Conference Agenda
Conference Agenda is pending and will be updated as sessions are confirmed, please check back!
Wednesday, September 11, 2024
4:00pm-6:00pm Early Registration
Thursday, September 12, 2024
6:45am-7:40am Registration and Continental Breakfast
7:40am-7:45am Welcome and Announcements
Moderators:
Nick J. Paslidis, MD, PhD, MACP, MHCM, CHCQM-PHYADV, FABQAURP
Chairman of the Board - ABQAURP
Medical Director - Accord Hospice
Sunil K. Sinha, MD, MBA, CHCQM, FACHE, FABQAURP
CME Committee Chair - ABQAURP
Vice President Population Health and Quality - Sentara Health Plans
7:45am-8:45am Closing the Communication Gap Between Facility and Revenue Cycle Clinical Teams
Sogol Sepehri, MD, MBA, CHCQM - Vice President of Physician Advisors - HCA Healthcare
- Describe how hospitalist clinical documentation impacts downstream billing efforts and the challenges faced when trying to address these issues in a traditional hospital structure.
- Identify how clinically trained denials management teams can have broader benefits in driving better transparency and education on denials-related issues to the front lines.
- Demonstrate initial findings and considerations that HCA has identified through their efforts in this space.
8:45am-9:45am Revitalizing Your Utilization Management Program: Lessons Learned During Development of Internal Physician Advisor Programs at Academic Medical Centers
William J. Frederick, III, MD, PhD, CHCQM-PHYADV - Physician Advisor Medical Director - Stanford Health Care
- Examine the current utilization management system in your hospital, including strengths and weaknesses.
- Explore new technologies, methodologies, and processes that have been successful in revitalizing health system utilization management programs.
- Formulate actionable strategies for implementing these solutions in hospitals considering factors such as cost, feasibility, potential barriers to implementation, and the expected impact on patient care and hospital efficiency.
9:45am-10:00am Networking Break
10:00am-11:00am Utilization Management vs. Utilization Review: It’s Not a Once-and-Done Process
Kathy Seward, MD, CHCQM-PHYADV - Physician Advisor - HPIR, LLC
- Differentiate between utilization management and utilization review.
- Identify methods to effectively manage patient status and resource utilization.
- Define the benefits of effective Utilization Management.
11:00am-12:00pm Secrets to Successful Peer-to-Peers
Melissa Buchner-Mehling, MD, CHCQM-PHYADV, FABQAURP - Associate Chief Medical Officer – Sound Advisory
- Identify the purpose of peer-to-peer calls.
- Describe communication styles and de-escalation techniques for peer-to-peer conversations.
- Formulate your clinical case for peer-to-peer presentation and tips for success.
12:00pm Closing Remarks and Adjournment
4:00pm-6:00pm Registration
Pick up your conference materials early for Friday sessions, save time in the morning!
(You do not need to register again if you've attended Thursday sessions.)
4:00pm-6:00pm Networking Reception
Relax and Network! Reception is open to Thursday, Friday, and Two-Day attendees.
Reception is ages 21 and over only, please.
Friday, September 13, 2024
6:45am-7:45am Registration and Continental Breakfast
7:45am-8:00am Welcome and Announcements
Moderators:
Nick J. Paslidis, MD, PhD, MACP, MHCM, CHCQM-PHYADV, FABQAURP
Chairman of the Board - ABQAURP
Medical Director - Accord Hospice
Sunil K. Sinha, MD, MBA, CHCQM, FACHE, FABQAURP
CME Committee Chair - ABQAURP
Vice President Population Health and Quality - Sentara Health Plans
8:00am-9:00am The Importance of Quality From a Leadership Perspective
Richard B. Siegrist, Jr., MS, MBA, CPA - Faculty Director - DrPH program, Harvard T.H. Chan School of Public Health
- Examine the perspective of organizational leadership on what information they should receive from members of the health care team regarding quality.
- Describe best practices for presenting quality information.
- Assess the value of a broader definition of quality that looks beyond the institution’s four walls to community impact.
- Evaluate the relationship between quality and financial performance.
9:00am-10:00am Advancing Digital Quality Transformation
Burke Burnett - Director, Partnerships – NCQA
- Discuss the history of traditional quality reporting.
- Discover why digital quality is important.
- Identify NCQA programs that support digital quality.
10:00am-10:15am Networking Break
10:15am-11:15am Panel Discussion: Successful Transitions for Patients to the Community
Mary Lomberk, PharmD, BCACP, CPh - Transitions of Care Clinical Pharmacist - BayCare
Mary McLaughlin Davis, DNP, ACNS-BC, NEA-BC - Program Manager - Cleveland Clinic
Jacqueline Vance, RNC, BSN, CDONA, IP-BC, CDP, LBBP - Senior Director of Clinical Innovation and Education - Mission Health Communities
Moderator: Cheri Lattimer, RN, BSN - Executive Director - National Transitions of Care Coalition
- Outline the barriers and concerns patients face when returning home and to outpatient services.
- Compare the roles of the pharmacist, case manager, and community health worker in transitions from acute or post-acute care to the community.
- Identify financial payment models that support improved medication management, transition, and care coordination in support of transitions of care interventions.
11:15am-12:15pm Reduce Reoperation Risk for Patients with Infective Endocarditis and Substance Use Disorder
Mary McLaughlin Davis, DNP, ACNS-BC, NEA-BC - Program Manager - Cleveland Clinic
- Describe the impact of treating patients with infective endocarditis (IE) and substance use disorder (SUD) on health systems and health plans.
- Identify an alternative paradigm for treatment of a population at high-risk for repeat surgery and mortality.
- Explain the benefit of comprehensive treatment for patients with IE and SUD.
- Support the implementation of dual treatment of IE and SUD within health plans and health systems.
12:15pm-1:15pm Networking Lunch (Buffet Lunch Provided)
1:15pm-2:15pm SAVOR to the Max - Fuel YOUR Success with the Power of HAPPINESS
Harjot Singh, MD - Leadership Consultant – HarjotSinghMD.com and Faculty – American College of Healthcare Executives
- Discuss how cultural myths of happiness are causing you harm.
- Describe the Full Spectrum of Happiness to put to use in your service.
- Build an easy weekly calendar of evidence-based wellbeing activities that take minimal time - some take only seconds.
- Identify a plan to continue this journey of happiness so you don’t “fall off the wagon” of joy.
- Apply the wisdom of this program into the fabric of your leadership: Your Leadership Playbook of Success.
2:15pm-3:15pm Charting the Course: Leadership Insights in Healthcare Systems
Pranav Mehta, MD, MBA, FACHE, CPE - Chief Medical Officer American & Atlantic Groups and Vice President of Clinical Operations – HCA Healthcare
- Define the essential components of hospital system capacity and capability, including infrastructure, staffing, and resources, and how they contribute to the delivery of quality healthcare services.
- Explore the role of information technology (IT) and artificial intelligence in enhancing hospital system efficiency and effectiveness, focusing on care transformation and innovation, electronic health records, and data analytics to optimize patient care delivery and operational efficiency.
- Discuss strategies for ensuring quality and safety within hospital systems, including the implementation of evidence-based practices, continuous quality improvement initiatives, and leveraging IT solutions to mitigate risks and improve patient outcomes.
3:15pm-3:30pm Networking Break
3:30pm-4:30pm Peeling the Onion: Why Hospital Leadership Need More Transparency into Utilization Management Data
Keith Fulmer, MHSA, PMP - Chief Technology Information Officer - Brundage Group
- Explain the importance of tracking key performance indicators for utilization management.
- Identify manual processes within the clinical revenue cycle that contribute to the inefficient workflows for utilization review staff.
- Discuss how effective utilization management processes can reduce payment denials to maintain an organization’s investment.
4:30pm-5:30pm Anatomy of an Artificial Intelligence Model and Why it Matters to the Quality Assurance Community
Allan S. Goldberg, DPM, CHCQM, FABQAURP - Podiatrist - Physician Affiliate Group of New York
- Define and analyze a representative artificial intelligence model and its use in medical decision-making.
- Highlight the expected benefits, challenges, and limitations of the use of artificial intelligence models in medical decision-making.
- Explain how the quality assurance community can utilize knowledge of artificial intelligence models to provide expert evaluation of artificial intelligence-enhanced medical decision-making.
5:30pm Closing Remarks and Adjournment
*Schedule, faculty, and content are subject to change.
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