On February 26, 2019 HFMA held a conference titled “Beyond Hospital Walls”. The conference focused on continuum of care delivered outside of the hospital and was attended by a vast mix of healthcare professionals creating a vibrant learning experience. The speakers included leaders from the University of Maryland Medical System, Western Maryland Health System, MedStar Health System, Lighthouse Healthcare Advisors the Co-Founder of BHWorks. There were three main topics thought the conference: physician onboarding and credentialing, understanding payer contacts and value-based care/the collaborative care model.
Each health system had a varied method of physician onboarding. The mandatory processes such as a welcome email including an informational packet, HIPPA training and credentialing assistance were completed but utilized different methods. Something that I found very interesting was that one of the health systems maintained a very close relationship with HR while credentialing doctors. This was done to ensure an efficient and timely enrollment process.
Consultants enlightened the audience of the complications in payer contracts. Some alerting factors included that although the new contract could warrant a 10% increase in revenue within the first year it could possibly be detrimental if the contract was for 5 years. This is because it does not promise a steady yearly increase, so contract length should not be ignored. Additionally, simply making modifications to contracts is not always beneficial. Therefore, new contracts should be made every few years in order to remain up to date. Renewal timing can cause frustration. In some cases doctors decide that they are ready to edit their contracts but are unable to due to the stringent renewal time periods. It is always essential to ensure that the contract outlines a decent amount of time for modifications to be made. There was a certain situation explained when a doctor was stuck with a contract because it only allotted one day for changes to be proposed and he attempted to start the process a week after the date, in turn the doctor had to wait an additional year.
Lastly, the collaborative care model was discussed as it contributed to success under value-based care models. These two models are attempting to shift healthcare from volume to value so that the patient is always put first. The collaborative care model was outlined to be a team approach, incorporating all faculty members in the care for the patient with focus on care coordination and managed care plans. On the other hand the value based care model was rooted in remaining patient focused, cost and reporting quality, comprehensive and coordinated care and paying for performance. These two models are very similar in that they both champion patient-centered care.
Overall, the conference fostered idea exchange and collaboration. The topics were operationally relevant and the panel discussions brought shared innovation.