President’s Message

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Dear HFMA South Texas Colleagues, It has been an honor and a privilege to serve as your 2016-2017 President. I can’t believe how quickly the time goes. I was just starting to get the hang of this president thing and we are almost through our fiscal year. First, I would like take this opportunity to recognize the many people who make it possible for the South Texas Chapter to continue to THRIVE. To our sponsors, none of this could be done without your support, THANK YOU! To the officers, board, committee chairs, co-chairs and volunteers, I am grateful for the time and talents you all continue to contribute. To the past presidents, your support, encouragement and advice has meant more than you know. It takes an inspired team to coordinate and facilitate the programs and initiatives we deliver and I am lucky to be a small part of it. As we look back on this past year, we held fantastic educational and networking opportunities for our members-most recently, Healthcare Landscape 2017, our annual joint conference with the South Texas Chapter of ACHE and the Greater San Antonio Healthcare Foundation. The speakers included Mary Mirabelli, HFMA National Chair and Vice Admiral Raquel C. Bono, United States Navy, Director, Defense Health Agency, Medical Corps. The HFMA Texas State Conference was back in Austin this year with great educational sessions and a networking event at Maggie Mae’s on 6th Street that bowled people over. Thank you to John Knighten, John Montaine and David…

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President’s Message

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Dear HFMA South Texas Colleagues, Happy New Year everyone! I hope 2017 is a year full of good health, opportunities, success and fun. As I get older I can’t believe how time goes by so fast. We are halfway through our fiscal year and it feels like we just started. As we look back on the last three months, the South Texas Chapter continues to THRIVE! We had a fantastic Region 9 meeting in New Orleans in November. Thanks to John Montaine and David Glazener for representing South Texas on the Region 9 planning committee. If you missed it, you missed a great time. Also, our Leadership Forum was held Jan. 20 at the Blanton Art Museum in Austin. The meeting was filled with interesting healthcare and leadership topics. The Forum ended with a guided tour of the museum and a networking event at Sholtz Beer Garten. I want to thank Chairman John Knighten and the program committee for all its hard work. We ask you to invite a colleague to join HFMA. We include the membership goal, set by National, and progress in each newsletter so you can see how we are doing. Please help us meet our membership goal by renewing your membership or sponsoring a colleague. This can be done online at www.hfma.org/membership. Membership satisfaction is also tracked. Thank you to those who took the time to complete the membership satisfaction survey. We value your feedback! We have many exciting programs scheduled in the upcoming months. Healthcare Landscape…

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Focusing on Patient Care: The Final Rule

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For the approximately 16,000 nursing home operators across the country, increased scrutiny and constant realignment have become a way of life. And if trying to prepare for a new administration that is likely to enact significant regulatory and reimbursement changes in the near future wasn’t enough, long-term care providers also end 2016 with a new 700-page rule from the Centers for Medicare & Medicaid Services (CMS). The new rule, commonly referred to as either “The Final Rule” or the “Rules of Participation,” is a series of guidelines and requirements for long-term care facilities that receive Medicare or Medicaid funding. The guidelines will be implemented in three phases. The first phase was initiated on Nov. 28, 2016, phase two will be implemented by Nov. 28, 2017, and phase three will be implemented by Nov. 28, 2019 (Figure 1). The goal of the new regulations is to continue the advancement of service delivery and safety that has occurred over the past several years, as well as put in place a series of mechanisms designed to achieve improvements in quality of care while simultaneously attempting to reduce burdens on providers. The new regulations represent the most comprehensive update in decades. The first time Medicare and Medicaid requirements were published by CMS was in 1989, and although there have been periodic revisions since then, this is the most thorough overhaul since 1991. Clearly, the health care industry has experienced substantial changes in care delivery in the past decades, so the Final Rule’s arrival has…

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Healthcare IT Spending on the Rise

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Survey finds top drivers of healthcare IT investment are improving patient experience and engagement In an era of digital natives, new technological solutions to healthcare challenges appear almost daily. Not surprisingly, two-thirds of hospitals report increased tech budgets for this fiscal year. Additionally, over a quarter of hospitals have seen more than a 5 percent increase. A recent survey* by First American Healthcare Finance, in partnership with the American Hospital Association, identified this rise in budgeting for hospital and health system information technology. Where Are Healthcare Organizations Investing? With endless possibilities, where are providers investing IT? In 2016, First American met with over 700 unique healthcare organizations to learn about their top investment priorities. Out of 900+ projects, top IT investments fell into four buckets: Infrastructure to run operations and keep data safe with server, software, and wireless infrastructure upgrades. Communication to make verbal and digital flow of information more efficient, using tablets, iPhone, nurse call systems, EMR upgrades, and telehealth. Patient monitoring devices to boost preventative care using heart failure prevention devices (necklaces, wristbands, and watches), nutrition tracking devices and apps, and food scanners. Revenue generating items such as da Vinci robots, hybrid operating rooms, cutting-edge ultrasound and imaging equipment, artificial intelligence in robots, and 3D bio-printing. In the past, technology in healthcare organizations meant a handful of computers, some digital monitoring equipment, and a few pieces of imaging equipment. In today’s healthcare environment, technology has never been more aligned with every aspect of the patient experience. Additionally, as…

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Swing-Bed Considerations for Rural Hospitals in providing Skilled Nursing Care

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Abstract Swing-beds are one approach to addressing two problems in rural communities: the shortage of nursing home beds and the decline in rural hospital occupancy. In the past, swing-bed demonstration hospitals have shown the greatest potential for quality improvement compared to nursing homes in providing a continuum of care.   Background A national swing-bed program was first authorized in the 1980 Omnibus Budget Reconciliation Act allowing Medicare reimbursement of swing-bed care in rural hospitals with fewer than 100 beds. The term “swing bed” is used to describe the level of care hospitalized patients receive once they are no longer in need of acute care. Swing bed admissions are limited to patients who require some level of skilled nursing care and are currently in a hospital acute care bed. Patients cannot be admitted to a swing bed from either the community or a skilled nursing facility unless they have spent three days in an acute care hospital bed for related needs within the past 30 days. Swing beds are generally limited to 40 days per patient under state law . Rural hospital leaders may be quick to blame Medicare and federal regulations for their collective financial crisis, but the biggest reasons so many rural hospitals are in danger of closing is because they simply do not have enough inpatients . Since the passage of ACA there has been a further downward utilization trend and subsequent cash flows issues in small rural hospitals. Increased out of pocket expenses for healthcare, associated with…

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President’s Message

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Dear HFMA South Texas Colleagues, Fall is here and that should mean leaves changing and cooler weather but that is not the case in South Texas. What it does mean is football, so whether you follow high school, college or professional football I hope your team is having a successful season. This fall a much more vicious sport is taking place, the presidential campaigns. I for one am glad it is nearly over. Remember Nov. 8 is Election Day, please get out and vote. As we look back on the last three months, the South Texas Chapter continues to THRIVE! We are coming off of two very successful joint meetings; the HFMA/ACHE Summer Institute held Aug. 25 at the Seton Administration Offices in Austin and the HFMA/TAHFA Fall Symposium held Sept. 12-13 at the Embassy Suites Riverwalk in San Antonio. Both meetings were filled with education around trending healthcare topics as well as plenty of networking opportunities. I want to thank Chairman John Knighten and the program committee for all their hard work. I also want to thank Lisa Keffer and Robbie Connell for an outstanding networking event held Sept. 10 at Top Golf in San Antonio. If you missed it, you missed a great time. If you have not renewed your membership, please take a moment to do so. You can renew online at www.hfma.org/membership. Being a member has advantages including free national and regional webinars, great educational sessions, fun networking opportunities and a variety of other valuable resources. Please…

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The Telephone Consumer Protection Act (TCPA) and Calling Cell Phones

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By: Med A/Rx Under the Telephone Consumer Protection Act (TCPA), calling cell phone numbers using an “automatic telephone dialing system” can cause legal problems for providers and revenue cycle companies trying to contact patients to pay their outstanding account balance. The TCPA (47 U.S.C. 227, 47 CFR 64.1200) prohibits the use of an “automatic telephone dialing system” to contact “any telephone number assigned to a …cellular telephone service” without “express prior consent” from the party being called. More than two-fifths of American homes (45.4%) had cell phones and no landline phones in the 2nd half of 2014 – a 4.4% increase from a year prior, and double since 2008. About 44.1% of all adults (106 million) lived in wireless only homes — and the same for 54.1% of all children (40 million children). In addition, a sixth of American homes (14.9%) still had a landline, but received all or almost all calls on their cell phones.1 To reduce the risk of legal fees associated with calling cell phones, we suggest adding the following language to your current MEDICAL TREATMENT AUTHORIZATION AND CONSENT FORM: You agree, in order for us to collect any amounts you may owe, we or an associated third party may contact you by telephone at any telephone number associated with your account, including wireless telephone numbers, which could result in charges to you. We may also contact you by sending text messages or e-mails, using any e-mail address you provide to us. Methods of contact may include…

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Presidential Positions: Where the Candidates Stand on Health Care, Housing

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In seemingly every presidential election, we are told by pundits and politicos that this particular contest represents the starkest choice between two vastly opposed ideologies that we’ve seen in decades. The future, your kid’s future and your grandchildren’s future, depends on its outcome. Some may argue that such hyperbole is an understatement this year, and, whether that’s true or not, one thing is clear—this election gives voters the choice between the known and the unknown. If Secretary Hillary Clinton wins, the nation will likely stay on its current path—a pursuit of incremental change shaded by Democratic ideologies. If Donald Trump wins, no one is quite sure what will happen, although a look at his proposals and the GOP’s 2016 platform provides some insight. Health Care Clinton has made it clear she believes in upholding and improving the Affordable Care Act (ACA). Her website lists several other health care policies including: • Expanding Medicare by lowering eligibility age from 65 to 55 • Lower prescription drug costs by requiring drug companies to invest in research and development in order to receive taxpayer support • Incentivize states to expand Medicaid (no specifics given) • Allow families to buy insurance on the health exchanges regardless of immigration status • Identify ways to make providers eligible for telehealth reimbursement under Medicare • Expand federally qualified health centers and rural health clinics • Double funding for primary-care community health centers All this amounts to what would be a hefty expansion of the ACA and would…

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