemic that will continue to be evaluated. CMS is seeking comments to determine future usage as well as additional temporary codes. QPP Updates We see ACO scoring and policy changes to acknowledge that providers will not immediately recover from COVID-19, and they will need support throughout their recovery. The Merit-based Incentive Payment System (MIPS) category weightings will shift to reduce the quality weight by five percent (to a total weight of 40 percent) and increase cost by five percent (to a total weight of 20 percent). Extras /episode/index/show/coffeewithcoker/id/15854720

Episode 71: The Ongoing Battle of Site Neutral Payments 08/20/2020

Episode 71: The Ongoing Battle of Site Neutral Payments Brandt Jewell and Taylor Cowart join Mark Reiboldt to discuss the latest news for site neutrality. Hospitals have historically benefited from the Outpatient Prospective Payment System (OPPS), the reimbursement mechanism for Hospital Outpatient Departments (HOPD) facility fees, in comparison to their private practice peers functioning under the Medicare Physician Fee Schedule. Contact Information Subscribe to our feed in , , , or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. Please email us: Connect with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Like us on Facebook: Episode Synopsis The procedures performed in a freestanding clinic versus an HOPD received 75% less reimbursement. Hospitals were highly incentivized to acquire independent sites, switch the designation to HOPD and begin increasing their reimbursement for the same procedures. This strategy caused HOPD billings to effectively double over the last decade. Both Medicare and its beneficiaries were under pressure to find a solution. Between 2018 and 2020, the Centers for Medicare and Medicaid Services (CMS) updated the OPPS rate and proposed to phase in a 60 percent reduction over two years. They believe site neutral payments will give patients more options for their care. Alternatively, hospitals predicted a massive loss under the site neutral payments into the millions for many organizations. The American Hospital Association (“AHA”), the Association of American Medical Colleges (“AAMC”) and various other private groups took up arms against CMS, arguing that hospitals should receive additional reimbursement as it is inherently more expensive to run HOPDs based on the standards they are required to uphold. Extras /episode/index/show/coffeewithcoker/id/15687980

Episode 70: Major E/M Coding Changes Coming in 2021: Here’s What You Need to Know 08/07/2020

Episode 70: Major E/M Coding Changes Coming in 2021: Here’s What You Need to Know Jeannie Cagle joins Mark Reiboldt to share the good news about evaluation and management (E/M) coding changes for 2021! Although telehealth and COVID-19 impacts received the most attention in the Proposed Rule, the E/M coding changes are still coming, and CMS will release the Final Rule by the end of 2020. Contact Information Subscribe to our feed in , , , or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. Please email us: Connect with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: Like us on Facebook: Episode Synopsis As part of the Patients over Paperwork initiative, the Centers for Medicare & Medicaid Services (CMS) is simplifying the documentation to support billing outpatient E/M professional services. In summary, the new guidelines affect only new and established office/outpatient E/M codes (99201-99215); however, they will significantly alter documentation of the patient visit. These changes will remove the history and exam as key components, and base code-level selection on either Medical Decision Making (MDM) or time. Also, the proposed increase in RVU value will create a financial boost. Coding education and audits are more important than ever. Medical decision making is moving to the core of medical coding with less emphasis on technicalities to support the level of coding. An educated physician is our number one priority! Coker Group is offering either a turn-key solution or a customized approach based on each client’s individual needs. Our extensive coding team, including certified professional coders and RNs, will complete these services with our in-house coding and compliance senior vice president, Roz Cordini, JD, MSN, RN, CHC, CHPC, overseeing Coker’s coding team. The components of these services include: Assessment of education and training needs for both providers and in-house coders Discussion with EMR template managers to determine internal policies for new requirements and necessary template revisions Development of a go-forward audit plan for provider documentation and coding audits 2021 follow-up education and audits Contact us today and use promo code EM2021 to receive a free checklist to assess the training needs for your healthcare providers and staff. /episode/index/show/coffeewithcoker/id/15522314

Episode 69: Leading in Crisis: Strategic Affiliations and Partnerships 07/22/2020

Episode 68: Remote Patient Monitoring, Engagement, and Communications with PREMEDEX 07/09/2020

Episode 67: New Opportunities with Remote HCIT Implementations 06/24/2020

Episode 66: Affiliation Options for Physicians and Hospitals Post-Pandemic 06/18/2020

Episode 65: Vendor Spotlight: Innovative Responses to Financial Challenges during a Pandemic 06/02/2020

Episode 64: Impact of COVID-19 on ACOs, CINs, and Shared Savings 05/28/2020

Episode 63: Is Virtual Care Here to Stay? 05/07/2020

Episode 62: Solving the Compensation Conundrum 04/23/2020

Episode 61: Key Issues and Guidance for Hospitals and Medical Groups during the COVID-19 Pandemic 04/10/2020

Episode 60: Responsive Compensation Arrangements to Battle COVID-19 04/03/2020

Episode 59: Combating COVID-19 with Digital Transformation 03/19/2020

Episode 58: Healthcare M&A: Improving the Marriage Post-Transaction 03/02/2020

Episode 57: HCIT: Security Risk Assessment 02/20/2020

Episode 56: Private Equity Deals: Operational Components of the Transaction 02/05/2020

Episode 55: Private Equity Deals: Approaching a Deal Strategically 01/14/2020

Episode 54: Live Recording: Healthcare 2020 Panel 12/31/2019

Episode 54: Live Recording: Healthcare 2020 Panel Dr. Stephanie Cross, Roz Cordini, and Michele Madison join Mark for a panel discussion on the healthcare industry. Mark moderates the conversation as Dr. Cross, Roz, and Michele outline current trends in the healthcare industry and how those trends will continue to evolve throughout 2020. The discussion focuses on rural health and access to healthcare, telemedicine, physician reimbursement, and the opioid crisis. Contact Information Subscribe to our feed in , , , or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know! We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or about issues that interest you. You can also recommend topics for future episodes. Email us: Connect with us on LinkedIn: Follow us on Twitter: Follow us on Instagram: About the Panelists Stephanie Cross is an assistant professor at the University of Tennessee and specializes in OB/GYN. Dr. Cross has been engaged as a part of the teaching faculty at UT and private practice throughout her career. Roz Cordini, JD, MSN, RN, CHC, CHPC, is a senior vice present and director of at Coker Group. Ms. Cordini leads the coding and compliance service line, which focuses on Office of Inspector General program compliance, compliance effectiveness reviews, physician compensation governance procedures, and governance education. She provides advisory services to boards of directors regarding compliance, virtual compliance officer services, provider documentation and coding audits, and other compliance-related services. Michele Person Madison is a Partner in the Healthcare Practice of Morris, Manning, and Martin, LLP, where she provides general legal advice to health systems in various regulatory and business matters. Ms. Madison is highly experienced in managing legal issues arising in hospitals, physician offices, or integrated health systems, including employment, investigations, risk management assessment, and corporation management. Also, she provides legal education for health systems’ medical staff, management team, and employees in these areas. /episode/index/show/coffeewithcoker/id/12574850

Episode 53: Physician Compensation Methodologies under the Stark Law 12/18/2019

Episode 52: FAQ: Business Valuation, Private Equity, and Telehealth 12/04/2019

Episode 51: Private Equity Deals: Forming a Management Services Organization 11/20/2019

Episode 50: The Digital Transformation of the Healthcare Industry 11/07/2019

Episode 49: Vendor Spotlight: Improving Patient Outcomes through Chronic Care Management 10/16/2019

Episode 48: Vendor Spotlight: Patient Access and Physician Utilization Automation 10/09/2019

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