first illinois speaks

As if the federal qui tam lawwasn’t enough to worryabout, now states have

incentive to encourage would-bewhistleblowers. To minimize unnec-essary whistleblower activity, areview of and update to organiza-tional policies, as well as mandatoryemployee training is the best bet.

The Deficit Reduction Act, signedinto law this past February, containstwo sections which pose challenges toand require the attention of providers.Section 6032 provides substantialincentives encouraging states to enactvigorous false claims legislation.Section 6033 mandates employeeeducation regarding the laws govern-ing false claims recovery. Althoughnot effective until January 1, 2007,the laws’ ramifications will becomeapparent soon. Providers shouldbegin preparations immediately.

Encouraging State FalseClaims Laws

The Deficit Reduction Act rewardsstates by permitting them to retainan additional ten percent bonus onfederal Medicaid payments recoveredin suits brought under their statefalse claims laws. This “bonus”incentive means that states likely willpass new whistleblower legislation,or enhance their current laws, toclosely emulate the federal FalseClaims Act (FCA). To qualify forthe bonus, the state’s legislation

must be approved by theDepartment of Health and HumanServices’ Inspector General and mustmeet Deficit Reduction Act require-ments. Currently only twelve stateshave broad false claims laws thatcontain qui tam enforcement:California, Delaware, Florida,Hawaii, Illinois, Indiana,Massachusetts, Michigan, NewHampshire, New Mexico, Nevadaand Virginia. Similar laws inLouisiana, Tennessee and Texasapply to Medicaid only.

Under the federal FCA, anyone whoknowingly (directly or indirectly)submits a false claim to the federalgovernment is liable for up to threetimes the amount of the govern-ment’s damages, plus mandatory perclaim penalties from $5,500 to$11,000. What makes this especial-ly effective – and troublesome - isthat qui tam provisions allow privatecitizens with knowledge of potentialviolations to file suit on behalf ofthe government for a share of thesettlement proceeds.

www.FirstIllinoisHFMA.org • First Illinois Speaks • 1

speaksfirst illinois

April, 2006

A Newsletter from HFMA’s First Illinois Chapter

INSIDE:

Highlights and RecapFirst Illinois Chapter Events

January 2006 Accounting andReimbursement Program

February 2006 Medical GroupsPractice Program

March 2006 Managed CareProgram

Avoid Unnecessary Whistleblowers:Prepare for New Compliance LegislationBY BOBETTE M. GUSTAFSON

continued on page 11

Inside This Issue

Message from the President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

First Illinois Chapter News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

HFMA Events: January 2006 Accounting and Reimbursement Program . . . . . . . . 4

February 2006 Medical Groups Practice Program . . . . . . . . . . . . . . 5

March 2006 Managed Care Program . . . . . . . . . . . . . . . . . . . . . . . . 6

Work Smarter, Not Harder: Portfolio Modeling in Revenue Cycle Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Financing Options for Nonprofit Rural and Community Hospitals . . . 8

New Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Calendar 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

2 • First Illinois Speaks • www.FirstIllinoisHFMA.org

Upcoming Chapter Events –

CFO Meeting/Golf OutingJust a reminder – The Chapter’s annual CFO committee will be hold-ing its 2006 meeting and golf outing on May 5th, 2006. The day’sevent will be held at the Calumet County Club.

Golf CommitteePlans are moving along for this year’s 1st Illinois Golf Outing which willbe held on Friday, May 26th, 2006. Continuing the tradition, scram-bles will be held at St. Andrews in West Chicago, and regulation play atKlein Creek. This is a milestone event – 2006 represents the 30thanniversary of the event and will feature food, fun and lots of good raffleprizes. Not a regular golfer – no problem! Both novice and veterangolfers are warmly invited to attend!!

Call for Sponsors – Requests for event sponsorship have recentlybeen mailed to chapter members on behalf of their organizations –multiple opportunities exist to support this year’s outing, either in theform of raffle prizes, general sponsorship or hole sponsorship on anyone or all of this year’s courses. Costs for general or hole sponsorshiprange from $100 to $400 – members of the outing committee will betouch with you organization shortly regarding this opportunities. If you are interested in becoming a sponsor, you may also contact Al Staidl, Golf Committee Co-Chair at 630-724-1197.

First Illinois Chapter News, UpcomingChapter Events & Committee Updates

President’s MessageApril Showers . . .

Bring May Flowers . . .

In January the Accounting and ReimbursementCommittee program “Winning Strategies 2006… WillYour Team be There?” had an attendance of 107. A

special thank you goes out to Susan Hull who agreed tobe a last minute replacement speaker – Sue did a GREATJOB!

On February 16th the Medical Groups and Physicians Committee program“Regulations, Competition and Entrepreneurism in Healthcare: The Challenge ofProviding Quality Medicine in Today’s Milieu of Competing and Conflicting Players”had an attendance of 125; although the weather on this morning was a challenge –once arriving at our meeting location of Gardner, Carton & Douglas they were aperfect host – even providing much needed umbrellas for our members at the endof the session – THANK YOU!

On February 24 the Certification Committee conducted a full day certificationcoaching course. Lead by committee chairs Suzanne Lestina and Mike Nichols, 26members were prepped, prodded, and prepared for the HFMA certification Coreexam as well as the Specialty exams. Good Luck to each our members as youcontinue to pursue certification (see the February 2006 First Illinois Speaks for thebackground story).

On March 3rd our Chapter Officers program “HFMA 201 – We Need You!”drew 41 members. During this program we outlined member opportunities to vol-unteer within our chapter as well as rewards for membership recruitment.

Coming up next is the Managed Care Committees program “Managed care2006 – Send Lawyers, New Computers, and Money! Emerging Managed CareIssues and Trends Facing Providers”. This program is co-sponsored with theAssociation of Illinois Patient Access Managers. As of this writing nearly 90 mem-bers have signed up for the event.

Please watch your mail for information about our last event of the year on May26th – the First Illinois Chapter Golf Outing. We will be retuning to St AndrewsCountry Club and Klein Creek Golf Course. I am looking forward to seeing all ofyou there for this years fun filled day.

The “April Showers” song about bringing May flowers is really about change.Change is also underway in all of our chapter activities. The election process fornext years Directors and Officers is currently out to membership for the vote. Weknow however that Vince Pryor will succeed to President on June 1, 2006 accord-ing to our chapter by-laws. During March and April we will also put a call out toevery member giving you the opportunity to volunteer for committee work in the2006 – 2007 year. In early May our Officers and certain Committee Chairpersonswill travel to Southern California to participate in National HFMA’s LeadershipTraining Conference. Finally, in June we will be going to the National HFMA AnnualNational Institute in Orlando Florida to wrap up the 2005 – 2006 year and to official-ly “kick-off” the 2006 – 2007 year. Busy, busy times filled with many changes!

King Whitney, Jr. sums up change this way:Change has considerable psychological impact on the human mind. To the fear-

ful, change is threatening because it means that things may get worse. To thehopeful, change is encouraging because things may get better. To the confident,change is inspiring because the challenge exists to make things better.

For me change is good and inspiring. Thank you all for giving me the opportuni-ty to lead the First Illinois Chapter this past year – and to Vince – I wish you all the best.

Sincerely,Jim Heinking, FHFMAPresidentFirst Illinois Chapter HFMA

First Illinois Chapter ElectionsNew Officers and Board Members

Congratulations to the First Illinois Chapter officers and board members for 2006-07

Officers:Vince PryorPresident

James WatsonPresident Elect

Guy AltonSecretary

Mike NicholsTreasurer

New board members for the coming yearCarl Pelletierre

Eleanor MichalekElizabeth Hills

They will join the existing board membersLiz Simpkin

Larry ConnellSylvia Sorgel

Get to Know Your Members!

Suzanne Lestina, CHPF, CPCSSuuzzaannnnee LLeessttiinnaa is the Technical Manager of Patient Financial Services/Revenue Cycle for HFMA. In this role, Suzanne will help revenue cycleprofessionals meet today’s healthcare challenges by providing education,analysis, and guidance. She will accomplish this by supporting coalitionswith other healthcare associations to ensure accurate representation of thehealthcare finance professional. She will work with and educate a broadspectrum of key industry decision makers on the intricacies and realitiesof revenue cycle operations. Ms. Lestina will be working with a broadcross-section of stakeholders to improve the healthcare industry by identi-fying and bridging gaps in knowledge, best practices, and standards.

Suzanne joins HFMA with over 20 years of healthcare experience,including 10 years as a revenue cycle consultant. Her consulting expe-rience includes education, revenue cycle operations assessments, workredesign, and compliance audit/reviews. Prior to her consulting work,Ms. Lestina held revenue cycle leadership roles for two Chicago areahospitals. She is a past president of the 1st Illinois chapter of HFMAand remains actively involved with her chapter. She speaks frequently toHFMA chapters across the country; healthcare providers; state hospitalassociations; and other professional associations.

Suzanne can be reached by phone at HFMA headquarters or by email at [email protected]

In MemoriamHonoring Susan Hull

With great sadness, the First Illinois Chapter ofHMFA reports that long-time member Susan Hull,MPH, RHIA, CCS, CCS-P passed away Friday,April 7th. Susan was a dedicated member of ourchapter and a valued associate at American HealthInformation Management Association. An indepen-dent, spirited individual, Susan kept very private just

how sick she was. In January Susan graciously stepped in for a speakerand facilitated a presentation at the Accounting and ReimbursementCommittee’s program. As late as mid-March she was taking on – andcompleting – new tasks, even though, as is now clear, she knew the endwas near.

Please take a moment to think of our lost colleague and the profes-sionalism and passion that Susan contributed to our chapter and ourprofession.Susan was a strong individual - I knew she had cancer but she gave usthe impression she was over the worst- not terminal. She never asked forspecial consideration and talked as if she was going to make it. Right upto the end she continued to take on tasks at work and with HFMA. Iwill miss her and her spirit – what an example she set as a professional.

– Gail Walker, Co-Chair, Registration Committee

Susan always had a friendly welcome and was the positive face greetingchapter members when registering at programs. She was always willing tocontribute and pinch hit at a moment’s notice to further member’s educa-tional experiences. Above all, she was always reliable and extremely knowl-edgeable on subject matter. Her expertise in the industry will be missed.

-Al Staidl, Membership Chair


HFMA Events

Winning Strategies 2006 . . . Will Your Team Be There?

Accounting and Reimbursement Program – January 19, 2006

Registration Committee membersRoss Stebbins and Susan Hull

Speakers Todd Ingles, JoAnnHelmer and Tracey Coyne

Brian Katz, Vicki Austin and James Heinking

David Warren Steve Perlin and Zack Fortsch

Stephanie Gilman and Greg Brock Mike Nichols and Tracey Coyne


The Accounting and Reimbursement Committee’s annual education program “Winning Strategies 2006…Will yourteam be there?” was held at the William Tell Holiday Inn

in Countryside on January 19, 2006. This year’s seminar was again a great professional development opportunity.

Jo Ellen Helmer and Tadd Ingles of Ernst & Young LLP provided an update on accounting and financial reporting matters that included variable rate bonds, interest rate swaps, malpractice reserves, defined benefit plans and asset retirementobligations. Unfortunately, Larry Manson was not able to speakdue to a very bad cold/flu. The Committee especially thanksSusan Hull of AHIMA for stepping-up at the 11th hour to discuss the OIG 2006 Work Plan. Her presentation was veryinteresting and insightful. Great job preparing a presentation andpreparing to speak on very short notice! Thanks again Susan!David Warren of the Healthcare Finance Group, Inc. provided anupdate on the capital markets, including a discussion on the typesof debt financing and asset based/cash flow based senior debt.Vicki Austin of CHOICES Worldwide provided a very dynamicdiscussion on networking.

The Committee’s own Mike Nichols of RSM McGladrey andTracey Coyne of Ernst & Young LLP provided a reimbursementupdate. Tracey provided a comprehensive Federal SSI update.Mike discussed Medicare bad debts and a model to compareMedicare reimbursement vs. cost. Unfortunately, Tom Hubner of Ernst & Young LLP was not able to speak due to a very badcold/flu, but he did provide the attendees with discussion materials related to current issues in Graduate Medical Education.

Finally, Stephanie Gilman and Greg Brock of Deloitte &Touche LLP discussed the structure of reimbursement depart-ments in the current healthcare environment and potential struc-ture changes in the future. Steve Perlin of Health ManagementAssociates provided a State of Illinois update. Zack Fortsch ofMcGladrey & Pullen LLP provided another comprehensive andinsightful tax update.

HFMA First Illinois Chapter was able to provide a very condusive environment to learn, exchange ideas and network with peers. A special thanks to the speakers who made thisanother successful program! You can reach committee chairs Patt Marlinghaus at [email protected] or Brian Katz [email protected].

HFMA Events

Regulation, Competition and Entrepreneurship in Healthcare: The Challenge of Providing Quality Medicine in Today’s Milieu of Competing and Conflicting PayorsMedical Groups and Physicians Program – February 16th, 2006


The Medical Groups and Physicians Committee’sannual education program “Regulation,Competition and Entrepreneurs in Healthcare” was

held at the law firm of Gardner, Carton and Douglas onFebruary 16th, 2006. As in past year’s, this program pro-vided an opportunity to hear insight into key topics andrepresented a diverse speaker group.

Frank McHugh of Provider Health and Dan Cain ofCain Brothers provided a joint discussion regarding capitalmarkets and its impact on the healthcare marketplace.Following a brief Q & A Session, Chairperson ElaineScheye moderated a panel discussion that included JohnSchneider – Chair of the AMA Council on Science andPublic Health and Leonard Kranzler, M.D., Neurosurgeonat Illinois Masonic Hospital. The discussion centered onthe latest in Pay for Performance methodologies andwhether or not they represent a long-term solution.

L. Edward Bryant, Sr. Partner at Gardner Carton Douglasprovided HFMA members with a timely update on pressinglegal issues and their short and long term financial impact forhealthcare executives. Pharmacy issues were also part of theday’s discussion, with Marilyn Daley of Edward Hospital pro-viding an overview on current drug reimbursements.

A second panel discussion followed – facilitated by JimUnland of The Health Capital Group, John Cusack ofGardner Carton and Douglas’s antitrust section and JohnMarren of Hogan Marren discussed implications of theantitrust issues involving the FTC, Evanston Healthcare,Advocate, and United Healthcare.

The day concluded with representatives of the office ofLisa Madigan, Attorney General providing participantswith updates on key legislative issues.

HFMA First Illinois Chapter was able to provide a verycondusive environment to learn, exchange ideas and net-work with peers. A special thanks to a number of individ-uals: Chairperson Elaine Scheye for facilitation of a well-rounded program; the speakers who contributed to thesuccess of the program;and our hosts atGardner, Carton &Douglas, who provideda setting conducive tolearning and networkingwith fellow HFMAmembers.!

Elaine Scheye

John Schneider, M.D. andLeonard Kranzler, M.D.

Frank McHugh

Rick Stock

HFMA 201 – “We Need You”As follow-up to a very successfulHFMA 101 program presented inAugust, the First Illinois Chapterconducted a secondary program –HFMA 201 “We Need You” atAramark Headquarters on March3, 2006. Over 40 individualsattended, including chapter officersin additional to other chapter lead-ers and committee chairs.Designed as a tandem program tothe August HFMA 101 program,HFMA 201 focused not only onthe structure and role of the 1stIllinois Chapter overall, but also onthe wide variety of volunteeropportunities fand contributionsavailable through the chapter.

Current leadership, including JimHeinking, current 1st IllinoisChapter President and Vince Pryor,1st Illinois Chapter IncomingPresident, spoke to the audienceregarding the roles of leadership,officers, and strategic planning forthe chapter. Other chapter leader-ship participating in the day includ-ed Jim Watson, current ChapterSecretary; Guy Alton, ChapterTreasurer; Brian Sinclair, ChapterEducation Co-Chair and AwardsChairperson; Al Staidl, Membershipand Golf Chair; and SuzanneLestina, Certification Chair.

Participants also received in-depth information regarding the

roles of each of the respective chap-ter committees and their contribu-tions to the chapter on an annualbasis. Amongst the opportunitiesidentified included various commit-tee opportunities, chapter certifica-tion efforts and future leadershipdevelopment. An interactive Q &A session followed each of the pre-sentations, along with recognition

that efforts from the initial HFMA101 program generated not only anincrease in new members but com-mittee participation as well!

A warm thanks to all attendeesfor participating and to chapterleadership for a well organized andinformation program!! Look foradditional chapter opportunitiessuch as this in the future!!

David Buysse, Ann Murphy andJim Unland

NNeeww mmeemmbbeerrss.. Back row, left to right : Richard Lanis, MichelAgriopoulos,Brian Sauvageau, Bob Dubow, Robert Clements. Front row, left to right : Gina Kociuba, Shayda Samarghandi, Mark Friedman, Keith Kellog


HFMA Events

Managed Care 2006 – Send Lawyers, New Computers and Money!Emerging Managed Care Issues and Trends Facing Providers

Managed Care Program – March 16th, 2006

The Managed Care Commitee’s annual education program“Managed Care 2006 – Send Lawyers, New Computers andMoney!! Emerging Managed Care Issues and Trends Facing

Providers was held at the William Tell Holiday Inn on March 16th,2006. Over 100 participants were in attendance to hear a diversespeaker group representing a broad scope of managed care topics.

Frequent managed care presenter Dave Grant from the IllinoisDivision of Insurance kicked off the morning’s discussion with anoverview of various pieces of legislation in Springfield – amendments

to the consumer fraud act, clean claimdefinitions, and the impact of HighDeductible Health Plan products (or asMr. Grant referred to as “Chase theDollar Plans) were amongst the bills dis-cussed. Following Mr. Grant’s presenta-tion, Managed Care Committee Co-Chair John Wyrostek provided the audi-ence with an updated summary of the

newly proposed AllKids program and its operational and financialimplications for providers and healthcare organizations.

1st Illinois Chapter member Carl Pellettierifocused his segment of the program on worker’scompensation – specifically reforms to the WorkersCompensation Act. Among the different seg-ments identified were issues regarding claims filing,hold harmless provisions, fee schedules changes,

utilization review programs, and pertinent outliers.Neil Greene of the law offices of Neal Greene

provided terrific insight into the complexities ofthe ERISA Act – reminding participants of theoriginal intent of the 1974 Employee RetireeIncome Security Act. At a basic level, this actencouraged employers to give benefits toemployees and also set a series of minimum stan-dards of how responsibilities are enforced for each party, fiduciary lia-bilities, and how plans are funded to comply with plan rules.

Following a lunch break, Mike Nichols of RSM McGladrey and amember of the Accounting and Reimbursement Committee presentedhighlights of the Medicare reimbursement model – this was a topic of

interest for program participants, as Mike’s presenta-tion focused on the applicability of using Medicaredata as a benchmarking tool for managed care negoti-ations. Some of the advantages identified of compar-ing costs versus reimbursement included easily under-standable summary information, as well applicabilityfor operational and strategic discussions.

Following Mike’s presentation, The 1st Illinois Chapter once againwas pleased to present a joint panel discussion with aIPAM – theassociation of Illinois Patient Access Management. Panel membersincluded the following: Katherine Murphy, Nebo Systems; BernieEncarnacion, Advocate Christ Hospital; Janet Blue, OnTarget Staff;Eleanor Michalek, Provena St. Joseph Hospital – Elgin; Lee Remen,HeathWare Systems; Joe Hickey, Nebo Systems; Vicki Mueller,Delnor Hospital; and Lori Shibbona, Advocate Good ShephardHospital. The group focused on a variety of challenges and oppor-tunities that providers have faced in confronting access issues – a keypart of the discussion focused around how the definition of accesshas evolved and how the role of access specialists has become criticalto ensuring operational efficiencies and improved bottom line results.

The day’s program concluded with a presentation on the emergingtrends of Pay for Performance methodologies by John Marren,Partner with Hogan Marren, Ltd. As a follow up to his presentationat the February program on this topics, audience members had theopportunity to hear a overview about the success of current Pay 4Performance programs to date ranging from targeted audiences andnecessary expansion to support more managed care and consumerdirected programs. Among the key elements for successful P4P pro-grams are incentives and rewards (both financial and non-financial),clinical integration, reporting quality and price considerations andidentifying what are the ultimate benefits of the program.

Once again, the Managed Care Committee planned an innovativeand thought provoking program that providing a great educational

opportunity for chapter members. A special thanks to a number of individuals who contributed to thesuccess of the day – committee mem-bers who helped develop topics andspeakers as well as Co-Chairs BrianWasha and John Wyrostek for facili-tating a diverse and beneficial program. Congratulations on a job well done!

Jim Heinking andKatherine Murphy

Carl Pellettieri

Neil Greene

Mike Nichols

Katherine Murphy, Janet Blue, L. Kascher, L. O'Roth, E. Michalek,L. Remen, R. Hickok

Managed Care Co-chairs, Brian Washa & John Wyrostek

At double the pace initially pro-jected, consumer-driven health plansare growing in prevalence. As aprovider, are you ready for the impli-cation that every patient is likely tohave significant liability as soon asthey walk in? The question is: Howhas your facility changed revenuecycle workflow in anticipation of thepotential “new crisis?”

Perhaps that is the problem. Themany cries of a “new crisis” mighthave desensitized some of us. Afterten to twenty years of issues that hadpotential to upend the industry, itmay be hard to believe that con-sumer-driven healthcare is going to“change everything”.

Taking healthy skepticism intoaccount, still it is hard to avoid theimplications of consumer-drivenhealthcare. The nation’s consumers(your patients) remain ambivalentand uncommitted to paying yourbills. Consider how consumer-drivenhealthcare will impact you and yourfacility. The following numbers showthe extent to which patient self payresponsibilities are increasing. Andthere is no end in sight: n “Traditional” PPO: $500

deductible, 80/20 coveragen High Deductible Plan: $2,000

deductible, 80/20 coveragen Out of pocket maximums: $5,100

single, $10,200 familyAs a result its likely that debt is

going to pile up at a rapid pace.Other industries dealing with consumer collections universallyrely on predictive modeling andrisk scoring to manage work. Nowin the same boat; healthcare is rapid-ly moving towards portfolio model-ing to reduce bad debt and betterrecognize charity accounts.

Does portfolio modeling work inhealthcare? Absolutely, both at thefront and back end. It is possible topredict, in advance, who is going topay. It is also possible to predict, in

advance, what collection workflow ismost effective.

Case-in-point:One large integrated healthcare sys-tem employed risk assessment mod-eling as “the brain” of workflowredesign. The system expected tolessen the pace of rising bad debtand better identify charity cases allwhile moderating collection costs.No small challenge.

The risk model focused on:n Generating early payments (at

time of service as well as at pointof billing)

n Improving recovery rates acrossall categories of account age

n Recognizing early all charity careand uninsured discounts

n Factoring in how account balancecorrelates to payment likelihoodand calls for different collectionworkflows

n Acknowledging non-traditionalfactors that can help prioritize col-lections (on the front-end as wellas the back-end)To start the modeling process, ret-

rospective data was analyzed to seewhich factors best indicated whenand how a patient would pay theirbill. Generally patients were placedinto high, medium or low paymentprobability categories. Charity/Medicaid qualification probabilitywas assigned as well. These probabili-ty quotients became the drivers ofworkflow redesign.

However, this was only the start-ing point. An initial model is justthat; it must “evolve” as patient col-lection data continues to be gatheredand results outcomes are continuallyupdated.

Assessing current workflows andplanning appropriate changes becamea part of management’s regular tasks.Focused on getting the best returnfor the least collection expense,changes affected the timing of

collection letters, how each group wasapproached and which patient groupswere given extra attention. The sameROI perspective was used to deter-mine when to outsource collectionefforts and what course of action totake regarding upfront collections.Essentially, the model allowed thishealthcare system to “work smarter,not harder.”

Another way of looking at thisapproach is to consider that eachpatient segment has a specific ROIrelating to a cash gain and/or anexpense reduction. For example,some patients are a “known ROI”and the best collection approach is

easy to implement. Another groupcould best be classified as a “knownROI given proper payment incen-tives.” A third payment group mightactually produce the best ROI whencollection expenses are minimized,rather than pursued for the sake of acash improvement goal. In eachcase, it is important to design work-flow based on the known ROI foreach payment group.

Validate the ROI of PortfolioModeling

Since payment prediction technologycarries an up-front cost, users must


Work Smarter, Not Harder:Portfolio Modeling in Revenue Cycle WorkflowBY BRUCE NELSON


“It is possible to predict, in advance, who is going topay. It is also possible to predict, in advance, what collection workflow is most effective.”


Financing Options for Nonprofit Rural and Community HospitalsBY THOMAS R. GREEN

Strong finances as well as up-to-date facilities and equipmentmean better physician attrac-

tion and retention, improved com-munity perception and assurance that a hos-pital will serve its region for the longterm. Many smaller hospitals, how-ever, often cannot access the capitalto make the investments critical totheir survival. Although profitable,many do not meet the high bench-marks required to earn investment-grade ratings and cannot raise thefunds on their own.

With the right guidance, however,most rural and community hospitalscan efficiently access capital. Manycan fund their growth and renovationswith conventional revenue bonds,either credit-enhanced or unen-hanced. In addition, the federal gov-ernment recognizes small hospitals’financial challenges and has estab-lished programs to enhance commu-nity and rural hospital credit so theycan borrow at lower interest rates.

PART I

Integrating Strategic Plansand Capital Financing

Whether a hospital chooses to buildnew, renovate or refinance, its plansand its credit strength will determineeligibility for funding options.Hospitals must evaluate their strate-gic plans and their funding needs intandem to determine their bestfinancial options. The first stepstoward acquiring funding are per-forming a needs assessment and eval-uating credit strength.

Strategic plans outlining long-term missions and anticipatedchanges to infrastructure and servicesshould be reviewed and updated reg-ularly. A well-crafted financial planmatches a hospital’s financialresources to the strategic plan, quan-tifying and allocating available capi-tal. The capital allocation planshould be integrated into a strategy

to manage assets and liabilities so thehospital not only accomplishes itsstrategic objectives, but improves itscapital structure — and hence itscredit strength.

When borrowing, hospitals andtheir advisers must consider theirneeds and objectives in the contextof creating a capital structure thatimproves or maintains the creditprofile. The ultimate goal is afinance strategy that maximizesaccess to the capital markets andminimizes the cost of capital, with-out damaging liquidity by contribut-ing too much cash to a project and,conversely, without relying extensive-ly on debt.

Recognizing Strengths andWeaknesses:The CreditProfile

A hospital’s credit strength or finan-cial health is the most important fac-tor in determining its cost of capital.Organizations with strong financialhealth have more ability to repay debtand tend to be more appealing toinvestors and lenders, who balancetheir risk with interest rates. The bet-ter the credit profile, the lower theinterest rate on the financing, and theless capital costs over time. Investorsand credit enhancement providerswill review both quantitative andqualitative factors to measure an orga-nization’s credit strength.

Ratios that demonstrate financialperformance are used in quantitativeanalyses. These ratios can be gener-ally grouped into three categories:capital structure; cash flow; and liq-uidity, profitability and operations.The following ratios are relied uponmost frequently when assessingcreditworthiness:

n Debt Service Coveragen Days Cash on Handn Operating Marginn Debt to Capitalization

Qualitative factors such as man-agement, demographic changes,

technological capabilities and med-ical staff characteristics affect hospi-tal credit profiles. Ignoring these fac-tors can give a hospital and the cred-it markets an incomplete picture ofthe hospital’s credit profile and itsfinancial options. For example, ahospital with strong financial ratioslocated far from a major bank mayfind accessing capital more difficultthan its ratios suggest. Conversely, awell-articulated qualitative analysisof a hospital’s long-term viabilitycould help it secure bond insuranceeven if its credit profile is slightlybelow the usual credit profilerequired for such enhancement.

After completing the credit pro-file, a hospital can work with itsfinancial professional to determinethe best way to leverage its strengthsand/or use strategic enhancements toachieve lower interest rates and lessexpensive capital.

PART II

Financing Options for Ruraland Community Hospitals

More detailed information onfinancing options is available in theunabridged “Financing Options forNonprofit Rural and CommunityHospitals.”

Long-term debt, usually tax-exempt bonds or taxable notes, is apopular choice for hospitals needingcapital. Bonds and notes represent aborrower’s obligation to pay interestto the investor in return for thelending of money over a given peri-od of time.

Bonds can be rated or unrated.The ratings range from AAA downto C or D, with AAA to BBB con-sidered “investment-grade.” Unratedor low-rated bonds are often referredto as “speculative-grade,” “junk ” or“high-yield.” The higher the rating,the lower the interest rate the bor-rower pays to offset investor risk.

Bonds generally can be sold either(1) without additional enhancementand marketed based on the borrow-ing hospital’s strength or (2) credit-enhanced using vehicles such as bondinsurance, mortgage insurance andletters of credit. Credit enhancementsmake mortgage notes and bonds lessrisky to the investor and more afford-able to the hospital. They can be pro-vided either by commercial institu-tions, such as banks and bond insur-ers, or a public entity such as the fed-eral government.

WANTED!Local healthcare organization seeking motivated and enthusiastic writerwith sharp eye for detail, knowledge of the healthcare marketplace, andan interest in becoming more involved with HFMA’s 1st Illinois Chapter?

If you fit any of those criteria, we have the opportunity for you – a spot on the 1st Illinois Speaks newsletter team!

Published quarterly, 1st Illinois Speaks is one of the primary communication vehicles to our chaptermembership and has received national recognitionfor its efforts. As the chapter is planning for its2006-07 activities, we would like to invite any andall comers to become involved with the productionof this publication.

Benefits include a flexible work schedule, flexiblejob responsibilities and a supportive team environ-ment as well as peer recognition for a job well done!

Please contact Paula Dillon, the 2006-07 Newsletter Co-Chair, if you areinterested in learning more about this great volunteer opportunity!!

The Fee Schedule

For services rendered on or afterFebruary 1, 2006, providers willreceive payment for Workers’Compensation services at the lesser ofcharges or a fee schedule which hasnow been posted at www.iwcc.il.gov.The schedule is primarily based onDRGs with reimbursement designedto occur at 90% of the 80th per-centile. Geographic modificationsoccur based on zip code.

For trauma services (level I and II),emergency room visits, outpatientprocedures, freestanding ambulatorysurgical centers and other limitedexceptions, bills will be paid at 76%of charges. Similarly, for high cost

(outlier) services when charges exceedtwice the new schedule’s proposedDRG reimbursement, the provider,after receiving the DRG rate will alsobe paid 76% of all charges that exceedthe DRG rate.

The exception to all reimburse-ment at the 76% rate is any portionof those bills involving prosthetics,implants, orthotics, ambulance, drugswith detailed coding and investiga-tional devices. Such items are classi-fied as “pass through charges” and willbe paid first at a rate of 65% ofcharges. For purposes of calculatingwhether outlier rates apply and forother services paid at 76% all passthrough items are first paid anddeducted.

Keep the Patient Involved

While the new act prohibits balancebilling, it is important for theproviderto maintain communicationwith the patient. By placing limits ona provider’s right to bill a patient forjob-related injuries (technicallyinjuries ‘incurred in the scope ofemployment’,)the Illinois legislature



February, 2006

A Newsletter from HFMA’s First Illinois Chapter

INSIDE:

Highlights and RecapFirst Illinois Chapter Events

A review of the October 2005 Revenue Cycle

and November 2005 ITPrograms

Founders Merit AwardRecipients 2005

Changes to Illinois’ Workers’ Compensation ActMaximize and Accelerate Your ReimbursementBY NEIL J. GREENE


Inside This IssueMessage from the President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2First Illinois Chapter News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Q:Tell me Again Why We are Doing This? A: We Are Professionals! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4HFMA Events:

Revenue Cycle October 2005 Meeting . . . . . . . . . . . . . . . . . . . . . . 6IT Program November 2005 Meeting . . . . . . . . . . . . . . . . . . . . . . . 7

Engaged Physicians Critical to Organization’s Survival . . . . . . . . . . . . . 810 Strategic Planning Resolutions You Can’t Afford to Break. . . 11Does Your Hospital Need a Check-up? . . . . . . . . . . . . . . . . . . . . . 12Non-Acute Facility Ownership – If Not You, Who? . . . . . . . . . . . 14New Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Calendar 2006-2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Recent changes to Illinois’ Workers’ Compensation Act (WCA)means an end to business as usual for providers. From prohi-bitions against balance billing patients to the imposition of areimbursement fee schedule there are opportunities and pit-falls for providers who render services to patients who haveincurred injuries in the scope of their employment. This articleis designed to help providers understand and navigate thesechanges.

continued on page 9


Financing Options for NonprofitRural and Community Hospitals(continued from page 8)

A) Unenhanced Bonds

Hospitals with excellent credit strength may choose toissue bonds without additional credit enhancement.These rated or unrated revenue bonds will tend to tradeat a broader range of interest rates depending on themarket’s perception of risk at the time of the sale.Borrowers who issue bonds and notes on their ownmerit do not have to pay fees for credit enhancement,but they may find capital more expensive over time orbe subject to longer lock-out periods, more restrictivecovenants or other investor requirements.

B) Bank Loans and Private Placements

Another source of borrowed funds is traditional com-mercial bank loans in the form of real estate or equip-ment term loans. In small communities with smallerlocal banks, the loan size often is restricted by the bank’slending limits and the types of credit risk a bank is will-ing to accept.

Tax-exempt bonds also can be privately placed, oftenwith the local bank. This structure can allow a localbank to stay involved with the hospital, and thosebonds that cannot be placed locally can be sold outsidethe community.

C) Commercial Enhancements

Hospitals also have the option of using commercialenhancements to obtain better interest rates on theirbonds. These include letters of credit and bond insur-ance.

A letter of credit issued by a commercial bank is anirrevocable obligation to make bond payments if a bor-rower cannot. Borrowers pay banks for this option. Ahospital with a letter of credit can issue tax-exemptbonds that carry the same rating as the letter of creditprovider. The primary benefits are lower costs ofissuance and somewhat lower annual debt service whencompared to some structures. The process for obtaininga letter of credit generally is shorter than that of otherenhancement options, and up-front closing costs are rel-atively low. Hospitals also may have the opportunity toleverage existing local bank relationships and can issuesupplemental or additional debt.

Letter of credit structures can provide more flexibilitythan other options, but banks can be hesitant to extendcredit. The project and the obligor’s credit profile mustfit into the conservative underwriting requirements of acommercial bank.

Bond insurance, like a letter of credit, guarantees thatinvestors will be paid even if the hospital cannot makeits scheduled payments. It generally is available to hospi-tals that independently can achieve a rating of BBB orbetter. Generally bond insurance is less expensive annu-

ally than the letter of credit option. The cost,however, must be paid up front, and bondinsurance may not be the most cost-effectiveoption for hospitals expecting to pre-pay theirbonds or restructure the debt before the finalscheduled maturity. Bond insurers tend to bemore receptive to longer amortizations (20 to30 years) than banks providing letters of cred-it.

D) Government Enhancements

The Federal Housing Administration (FHA)and the U.S. Department of Agriculture(USDA) have special enhancement programsthat feature longer amortizations and lowerinterest rates. Government enhancements put

the full support of federal organizationsbehind these hospital loans and bonds, mak-ing them much more attractive (less risky) topotential investors.

The USDA offers three funding optionsunder its Community Facilities program:guaranteed loans, direct loans and grants. Allthree are designated for nonprofit rural orga-nizations that serve communities of less than20,000. The funds can be used to build,enlarge or improve essential facilities includinghospitals and clinics and to buy new equip-ment. Applicants must be unable to obtainfunds from commercial sources at reasonablerates and terms.

The guaranteed loan program has severalcontinued on page 10

advantages not shared by either traditional bondissuances or other federal programs: The loan can be for up to 100 percent of the costof the project, and 90 percent of that loan is guar-anteed. While the loan is designed for buildingnew and improving existing facilities, it can beused toward refinances under certain conditions.

Federal loans come with federal oversight.Borrowers generally are required to contribute toan escrow account for real estate taxes (if applica-ble), insurance and replacement reserves. TheUSDA also requires annual audited financialstatements.

The Federal Housing Administration’s Sec.242 program generally is available to fund newfacilities, acquisitions or the substantial renova-tion and modernization of existing projects.Hospitals may refinance debt through the 242program with certain caveats. The program offersborrowers the opportunity to issue bonds at an“AAA”-equivalent rating. Interest rates are fixed,and no financial guarantees are required by par-ent or affiliated entities. Subject to certain debt-service coverage and liquidity levels, hospitals uti-lizing the program may transfer excess cash flowto parent organizations.

Issuing debt through the FHA Sec. 242 pro-gram can save hospitals money, but initial costsand the time necessary to apply for the programshould be taken into consideration. Hospitalsmust pay a one-time fee of 0.8% of the loanamount in addition to an annual premium andmust make monthly payments to a mortgagereserve fund.

The government streamlines the FHA Sec.242 application process for Critical AccessHospitals, offering slightly different underwritingcriteria to speed up consideration and make iteasier for these small hospitals to qualify. CriticalAccess Hospitals still, however, must meet oper-ating margin and debt-service coverage ratiorequirements. This is where the special provisionsmake a significant difference: Hospitals that onlyrecently received their Critical Access Hospitaldesignations and cost-based Medicare reimburse-ment are allowed under the program to calculatetheir historical pro forma debt service coverageratio as if they had been receiving the full cost-based reimbursement for the last three years. Notevery Critical Access Hospital will qualify; evenwith the special provisions, careful evaluation offinances is essential when applying.

Conclusion

The financing options for nonprofit rural andcommunity hospitals can be complex and confus-ing. Each financing structure has a unique set ofcharacteristics that will likely be perceived to haveboth desirable and undesirable qualities. Eachoption must be evaluated with input from aknowledgeable investment banker/financial adviserand in concert with the unique credit profile ofthe hospital and its long-term strategic plans.

Thomas R. Green can be reached at 614-224-8800or [email protected]__________________

(This article is abridged from “FinancingOptions for Nonprofit Rural and CommunityHospitals.”


Financing Options for Nonprofit Rural and Community Hospitals (continued from page 9)

Under the DRA, state false andfraudulent claims laws must: meetthe following requirements:

1. Establish liability to the state forfalse or fraudulent claims describedin the Federal False Claims Actwith respect to Medicaid expendi-tures

2. Contain provisions that are at leastas effective in rewarding and facili-tating qui tam actions as thoseincluded in the federal FalseClaims Act

3. Contain a requirement for filingan action under seal for 60 dayswith review by a state AttorneyGeneral

4. Contain a civil penalty that is notless than the amount authorized inthe federal False Claim Act

Medicaid Fraud and ControlUnits (MCFUs) will become evenmore aggressive and sophisticated intheir efforts. Laws already requireMCFUs to investigate every whistle-

blower inquiry filed – even beforepotential merits are evaluated. It islikely that additional MCFU fund-ing will be made available this yearand it is predicted that states willhire more investigators and invest innew and more sophisticated frauddetection technology.

Employee EducationRequirements

The Act requires that effectiveJanuary 1, 2007 any entity thatreceives or makes at least $5 millionin annual Medicaid payments to pro-vide mandatory employee educationincluding:

1. Written policies, procedures andtraining protocols with detailedinformation related to:

n The federal False Claims Act n State false claims lawsn Federal administrative remedies for

false claims and statementsn Whistleblower protections with

respect to the role of such laws inprevention and detection of fraud,

waste and abuse in federal health-care programs

2. Written materials with detailedprovisions and training regardingthe entity or provider’s policies forpreventing waste, fraud and abuse

3. Information in the EmployeeHandbook regarding the law andrights of employees to be protectedas whistleblowers along with theprovider/entities policies and pro-cedures for detecting and prevent-ing fraud, waste and abuse

PREPARE EARLY for the DeficitReduction Act of 2005… A Provider Checklist

n Stay abreast of revised or new StateFalse Claim legislation – Assumethere will be activity!

n Evaluate and monitor currentand/or pending State False Claimlegislation

n Monitor progress of whistlebloweradvocacy groups and their impacton False Claim legislation modelswhich heavily favor qui tam

whistleblowers and their lawyersn Stay focused on new or enhanced

Medicaid Fraud and Control Unitinitiatives

n Review and revise policies and pro-cedures in light of the Act andState laws that are in effect, beingrevised and/or implemented –Make sure they:

n Fully comply with the FederalFalse Claims Act

n Fully comply with State FalseClaims laws

n Address detection and preventionof fraud, waste and abuse

n Clearly state employee rights andprotections as whistleblowers

n Review and update employeehandbook in light of the Act –Make sure it:

n Clearly defines compliance pro-gram including the law and rightsof employees to be protected aswhistleblowers

n Completely defines policies andprocedures for detecting and


Prepare for New Compliance Legislation (continued from page 1)


Prepare for NewCompliance Legislation(continued from page 11)

preventing fraud, waste and abusen Educate employees and ensure

that business partners and agentsare doing the same

n Develop and implement a formaleducation plan for employees andleadership teams. The planshould address all aspects of theFederal and State laws, as well asinternal compliance policies andmethods for detecting and pre-venting fraud, waste and abuse

n Develop and administer post-training competency assessments;provide additional training asnecessary

n Approach contractors, agents andother external parties and reviewtheir education plans, tools andcompetency assessments

n Eliminate the potential forwhistleblower situations! – Createa “Compliant Culture!”

n Review the organization’sCompliance Plan, ensure that itmeets the Federal Guidelinespublished in January 2005

n Make sure to conduct annualCompliance Plan evaluations,make the necessary changes to beconsistent with the January 2005Federal recommendations

n Evaluate efforts to ensure compli-ance with the 2006 OIG WorkPlan and special advisory bul-letins and special fraud alerts

n Ask employees to help build thetools and to assist in conductingaudits to identify compliance

n Solicit employee assistance inconducting “root cause” analysisof all potential problems and askfor their input in building andimplementing the necessary newand procedures and controls

n Make a “big, positive deal” out of employees who participate inany way with the compalianceprocess and openly celebrate theseactivities

Bobette M. Gustafson is a memberof the HFMA Great Lakes Chapter.She can be reached [email protected].


have confidence that their investmentwill result in an appropriate ROI. Aspreviously mentioned the ROI can berelated to improved cash flow and/or itcan be related to reducing collectioncosts. Demonstrating that the modelforecasted accurately and more impor-tantly delivered measurable results isthe key to proving the methodology’sworth and the ROI of its supportingtools.

Compare the results of a controlgroup against an experimental group.To achieve about 95% accuracy, thecontrol group must be of statisticallysignificant size, include a random dis-tribution across patent segments, andbe worked by the organization’s tradi-tional collection methods. Accountsin the experimental group should besegmented by payment probability, orpredictive modeling, and then eachaccount pursued according to theworkflows appropriate for its respec-tive segment. After a pre-establishedtime period, compare the control withthe experimental populations in termsof collection results, collection expens-es, aging, public relations, and writeoff allocations. For example measur-able collection expenses may include:

n Amounts collected upfrontn Average cost per collection letter n Average cost per collection attempt n Percent of accounts closedn Average age of at account closure

Documented improvements inoverall collection percentages can addmillions of dollars to a healthcareprovider’s bottom line.

Conclusion:

Healthcare providers must be preparedto meet the demands of sharply-rising,self-pay liabilities Hospitals that arecurrently challenged by bad debt andself-pay collections will suffer asCDHP plans grow in number nation-wide. Risk assessment modeling isincreasing across the nation’s health-care systems. ROI results show thatmodeling works. Many moreproviders are currently evaluating thisnew technology as solution for theirway of working smarter, not harder inthe future.

Bruce Nelson is a member of HFMA’sMinnesota chapter and can be reachedat [email protected].


Portfolio Modeling in Revenue Cycle Workflow (continued from page 7)


Publication Information

EEddiittoorrss 22000055--22000066Paula Dillon..................(630) 737-7212 [email protected] Sova ...................(847) 226-9087 [email protected] CChhaapptteerr pphhoottooggrraapphheerrAl StaidlAAddvveerrttiissiinnggJim Ventrone ...............(847) 550-9814 [email protected] Solutions ....(312) 226-2227 [email protected]

HFMA Editorial GuidelinesFirst Illinois Speaks is the newsletter of the First Illinois Chapter of HFMA. First Illinois Speaks is published 4 times per year. Newsletter articles are written byprofessionals in the healthcare industry, typically Chapter members, for professionalsin the healthcare industry. We encourage members and other interested parties tosubmit materials for publication. The Editor reserves the right to edit material for content and length and also reserves the right to reject any contribution. Articlespublished elsewhere may on occasion be reprinted, with permission, in First IllinoisSpeaks. Requests for permission to reprint an article in another publication should bedirected to Editor. Please send all correspondence and material to either of the editors listed above.

The statements and opinions appearing in articles are those of the authors and notnecessarily those of the First Illinois Chapter HFMA. The staff believes that the con-tents of First Illinois Speaks are interesting and thought-provoking, but the staff hasno authority to speak for the Officers or Board of Directors of the First Illinois ChapterHFMA. Readers are invited to comment on the opinions the authors express. Lettersto the editors are invited, subject to condensation and editing. All rights reserved.First Illinois Speaks does not promote commercial services, products, or organizationsin its editorial content. Materials submitted for consideration should not mention norpromote specific commercial services, proprietary products or organizations.

StyleArticles for First Illinois Speaks should be written in a clear, concise style. Scholarlyformats and styles should be avoided. Footnotes may be used when appropriate, butshould be used sparingly. Preferred articles present strong examples, case studies,current facts and figures, and problem-solving or “how-to” approaches to issues inhealthcare finance. The primary audience is First Illinois HFMA membership: chieffinancial officers, vice presidents of finance, controllers, patient financial servicesmanagers, business office managers, and other individuals responsible for all facetsof the financial management of healthcare organizations in the Greater Chicago andNorthern Illinois area.

A broad topical article may be 1000-1500 words in length. Shorter, “how-to” or sin-gle subject articles of 500-800 words are also welcome. Authors should suggest titlesfor their articles. Graphs, charts, and tables (PDF or JPG only) should be providedwhen appropriate. Footnotes should be placed at the end of the article. Authorsshould provide their full names, academic or professional titles, academic degrees,professional credentials, complete addresses, telephone and fax numbers, and e-mailaddresses. Manuscripts should be submitted electronically, on computer disk or bye-mail as a Microsoft Word or ASCII document.

Founders PointsIn recognition of your efforts, HFMA members who have articles published willreceive 2 points toward earning the HFMA Founders Merit Award.



Suzanne AdamicProvena Health

Lisa AnastosNorthwestern Medical Faculty

Foundation

George AngrickMedical Corporation

Deb ArmerSg2

Constantino AurigemmaBank of America

Matthew AuxierRobert Half International

Ruby BarthWolcott Woodland Taylor

John BolandMedSynergies

Alex BowerCommunity Hospital of Ottawa

Michael BudzynskiCardiac Surgery Associates

Kevin BurkePalos Community Hospital

Edward CampbellPridevel Consulting, Inc.

Lisa CampbellBlickenwolf, Llc

David ChabalaUniversity of Illinois Medical

Center

Jay ChibeMetropolitan Healthcare Council

Ellyn ChinGottlieb Memorial Hospital

Dennis ConleyThe Schroer Group

Todd ConklinEdward Healthcare Services

Corporation

Nasim CoryMount Sinai Hospital Medical

Center

Bettina Cotton-GibsonLynx Medical Systems

Stephanie CowserMedical Specialists Centers of

Indiana

James CroninIllinois Collection Services, Inc.

Dianna Dickerman

Laura DornCharter One Bank

James EngUniversity of Illinois Medical

Center

Eileen FeelyAdvocate Health & Hospitals

Corporation

Jolyn FellerFayette County Hospital

Andrew Fischer3M Health Information Systems

Meg FlanaganHFMA

Mary FurrerEvanston Northwestern

Healthcare

Melissa GentileChildren’s Memorial Hospital

Christine GidleyNorthwestern HealthCare

Corporation

Susan GoldbergRsm McGladrey

Robert GorskiRainbow Hospice

Gerald Granath

Ross GuillenLake Forest Hospital

David HeyMetropolitan Chicago Healthcare

Council

Shawn Helms-FeatherstoneLoyola University Physician

Foundation

James Hillenmeyer

Linda HodgesWitt/Kieffer

Colleen HoltonMercy Health Partners

Sunil John

Daniel JohnstonHFMA

Robert KempRehabilitation Institute of Chicago

Dennis KibbyGreat Lakes Medical

Harriet KinneyTrinity Health

Patricia KnepperGreat Lakes Medicaid

Lawrence LakeProtiviti, Inc.

Timothy LaurentAccurate Health Systems

Christy LenhartBeaumont Services Company, Llc

Suzanne LestinaHFMA

Glenn LezonNephrology Associates of

Northern Illinois

Terry McDonaldHuron Consulting Group

Thomas McKeeEdward Health Services

Corporation

Mary Meade Michael Reese Hospital

James MitchellCardinal Health

Jeff MoserSg2

Sharon NassinTrinity Medical Center

Dennis Nicholl

Mary NowakMerit Healthcare Inc

Sarah OaksAHA/ahrmm

Daniel ObergVista Health

Gary PaarenOutlook Associates, Inc.

Richard PanicoIntegrated Project Management

Company, Inc.

Darryl RackiSr. Manager, Provider

Reimbursements

Mark RandolphNational City Vendor Finance

Charles RubinLFC Capital, Inc,

Shayda SamarghandiAim Healthcare Services, Inc.

Margaret SaucedoUniversity of Chicago Hospitals

Isaac SchreibmanRevenue Production

Management

Deborah SprindzunasAssociation for Healthcare

Resources

Lucas StromAccretive Health

Sterling SullivanThe Northern Trust Company

Luann TenutaFresenius Medical Care

Scarlett UngureanMercer Investment Consulting

Kimberly WachterGE Healthcare Financial Services

Timothy Walsh

Jack WellsVan Kampen Investments

David WursterUniversity of Illinois Medical

Center at Chicago

New Members

The Chapter welcomes the following new and transferredmembers for February and March:


Tony Kazwell (Silver Award) Michelle Holtzman (Bronze Award)

The First Illinois ChapterThe First Illinois Chapter wishes to recognize

and thank our sponsors for the 2005-2006 Chapter year.

Thank you all for your generous support of the Chapter and its activities.

Platinum SponsorsCrowe Chizek & Co. LLP

Nebo Systems, Inc.RSM McGladrey and McGladrey & Pullen, LLP

Gold SponsorsHealthcare Financial Resources, Inc.

HealthCom Partners, LLCJPMorgan Chase BankPlante & Moran PLLC

Silver SponsorsDST Systems, Inc.Claimquest Corp.

Harris & Harris, Ltd.Mailco, Inc.

Pellettieri & Associates, P.C.Virtual Recovery, Inc.

Bronze SponsorsAccelerated Receivables Management

CMD Outsourcing Solutions, Inc.Cymetrix Corp.

H&R Accounts, Inc.IMaCS, Ltd

MedAssist, Inc.MEDCLR

Medical Recovery SpecialistsOn Target StaffR&B Solutions

Revenue Cycle SolutionsRevenue Production Management

Senex ServicesStrategic Reimbursement

United Collections Bureau, Inc.Ventrone, LTD

Wellspring Valuation, Ltd.

A Newsletter from HFMA’s First Illinois Chapter speaks

first illinoisPRESORT STANDARD

U.S. POSTAGEPAID

GENEVA, IL 60134PERMIT NO. 85

Healthcare Financial Management AssociationFirst Illinois Chapter

2006 Calendar

May 5, 2006CFO Meeting and Golf Outing, Full Day, Calumet Country Club

May 26, 2006

Annual Golf Outing, Full Day, St. Andrews & Klein Creek

first illinois speaks

Documents