9:00AM – 9:15AM

Welcome Presentation & Agenda Overview

Speaker:        Al Holloway, MBA, MHAPresident/CEO TIPAAA, Milton, GA 

9:15AM – 10:00AM 

Maneuvering the Revenue Cycle Minefield

Revenue cycle management (RCM)—formerly known as accounts receivable (A/R) management—is no longer identified through a linear process.  This session will illustrate how explosive the RCM landscape has become and why getting paid for services rendered now goes far beyond the historical application of “best practices” within the walls of your billing department or billing service.  This presentation will begin with bringing awareness to the many internal and external factors that create what is described to be the RCM minefield.  It will follow this with examples of how and why cash flow is either interrupted or is inevitably flowing into an A/R abyss.  Such things as hiring the right people, implementing an EHR system, and belonging to best insurance plan networks is not enough if there is not accountability, vigilance, and responsiveness.  This session will challenge TIPAAA’s members to recognize what role they must play in determining the success of their own organizations’ revenue cycle management and provide them with some helpful advices in which to make it happen.

Speaker:        Frances Burton, Owner, Kaizen RCM Consulting, Louisville, KY

Moderator:    Evelyn Jones, CEOAllied Physician Services, LLC, Watkinsville, GA

10:00AM – 10:45AM      

Building The Ideal Alternative Payment Model

America’s appetite for momentous change in U.S. healthcare brings tremendous opportunity for independent physicians to organize around care solutions that restore the physician-patient relationship.  For that to happen, Alternative Payment Models like Direct Primary Care, which incorporate the direct pay capacity of public and private payors, must be tailored to the needs of physicians, consumers, and self-insured employers to continuously improve physical and economic health.  There’s a growing network of tech-enabled tools and services available to support more cost-effective, proactive care, too.  Just how we get to restoring the physician-patient relationship relies largely on doing what one can in their circle of influence. We must advocate and actively create market conditions favorable to medical cost transparency and accountable quality.  Physicians may seize great opportunity by applying the lessons of wasteful “fee-for-service” medicine by developing virtually monitored individual care plans guided by evidence-based clinical protocols.  By adopting outcomes-based models of medical care, physicians have the potential to influence local health plan design, become health stewards, drive lower catastrophic insurance rates, reduce waste, and enjoy a better quality of practice/life balance.

Speaker:        A. Jefferson Ellington, III, CEO, Concentric Health, Inc., Concentric Health Systems, Burlington, NC

Moderator:    Evelyn Jones, CEO, Allied Physician Services, LLC, Watkinsville, GA

10:45PM – 11:30AM     

What Real Predictive Analytics Can Do For You

Are you tired of hearing all about the promises that analytics companies’ keep making but nothing seems to really materialize? Are you beginning to feel that analytics is just more work for everybody without substantial benefits in return? This session will show you what real predictive analytics, when done in a thoughtful, personalized manner, can do to reduce your burden, to help your patients and employees, and to keep your institution well-rounded both clinically and financially.

Speaker:       Sriram VishwanathProfessor of Data Science, Cockrell School of Engineering at The University of Texas, Austin and former CEO of Accordion Health Inc.,                        Austin, TX

Moderator:   Evelyn Jones, CEOAllied Physician Services, LLC, Watkinsville, GA

11:30AM – 12:00PM

Physicians in the Cross-Hairs:  The Government’s Increased Focus on Physician Liability in Healthcare Fraud and Abuse Enforcement

According to a Department of Justice (DOJ) press release, it obtained nearly $5 billion in settlements and judgments in False Claims Act (FCA) matters in fiscal year 2016.  This represented the third highest annual recovery in FCA history, bringing the fiscal year average to nearly $4 billion since 2009.  According to the DOJ, over half of its 2016 recovery came from the healthcare industry, including drug and device manufacturers, hospitals, nursing homes, and physicians.  Moreover, since 2015, the DOJ has increasing sought enforcement against individual physicians in FCA matters.  This session will discuss the three major enforcement statutes governing the healthcare industry – the FCA, the Stark Law, and the Anti-Kickback Statute – and how physicians can work to avoid becoming the target of government scrutiny in this area.

Speaker:       Scott R. GrubmanPartner, CHILIVIS, COCHRAN, LARKINS & BEVER LLP, Atlanta, GA

Moderator:   Evelyn Jones, CEOAllied Physician Services, LLC, Watkinsville, GA

12:00PM – 1:30PM         

Lunch on your own

1:30PM – 2:30PM

Washington Update: The future of U.S. Healthcare and Health Insurance

Learn what “replace and repeal” health legislation is developing and how it will affect physician practices.  Get an insider’s perspective from Doug Badger, Sr. Fellow at the Galen Institute and former Chief Healthcare Policy Advisor to the Bush Administration.   Mr. Badger has been working in WDC and with Republicans on health reform for many years.  He expertise and ideas have been instrumental in passing reforms for Medicare, prescription drugs, and Health Savings Accounts.

Speaker:      Doug Badger, Senior Fellow, Galen Institute, Alexandria, VA

Moderator:  Ronald Bachman, FSA, MAAA, President & CEO, Healthcare Visions, Inc., Duluth, GA

2:30PM – 3:15PM

Strategies to Survive and Thrive – An IPA Case Presentation

Highlands Physicians, a 1500 provider multi-state IPA, presents its challenges and solutions to thrive in a highly concentrated market where two 800-pound gorilla hospital systems are merging to create a King Kong.  Presenters will address strategies and tactics used to assist the IPA’s members maintain their independence.  Issues discussed will include: Dealing with a Certificate of Public Advantage (COPA) and CON process and politics, Maintaining engagement and support of independent physicians who fear retaliation if the speak in such a market, Countering aggressive hospital system acquisition of independent practices, Importance of the ACO/CIN platform to help protect independent physicians, Serving as the back office of a physician ACO that’s saved CMS $40+ million over a 3-year period while achieving quality of 98+%, Where we go from here (strategic responses to merger approval/denial scenarios).

Speaker:      A Walter Hankwitz, MBA, FACHE, CMPEKnoxville, TN

    Brant Kelch, Executive Director, Highlands Physicians Inc, Kingsport, TN

Moderator:  Steven Grant, M.D., F.A.C.P., Detroit, MI

3:15PM - 3:45PM Sponsored By: PHILIPS Lifeline

Use of Predictive Analytics in  the long-term, post-acute care management of at risk seniors using a highly accepted senior wearable to avoid unnecessary hospitalizations and reduce cost of care

Today, seniors represent 12% of the US Population, yet consume roughly 44% of the entire US healthcare expenditure and 25% of Medicare patients will move into high acuity populations annually. Success under evolving value-based care models requires visibility into at-home patient risk of avoidable hospital admissions so that appropriate and cost effective interventions can be delivered. A study conducted by Partners Healthcare identified the value of combining a highly accepted senior wearable, EHR data and monitoring with a new predictive analytics engine to provide actionable insights that assist clinical caregivers in potentially reducing healthcare costs and improving quality of life benefits to patients. Nick will share how the predictive analytics tool can help enable healthcare professionals manage their patient populations by providing significantly improved, and longitudinal, line of sight into the home for at-risk elderly patients for improved, proactive care management.

Speaker:      Nick Padula, Vice President, Philips Home Monitoring, Framingham, MA  

Moderator:  Steve Grant, MD, Vice President, Physician Partnership, Detroit Medical Center, Detroit, MI

3:45PM – 4:00PM

Break

4:00PM – 5:00PM

IPAs Continue to Encounter Many Issues

Come hear from IPA CEOs on the positive and not so positive experiences that they have encountered.  These CEOs will outline what happened, how their organization overcame, and the lessons learned.  We all learn from others experiences.  Take advantage of these IPA leaders successes and challenges.

Speaker:       Brant Kelch, Executive Director, Highlands Physicians Inc, Kingsport, TN

      Patrick Lubitsky, Executive Director, Physicians’ Care Network, Gainesville, FL 

      Mike Repka, Executive Director/CEO, Independent Physicians Network Inc, Milwaukee, WI

      Richard M. Tuten, J.D., President & CEO, Health First Network, Inc., Pensacola, FL

Moderator:    Richard M. Tuten, J.D., President & CEO, Health First Network, Inc., Pensacola, FL

5:00PM – 6:00PM

The Future of TIPAAA

Join a spirited discussion of how TIPAAA can continue to be relevant and help our members embrace the opportunities presented by changes in the healthcare landscape proposed by the new administration. Please bring your thoughts, hopes and suggestions!

Speaker:       Brant Kelch, Executive Director, Highlands Physicians Inc, Kingsport, TN

      Patrick Lubitsky, Executive Director, Physicians’ Care Network, Gainesville, FL 

      Mike Repka, Executive Director/CEO, Independent Physicians Network Inc, Milwaukee, WI

      Richard M. Tuten, J.D., President & CEO, Health First Network, Inc., Pensacola, FL

Moderator:    Richard M. Tuten, J.D., President & CEO, Health First Network, Inc., Pensacola, FL

6:00PM - 7:30PM

Exhibitor Network Reception – Dinner

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9:00AM – 10:00AM

Exhibitor Network Reception – Breakfast

10:00AM – 10:45AM

Trends Overview: The Shifting Health Policy Landscape

          With a new administration in office, the political landscape in Washington DC looks nothing like the pundits predicted a few short months ago. The concepts of ACA repeal and replace are now in play. But, how will changes to the ACA repeal ultimately affect the health industry and consumers? What other trends will be influencing the health ecosystem? Join Ben Isgur, PwC Health Research Institute Leader, for a conversation on how a second round of healthcare reform will impact the industry.

Speaker:      Ben Isgur, Director, Health Research Institute, PricewaterhouseCoopers, Dallas, TX

Moderator:    Connie Richardson, Director of Operations, Arizona State Physician’s Association, Phoenix, AZ

10:45AM – 11:30PM

SUPER-SIZE IT!  The Antitrust Perils of the Super IPA, PHO and ACO

In the 20 years since the FTC and the Department of Justice issued the Statements of Antitrust Enforcement Policy in Health Care, IPAs have come to know, understand and, for the most part, follow the applicable principles of the Statements.  But now, competing IPAs are affiliating with one another and with hospitals to form “super” organizations.  This session will explore how the antitrust principles of the government’s Statements apply to the Super IPA, PHO and ACO.

Speaker:       John Wiegand, Antitrust Attorney, Federal Trade Commission, San Francisco, CA

Moderator:   Connie Richardson, Director of Operations, Arizona State Physician’s Association, Phoenix, AZ

11:30PM – 12:00PM

Specialty Pharma & Physicians  – Collision or Collaboration?

In 2014, less than 1 percent of all prescriptions were written for specialty drugs, yet they accounted for approximately 32 percent of total drug expenditures.  How can physicians avoid being held hostage to unsustainable pricing, while offering patients and payers the best possible value? We’ll discuss the role of data in making this process easier.

Speaker:       Pat Trifunov, CEO, Velocity BioGroup, Philadephia, PA

Moderator:   Connie Richardson, Director of Operations, Arizona State Physician’s Association, Phoenix, AZ

12:00PM – 12:30PM

Captives for Capitation Risk: The Inevitability of New Performance Risk Based Contracts

Medicine is quickly moving towards incentive based compensation and away from pure fee for service.  This is especially so in the Medicare arena, which then inevitably finds its way into the non-Medicare market.  Medicare is moving towards risk based compensation where ACO’s bear some of the risk associated with the patient population in exchange for some of the savings.  Capitated Providers and ACOs will learn about strategies to manage and mitigate the risk of higher than expected utilization or catastrophic claims by using third party reinsurance arrangements and /or captive insurance companies owned by the ACO/IPA.  This presentation will explore, from the doctor’s perspective, risk, money solutions, and new financial models that have been successfully used by other capitated providers. Doctor groups will learn how reinsurance programs/captives can protect the ACO/IPA (and its profits) and how to better handle the ups and down of financial results arising from New Payment Risk models and changes of an IPA’s membership matrix. The captive can also insure unique exposures faced by ACOs/IPAs such as a drop in Star Rating, Medicare Risk Adjustment changes, failure to achieve ACO Benchmarks, Loss of an HMO Contract, Loss of a Key Doctor or Physician Group, and adverse Changes in Payment Methodology from CMS or the HMO.

Speaker:       Terry Chesser, ARM, Principal and Founder, U.S. Advisors, Inc., Brentwood, TN

      Stewart Feldman, CEO and Managing Partner, Capstone Associated Services, Ltd., Houston, TX

Moderator:    Connie Richardson, Director of Operations, Arizona State Physician’s Association, Phoenix, AZ

12:30PM – 2:00PM   

Exhibitor Network Reception – Lunch

2:00PM – 3:00PM      

The Status of Post-ACA Health Reform and the Likely Impact of Physicians   

Congressman Michael Burgess, MD has been an influential voice at the center of health reform for many years. Be among the first to hear straight from Congressman Burgess up-to-date insights on the status of the ACA Repeal and Replacement legislation.  He is  Chairman of the powerful House Energy and Commerce Subcommittee on Health where health reform legislation is developed.   His controlling Committee is scheduled to develop the first proposals that will go to the U.S. Senate for their input.  Ultimately, a conference committee will iron out any differences to develop a consensus bill for President Trump to sign into law.  He is unique as most senior medical doctor, on both sides of the aisle, serving in the House of Representatives. Because of his medical background, he has been a strong advocate for health care legislation aimed at reducing health care costs, improving choices, reforming liability laws to put the needs of patients first, and ensuring there are enough doctors in the public and private sector to care for America’s patients and veterans His presentation will include a view on the impact of the post-ACA reforms on physician practices. This is an exceptional opportunity to get the straight unfiltered word on how patient-centered healthcare reforms will affect your practice.

Speaker:        Michael C Burgess, M.D. MD, House of Representatives, Washington, DC

Moderator:    Steven Grant, M.D., F.A.C.P., Detroit, MI

3:00PM - 3:30PM     

MACRA – Ready, Set, Go!

Join us for engaging session to learn how MACRA, the new mandatory Medicare quality payment program, will impact the future bottom line.  Hear how value reimbursement will affect practices and discover value opportunities across the care continuum.  Leave with a vision of next steps.  Participants will hear an overview of MACRA regulations, how MACRA will impact their revenue, and a roadmap for the future of value reimbursement.

Speaker:        Nancy Babbitt, FACMPEFounder, Transformationist, V2V Management Solutions, Atlanta, GA

Moderator:    Richard M. Tuten, J.D.President & CEO, Health First Network, Inc., Pensacola, FL

3:30PM – 4:15PM

Putting the Green in MACRA; IPA Resources

How can your IPA help members with MACRA?  Hear from a panel of seasoned IPA executives who will share their challenges and successes helping their members meet MACRA requirements.  Hear how you can optimize resources and be part of the solution.

Speaker:       Thomas Samuels, CPA, MBA, CFO, Quality Independent Physicians LLC, Louisville, KY

      Peggy Sheng, COO, CAIPA Coalition of Asian-American IPA, Inc., New York, NY

                      Richard M. Tuten, J.D., President & CEO, Health First Network, Inc., Pensacola, FL

Moderator:   Nancy Babbitt, FACMPEFounder, Transformationist, V2V Management Solutions, Atlanta, GA

4:15PM – 4:30PM         

Break

4:30PM – 5:15PM

Revenue Enhancement Opportunties

Today’s environment is always looking for opportunities to improve the bottom line and for ways to enhance the physician’s ability to communicate effectively with their patients.  This session will provide opportunities for attendees to be exposed to some potential solutions to these challenges.

Speaker:       Steven M. Meyer, MD JDCEO, PSC Technology Incorporated, Sherman Oaks, CA

      James WestCEO, MyGenetx, Franklin, TN

 Moderator:  Barbara Massey, Director, Provider Relations, Boulder Valley IPA, Boulder, CO

5:15PM – 5:45PM

Risk or Risk Death

SPONSORED BY: National ACO, LLC

To most providers, risk is a four-letter word. To some the 4 letter word is love, to others it is something else. Risk or Risk Death is a discussion that details how independent IPA’s thrive moving from volume to value based care in Health Care assuming risk. Dr. Berger will explain risk-model and payment for performance strategies now and future.

Speaker:       Andre Berger, MD, CEO, National ACO, LLC, Beverly Hills, CA  

Moderator:   Barbara Massey, Director, Provider Relations, Boulder Valley IPA, Boulder, CO

5:45PM – 6:15PM

Polypharmacy and Medication Non-Adherence – potential health hazard for the elderly

SPONSORED BY: Philips Lifeline

Poor medication adherence represents a significant source of wasteful health care spending n the US healthcare system and is estimated at more than $310B annually and is attributable to drug-related morbidity with hospital admissions. The causes of non-adherence are complex and systemic, resulting from high out-of-pocket costs, poor care coordination and the failure to account for the patient’s personal circumstances. Medication Adherence has been clinically proven to reduce overall medical costs and reduce the risk of hospital admission. With 42% of US adults age 65 or older taking five or more medications, medication adherence strategies and solutions has an integral role in Connected Health and is a vital part of long-term care management plans. A recent study showed a 53% reduction in emergency room visits after incorporation of a novel medication management solution.

Speaker:       Mark Howard, Director, Philips Medication Adherence Solutions, Framingham, MA

Moderator:   Richard M. Tuten, J.D., President & CEO, Health First Network, Inc., Pensacola, FL

6:15PM – 6:45PM

Patient Engagement Fundamentals

SPONSORED BY: RoundingWell

In an era of at-risk payment models, physician groups recognize the increasing importance of meaningful, cost-effective, and sustainable patient engagement.  There are a variety of approaches available in the market to meet this need.  There is also a lot of noise.  What are the drivers or enablers of successful patient engagement initiatives?  What impact will effective patient engagement efforts have on your practice?  Hear the perspectives (and lessons learned) from a healthcare technology company CEO who has focused more than a decade developing solutions to address the challenges and complexities that often accompany patient engagement initiatives.

Speaker:       John Smithwick, CEO, RoundingWell, Nashville, TN

Moderator:   Richard M. Tuten, J.D., President & CEO, Health First Network, Inc., Pensacola, FL

6:45PM – 7:45PM

Exhibitor Network Reception – Light Dinner

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9:30AM – 10:15AM

The Future of Value-Based Payment for Independent Primary Care Physicians 

This session covers the WHO, WHAT, WHERE, WHEN and HOW of Value Based Payment (VBP): WHO is leading the charge for transformation to VBP; WHAT does VBP look like under the current, near-term and future healthcare reform models; WHERE will VBP most likely catch hold; WHEN is the healthcare system likely to transition to VBP (projected timetable) and HOW can IPA independent physicians get prepared for success under VBP.

Speaker:       Hal Sadowy, President, Premier Healthcare Advisors, Carmel, IN

Moderator:   Christ Pavlatos, MD, CEO, PatientMD with Illinois Bone and Joint Institute (IBJI), Lake Forest, IL

10:15AM – 10:45AM

*UPDATING SESSION – TBA

Healthcare today is individually and community focused.  This session will address the importance of a healthy community, how to effectively go about establishing programs in your communities, and how to engage community members in effective health awareness programs.

Speaker:      Blair Pickerill, Partner, MOGHI, Louisville, KY

Moderator:  Christ Pavlatos, MD, CEO, PatientMD with Illinois Bone and Joint Institute (IBJI), Lake Forest, IL

10:45AM – 11:30PM

Improved Health Outcomes and Increased Satisfaction: Southcentral Foundation’s Transformation into a Customer-Owned System

SPONSORED BY: Southcentral Foundation Nuka System of Care

Southcentral Foundation in Alaska has seen a 36 percent drop in ER visits for patients from 2000 to 2015, a 36 percent drop in the rate of hospital admissions for patients during that same period, and is below the Healthcare Effectiveness Data Information Set (HEDIS) 10th percentile in ER visits per 1,000 member months. This session will cover the whole system transformation which allowed SCF to achieve these results and the two key elements of that transformation—customer-ownership and relationship-based care. The presentation will feature detail about why SCF chose to make the reforms it did, the steps SCF took to implement them, and how SCF dealt with obstacles that arose in the process of reform.

Speaker:        Melissa K. Merrick, LCSW, MSW, CDC I, Clinical Director of Brief Intervention Services, Behavioral Services Division, Southcentral Foundation’s Nuka System of Care, Anchorage, Alaska

                       Dr. Verlyn Corbett, Medical Director, Southcentral Foundation’s Nuka System of Care, Anchorage, Alaska

Moderator:    Christ Pavlatos, MD, CEO, PatientMD with Illinois Bone and Joint Institute (IBJI), Lake Forest, IL

11:30AM – 12:15PM

What Real Predictive Analytics Can Do For You

Are you tired of hearing all about the promises that analytics companies’ keep making but nothing seems to really materialize? Are you beginning to feel that analytics is just more work for everybody without substantial benefits in return? This session will show you what real predictive analytics, when done in a thoughtful, personalized manner, can do to reduce your burden, to help your patients and employees, and to keep your institution well-rounded both clinically and financially.

Speaker:        Sriram Vishwanath, Professor of Data Science, Cockrell School of Engineering at The University of Texas, Austin and former CEO of Accordion Health Inc., Austin, TX

Moderator:    Christ Pavlatos, MD, CEO, PatientMD with Illinois Bone and Joint Institute (IBJI), Lake Forest, IL

12:00AM - 12:15PM

22nd ANM 2017 Closing Remarks

Speaker:    Al Holloway, MBA, MHA, President/CEO, Milton, GA

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