INSIDE THIS ISSUE President’s Message

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Dear HFMA NENY Members,

We have had an extremely successful and

exciting 2017 to date. Our chapter has enjoyed

a very active summer full of networking and

cultivating new relationships through our

Annual Golf Tournament, Day at Races, and

Volunteer Picnic.

On the topic of relationships, we recognize how

important collaborations with other professional

organizations in the capital region are. This is why we have recently

come together with MGMA to create a Payer Symposium Event on

November 16th. This event serves as a place for payers to provide

updates to healthcare organizations as well as a payer panel where

we will be asking panelists questions regarding industry trends. Dr.

Lawrence from IHANY will be there speaking on some of the

innovative things the ACO is currently doing. I highly encourage all

to attend but please leave your boxing gloves at home – this event

is all about collaboration.

Education and growth are also on the chapter’s radar this season.

We have two very exciting opportunities to tell you about:

HFMA NENY is working with Avadyne Health to provide three

membership scholarships for new members through May 2019!

We have sent an e-mail out regarding how to apply and are

accepting applications now until November 17th! For questions

regarding this please contact me at Jade.Litchfield@Cerner.com

The second opportunity is that HFMA NENY is working with local

colleges to increase access to education and did you know that

HFMA's Vision Is "To Be An

Indispensable Professional

Resource For Healthcare

Financial Managers."

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Educational Events 2

Feature Article:

Determining if the

Provider Sponsored

Health Plan is

Right for You

4

HFMA Region

2+You Puerto Rico

Relief Fund

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New & Reinstated

Members!

8

Career Corner 9

Pictures: Day at the

Track and Volunteer

Picnic 2017

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Northeast Chapter

Leaders

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“Vital Signs of Northeastern New

York” is the official newsletter of

the Northeastern New York Chap-ter of the Healthcare Financial

Management Association.

EDITORIAL POLICY

Submission of material for publica-

tion is strongly encouraged. Arti-

cles should be typewritten. The

editor reserves the right to edit

material and accept or reject contri-

butions whether solicited or not. All

correspondence is assumed to be a

release for publication unless other-

wise indicated. Send all corre-

spondence, or materials for publica-

tion, to:

Diane Seeley

Saratoga Hospital 211 Church St

Saratoga Springs, NY 12866

FAX: 518-584-4108 Email: dseeley@saratogacare.org

Opinions expressed in articles or features are those of the author and

do not necessarily reflect the views

of the Healthcare Financial Man-agement Association, Northeastern

New York Chapter or the editor.

membership is FREE for full

time college students? This

allows free admission to all

chapter events and

networking socials in

addition to access to online

HFMA resources! If you

know a college student

have them apply today -

http://www.hfma.org/apply/

As you go through this holiday

season I hope that our

chapters’ vision will resonate

with you and encourage

increased collaboration in your

own daily life. Wishing you all

the best – let’s keep in touch.

Best,

Jade Litchfield

Jade.Litchfield@cerner.com Jade is the Senior Project Manager of “ITWorks” at Cerner

APC/OPPS Update for 2018

Date: December 13th, 2017

Time: 1:00-2:00pm EST

Price: FREE for Members and

Non-Members!

CPE’s: 1.0 hours

Speaker: Jean Russell, MS,

RHIT, Epoch Health Solutions,

LLC

The Medicare Outpatient

Prospective Payment System

(OPPS/APCs) final rule is

published in early November each

year. This presentation will

include an overview of the

significant changes associated with

the 2018 final rule. Some of the

key changes expected this year are

as follows:

A reduction in the payment

rate for certain Medicare Part

B drugs purchased by hospitals

through the 340B program.

A two-year moratorium on

Recruit a HFMA

Member Today!

HFMA helps finance lead-

ers create and maintain

fiscally sound healthcare

organizations in order to

provide excellent patient

care.

Benefits of membership!

2

REGION 2 WEBINAR

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direct supervision

requirements currently in place

at rural and critical access

hospital packaging of low-cost

drug administration services.

Further reduction of the APC

payment for services

performed in a non-excepted

off campus provider based

department.

A continuation of the increased

consolidation and packaging of

services paid under OPPS.

For more information and to

register, visit the following link:

https://register.gotowebinar.com/

register/5695997283154648066

Moving From Volume to Value

in Purchased Services-

Information Technology

Date: January 10th, 2018

Time: 1:00-2:00pm EST

Price: FREE for Members and

Non-Members!

CPE’s: 1.0 hours

Speakers: Brent Petty and Gary

Davis, Lexmark Healthcare

Healthcare is under extreme

pressure to find cost savings and

efficiencies and a ripe area for this

is in purchased services. This

webinar will guide you to a better

approach employing a value based

framework to better achieve cost

and efficiency targets.

The Value Based Framework

A Specific Application as

Applied in Managed Output

Services

The SOFTR approach for

helping make smarter

decisions for IT investments

For more information and to

register, visit the following link: https://register.gotowebinar.com/

register/5764290149999909634

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Please remember to

support our generous

sponsors:

DIAMOND

MLMIC

Determining if the Provider-

Sponsored Health Plan Path is Right

for You

By John Tam, Executive Vice President of

Strategy, and Ken Wood, Senior Vice President

of Health Plan Development, Evolent Health

Providers have historically lacked control over

the ability to tie meaningful quality metrics to

reimbursement, and some would put this at the

top of the list of issues that hamper their

success. After all, it is the providers on the

frontlines of care delivery who can truly

manage medical costs and quality for patients,

as they have a unique set of controls only they

can execute.

Couple that desire for more control with the

industry’s continual shift toward value-based

care, and more and more providers are seeing

the true value in assuming risk. Some are even

wondering if they should launch their own

health plans.

A provider-sponsored health plan (PSHP)

represents the ultimate value-based care or risk

arrange-ment. Simply defined, a PSHP is an

organization of individual practitioners,

ancillary service providers and/or hospitals that

come together to design and run their own

health plan. These provider PSHPs are com-

pletely responsible for all aspects of costs,

quality, network configuration, benefit de-sign

and other activities associated with providing

health insurance to their members. Those

succeeding—well-known national players like

Intermountain and Kaiser Permanente, re-

gional leaders like Driscoll Children’s Health

Plan in Texas and Alliant Health Plans in

Georgia, and the more than 250 other PSHPs

currently operating in the U.S.—have

showcased the potential for upside rewards.

PSHPs can also offer some distinct advantages

over other types of health plans, such as more

effective population health management. Some

studies suggest that PSHPs are more efficient,

paving the way for lower premiums and other

incentives that benefit their members.

But let’s be frank: PSHPs are not for the faint

of heart, and many of us remember PSHPs that

failed in the 1990s. Becoming a traditional

PSHP is a massive undertaking and requires

getting to scale in a way that not all providers’

market dynamics will support. While some

groups will decide to move forward with the

creation of a full-blown PSHP, others will find

they’re left with gaps to fill and aren’t quite

ready. Yet, they still want to take on more risk.

So then what?

Evaluating Your Risk-taking Capabilities:

Nine Critical Considerations

Fortunately, advances in technology, business

intelligence and information-sharing plat-forms

are opening new opportunities for new PSHP

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FEATURE ARTICLE

players. There are more tools available today to

help all types of health care organi-zations

aggregate the necessary capabilities to design,

build and successfully run a PSHP. The

question, then, becomes which ones you have

in house, and which ones you need to contract

for or otherwise acquire.

Having had the opportunity to work for and

alongside some successful PSHPs, we offer

nine critical business considerations your

organization needs to honestly discuss and

deeply analyze to determine if becoming PSHP

is a viable option for you.

A comprehensive feasibility analysis must

answer tough questions. Specifically, we

recommend that you:

Identify the potential network size and

types of providers you will need

Evaluate your change management

capabilities

Analyze the organization’s market position

and local competition

Assess local payer reaction

Gauge consumers’ buy-in

Investigate your specific regulatory

environment

Consider costs and financial realities

Evaluate different sales options

Assess your insurance IQ

Accurately and objectively analyzing these

considerations is crucial to gauging the po-

tential success of your risk-taking endeavor and

determine whether and how to ultimately move

forward.

For those groups who identify capability gaps

and aren’t sure how to fill them, partnering

with a third party could be a viable option.

A partnership with a traditional commercial

payer, for example, can offer the license,

capital, scaled infrastructure and expertise that

eases your own administrative burden, and can

provide advanced regulatory knowledge and

insight. Such an arrangement requires careful

consideration of the potential partner, as some

provider independence will necessarily be lost.

It’s also important to consider how any new

arrangements could impact your strategic

relationships with other payers in your local

market.

Industry Shifts Pave Way for Emergence of

Neutral Payers

Other options have emerged as the health

paradigm has shifted. While we’re conditioned

to think of payers as either state or federal

government or the historical private

commercial types, a new third category of

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Sponsor Highlight!

payer has emerged in recent years. Purpose-

built for a value-based care paradigm and for

data-driven population health initiatives, these

“neutral payers” have collectively raised $1

billion in capital to solve the unmet needs of

providers and patients. Neutral payers offer a

different approach for providers who might not

be ready to launch their own PSHP and aren’t

keen on partnering with a traditional payer.

Some key advantages and benefits to

partnering with a neutral payer include:

Innovative consumer technology

Collaborative mindset and a desire to

disrupt legacy incumbents which may lead

to more favorable deal terms for providers

Customizable approaches, such as

cobranding or white labeling insurance

plans with provider systems that have

prominent brands

Openness to exclusivity because there is no

historical relationships to maintain

Robust change management capabilities

combined with on-the-ground physician

and staff training and reinforcement

A third party’s ability to ensure incentives

align with your physicians’, staff’s, and

overall business’s needs and goals

There are also potential challenges. Most

neutral payers lack the brand recognition of

their larger counterparts. Some have less of a

track record and balance sheet, creating

uncertainty about their longevity.

The good news is that after you conduct your

feasibility study and weigh the advantages and

benefits against challenges, you will be steeped

in critical value-based care information and

ready to take on greater amounts of risk, either

on your own or with a partner. And for those

groups that decide to pursue a full-blown PSHP

or partner with a traditional or neutral payer,

you’ll have much of the information you need

to fine-tune your risk-taking appetite.

John Tam is Executive Vice President of

Strategy for Evolent Health.

Ken Wood is Senior Vice President of Health

Plan Development for Evolent Health.

You can reach them via e-mail at

JTam@EvolentHealth.com and

KWood@EvolentHealth.com.

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Sponsor Highlight!

Dear HFMA Region 2 Friends & Colleagues,

We have been following closely the heart

wrenching pictures and reports regarding the

extensive damage caused by Hurricanes Irma

and Maria to our HFMA friends and colleagues

in Puerto Rico, a member of Region 2. The

effects of these storms will be felt for years and

their impacts on the communities, first

responders, healthcare leaders, and

professionals will likely last a lifetime. In

times like these, community matters. Our

commitment to the communities we help and

serve is our primary focus. Because of our

strong desire to do something, we have set up a

website to raise funds for our fellow HFMA

members and their loved ones in Puerto Rico

during their time of need.

www.youcaring.com/

HFMA_Region_2_Hurricane_Maria

Please note, that donations made to the above

may not be considered tax deductible, please

consult your tax professional for determination.

You may also contribute to these fundraising

organizations:

The American Red Cross

Federal Emergency Management Association

(FEMA) (This page offers resources for you

and your community)

Government of Puerto Rico

To offer your support and help, or to obtain

additional information, please consider using

the resources provided above. Additionally,

HFMA National has dedicated a page on their

website to provide updates regarding the

effects of these storms as well as Hurricane

Harvey. Please check this page often for

updates.

HFMA sends its heartfelt thoughts and wishes

to everyone impacted by these storms and for

those who are stepping up to help during these

extraordinarily challenging times.

Kristen Zebrowski, Region 2 Regional

Executive

Kiran Batheja, Region 2 Regional-

Executive Elect

Michele Mecomonaco, Region 2 Regional

Executive Elect-Elect

Sincerely,

Jade Litchfield

President – NENY HFMA

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HFMA Region 2+You-Puerto Rico Relief Fund

8

New Members Juanita Wheeler

Heather Radliff

Colleen Gilchrist

Kristin Signor

Paul O’Brien

John Habermehl

Lori Santos

Lynette Turo

Amy Bourdeau

Nella Moran

Michael Bobersky

Stephen Beyer

Thomas Robert

Cherie Smith

Judith Joly

Peter Oldytowski

Janice Macke

Tanya Herd

Kevin Frodyma

Lisa McElheny

Melissa Inman

Lana Ayzikovich

Kevin Curtis

Sharon Prescott

Emily Rings

Cynthia Spaulding

Lindsay Portu

Eileen Smith

Stephen Miano

Rachael Mennor

Kathleen Buckley

Sasha Bliss

Karen Crevier

Ryan Smalley

Dan Kilmartin

Greg Jones

Reinstated

Rebecca Slagle

Kevin Burke

Roland Surprenant

Jeffrey Cohen

Eugene Laks

Michele Kelly

Donald Booth

Shannon Burke-Doomchin

Laura Pasco

Frances Lockrow

Ann Marie Hatch

Please contact Matt Hunt at mat-

thew_hunt@keybank.com if you would like

more information on becoming a member or

have any questions regarding current member-

ship status.

New & Reinstated Members July-September 2017

The Have and Have Nots of Group

Disability Insurance

Provided By: Barry Rings Jr. Northwestern

Mutual

If you are one of the lucky workers covered by

an employer sponsored Group Long Term

Disability Income (LTD) insurance policy,

you are more fortunate than most. Even if you

are covered, it is extremely important to make

sure you are adequately protected.

Becoming disabled due to accident or illness is

a very real risk.

While the likelihoods vary with age, during

your income producing years, 1 in 4 of today’s

20 year olds will become disabled before

reaching the age of 67.1 Yet, few American

workers are financially prepared to weather a

disability. In fact, the Council for Disability

Awareness reports that 65% of working

Americans say they could not cover their

normal living expenses for a year if their

employment income was lost; 38% could not

pay their bills for longer than three months.2

The question to ask yourself is whether your

family could meet expenses for three or four

months if the primary wage earner lost his or

her income due to a disability. Given the

current economic conditions, now would be an

excellent time to review your assets and

consider how long your family could make

ends meet if the primary wage earner suffers

from cancer, a heart attack, an accident or

some other disabling event.

Even if you have employer provided group

LTD coverage, such coverage alone, seldom

provides families with enough benefits to meet

all their financial obligations.

Limitations of Employer-Provided LTD

policies

Here are some typical limitations of group

LTD policies provided through an employer:

Most group LTD policies only cover 60

percent of base salary, which leaves you to

meet your financial obligations on a 40

percent drop in income.

Typically, group LTD polices do not cover

incentive compensation such as profit

sharing contributions, deferred

compensation or regular incentive

bonuses.

When the employer pays the premium for

group LTD coverage, any benefits

received are considered taxable income to

the employee.

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CAREER CORNER

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Group LTD benefits are often reduced dollar

for dollar with any Social Security benefits,

workers compensation benefits, or auto no

fault benefits received by the disabled

employee.

Group LTD policies may have low monthly

benefit maximums which can reduce the

amount of income replaced for higher paid

employees. For example, if the group LTD

policy replaces 60% of salary with a

maximum monthly benefit of $5,000,

anyone making more than $100,000 per year

receives less than 60% when faced with a

disability.

Calculating Your Income Post Disability

Clearly, everyone who relies on a paycheck

needs to assess how long he or she could

continue to meet their financial obligations in

the event of a disability, including any ongoing

savings for education and retirement.

As a first step, it’s important to consult with an

experienced financial professional. Look for

someone who is both knowledgeable and

trustworthy. Make sure the insurance company

is reputable, and has financial strength and

stability and commitment for the future.

A financial professional can help you assess

whether you would have the financial resources

to meet your obligations in the event of a

disability and for how long. If additional

disability income coverage is needed, he or she

can advise what types of supplemental coverage

would be appropriate. Underwriting rules by

insurance companies often dictate how much

coverage is available to an individual, but the

wide variety of policies on the market today can

suit many different income levels and budget

requirements.

What’s most important is to have a solid,

complete plan in place to get you through the

“have not” periods of life.

1U.S. Social Security Administration, October 2015 2 Disability Statistics, Council for Disability Awareness,

March 2013.

Article prepared by Northwestern Mutual with

the cooperation of Barry J. Rings Jr.

Barry J. Rings Jr is an Associate Wealth

Management Advisor to William Newman with

Northwestern Mutual. Barry Rings and William

Newman are based in Albany, NY. To contact

Barry J. Rings Jr. please call 518.459.4665, e-

mail at Barry.Rings@nm.com or visit

www.wmnewman.com.

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A fun filled day with NENY Friends and Family!

Did I just hear “First Call” for the next Race or another round of drinks?

Girls just want to have FUUUNNN... and win $$$ of course!

HFMA-NENY Day at the Track 2017

Great food and good times were had by all!

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Festive decorations...

….and most importantly the great company! An abundance of good food….

What a perfect day to celebrate our NENY Volunteers!

Volunteer Picnic 2017

hfma

Northeastern New York

Chapter

Officers

President Jade Litchfield President Elect Mike Ostrander Secretary Deb Trumbull Treasurer William Vooris

Directors

Mike Wallner, FHFMA, MSHA Rico Viscusi Diane Seeley, CRCR Bob Shwajlyk

Jim Gavin Marty Dunbar

Committee Chairs and

Members:

Certification Rico Viscusi Programming Committee Alyson Belz, Co-Chair Flora Pagan, Co-Chair Marty Dunbar, Comm Member Membership Matthew Hunt, CRCR, Chair Brianna Frisch, Comm Member Newsletter Diane Seeley, CRCR, Chair Social/Awards Committee Robert Shwajlyk Rabin Kayastha, MPA, CRCR

Dan Berryann Bill Walbridge Sponsorship Committee Mike Wallner, FHFMA, MSHA Karen Richards, FHFMA, CPA Webmaster Rabin Kayastha, MPA, CRCR Bob Shwajlyk DCMS Contact Jade Litchfield Founders Contact Jade Litchfield LINK Committee Jade Litchfield

2018-2017 Northeast Chapter Leaders

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2015 redesigned CHFP Certification Program

The new CHFP is structured into two parts:

Module I: The Business of Health Care & Module II: Operational Excellence

Earning the CHFP - The CHFP credential is awarded upon successful completion of module I end of course

assessment and successful completion of module II case study exercises. For more details, updates and FAQs

please go to the Certification area of the HFMA website. Questions? Please email careerservices@hfma.org.