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Pre-Conference Programming
Sunday, March 9
8:00 a.m. – 3:00 p.m.
NHIA 2008 Executive Pre-Conference:
Transforming Our Future—Successfully Navigating the Changing Landscape of Alternate-Site Infusion
Supported by an unrestricted educational grant from Managed Health Care Associates Inc. (MHA)
Phoenix Convention Center – South Bldg.
ACPE # 207-999-08-154-L04-P
VNA Approver Number:
Pharmacy & Nursing Continuing Education Contact Hours: 5.0
Executive Pre-Conference - Agenda
Session Summary:
The NHIA Executive Pre-Conference is uniquely designed for senior executives, owners, managers and others with strategic leadership responsibilities—and strives to tackle the most pressing issues influencing our field. In case you haven’t noticed (and we are quite sure you have), there are numerous, sweeping changes taking place in the pharmaceutical marketplace that are impacting alternate-site infusion organizations at an unprecedented pace. Just what are the primary drivers generating the multiplicity of transformations to our field’s landscape—and how should your organization strategically address these elements to ensure a successful future? Join fellow leaders to obtain a critical update on the many factors driving the considerable modifications to the alternate-site infusion marketplace:
- Trends: Reflect upon the significant trends emerging in our field with regard to mergers, acquisitions, consolidation and payer-owned infusion organizations—and strategically assess how such activity will impact your alternate-site infusion business.
- Models: Discover promising business models for providing infusion therapies, including the important role of ambulatory infusion.
- Challenges and Opportunities: Understand the potential benefits of an increasing number of infusible therapies in the biotech pipeline and vital emerging technologies in our field—while investigating data collection infrastructure challenges, and new drug pricing methodologies that will impact reimbursement and contracting.
- Strategies: Formulate innovative strategies and leadership approaches for successfully transforming your alternate-site infusion organization to ensure a thriving future, even in the face of our field’s shifting landscape.
Faculty: Russ Bodoff, Executive Director, NHIA, Alexandria, VA; Debbie Cain, RN, CRNI, NHIA Board of Directors& Cox Home Parenteral Services, Springfield, MO; Richard Bulich, PharmD, Senior Vice President, Specialty Pharmacy, Managed Health Care Associates, Nederland, CO; Dexter Braff, MBA, President, The Braff Group, Pittsburgh, PA; Cynthia J. Schmeichel, BS, MS, PhD, Principal Scientist-MSL, Economics, Clinical, Health Outcomes (ECHO) Team, Centocor, Inc., Horsham, PA; David Willcutts, Chairman of the Board (formerly CEO), Ancillary Care Management, Inc., Pasadena, CA
Panel of Providers: Paul Mc Connell, President, Critical Care Systems, Nashua, NH; Connie Sullivan, RPh, Heartland I.V. Care, Lyons, CO; Mike Rigas, RPh, Crescent Healthcare, Anaheim, CA; Dave Grady, BA, Big Sky Infusion, Kalispell, MT and Lynn Kelley, R.Ph. Cox Home Parenteral Services, Springfield, MO
Educational Objectives:
- Discuss the current climate and market dynamics of the home infusion therapy sector
- Describe specialty pharmacy market dynamics as they relate to drug manufacturers, payers and providers
- Discuss emerging business models for delivery of specialty infusion therapies
- List the current pharmaceutical classes of trade and current controversies related to pharmaceutical purchasing
- Discuss the impact the recent home infusion mergers, acquisitions, and market consolidation is having on the home infusion marketplace
- Identify key characteristics that determine value of a home infusion organization
- Discuss the impact of the biotechnology pipeline and the use of various pharmacy distribution models on the home infusion and specialty pharmacy markets
- Discuss the legal and regulatory implications of biogenerics/ follow-on biologics on the pharmaceutical market dynamics
- Discuss the impact of payers entering into providing specialty pharmaceuticals and related services.
- Describe strategies payers are using to manage high-cost pharmaceutical therapies
- Identify key opportunities for infusion providers in the development of care management programs that address the needs of specific populations
- Describe the increasing need for data to manage high cost of specialty infusion therapies
- Describe current challenges pharmacy providers face in meeting payer requirements for data collection and reporting
- Describe the impact of new drug pricing methodologies on home infusion therapy providers
- Identify challenges and opportunities for infusion providers in the changing environment
8:15 a.m. – 3:15 p.m.
NHIA 2008 Reimbursement Pre-Conference:
The Fundamentals of Alternate-Site Infusion Reimbursement
Supported by an unrestricted educational grant from Definitive Homecare Solutions (DHS/CPR+)
Phoenix Convention Center—South Building
ACPE # 207-999-08-155-L04-P
VNA Approver Number:
Pharmacy & Nursing Continuing Education Contact Hours: 5.0
Session Summary:
Back by popular demand—this all-day, comprehensive seminar provides the basics of alternate-site infusion reimbursement presented by the highly-skilled author of Infusion magazine’s Bottom Line reimbursement column. Specifically crafted to be both practical and matter-of-fact, the valuable information offered can be put to use immediately upon returning to your office—and is intended for individuals occupying all levels of the organizational chart. The 2008 pre-conference topics include:
- Concepts: Review the essential concepts all infusion personnel must understand—such as key terms, reimbursement methodologies, drug reimbursement methodologies, private payer contracts, and the basic components of the infusion claim.
- Processes: Examine reimbursement-related processes in great detail—including intake, revenue qualification, documentation, billing Medicare for denial, the management of claims rejections, the revenue cycle, accounts receivable, collections, and the relationship between the clinical and financial components of the organization.
- Tools: Receive vital reimbursement-related tools to help you manage the charge master and infusion claims rejections, as well as enhance your cash management techniques.
- Controls: Explore how to use controls to ensure strong outcomes—inclusive of statistical management of performance, controlling write-offs and monitoring regulatory compliance.
Faculty: David Franklin, MSA, President, Advanced Care Consulting Services, Shelby Township, MI
Educational Objectives:
- Compare and contrast healthcare financial management with financial management of non-healthcare businesses.
- Review the basic benefit structure of the Medicare Program and other governmental programs that pay for healthcare.
- List the nine steps of the healthcare revenue cycle.
- Identify issues impacting the reimbursement function for infusion related to payer contracts and the information system infrastructure.
- Describe the infusion intake process from an information gathering perspective.
- Discuss the revenue qualification process.
- Discuss healthcare reimbursement models used by both public and private payers.
- Describe various drug reimbursement methodologies.
- List the major components of a claim for infusion drugs and services.
- Discuss the appropriate management of telephone collections calls.
- Review effective cash management techniques.
- Discuss the general principles of accounts receivables’ management.
- Review the use of statistics in the management of a reimbursement operation.
- Describe tools and processes to manage infusion claim rejections.
- Identify issues pertaining to regulatory compliance as it relates to the reimbursement function
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