Agenda

Education Committee Programming: Emerging Education Modalities
Monet 1-2
The Education Committee offers valuable educational opportunities for EDPMA members, including workshops, webinars, our EMRA scholarship program, Fellowship program and EMerging Leaders Academy.

Practice Management Committee Programming: PMC Priorities for 2023 and Beyond
Monet 1-2
The Practice Management Committee addresses issues including gathering data that supports our advocacy efforts, legal compliance, provider enrollment, rural health, alternative payment models, telehealth and emerging ED technology, medical bad debt, financial management and more.

Quality, Coding, and Documentation Committee Programming: You Bring It and We Will Discuss It! Documentation, denials, splits, bad payers, coding, and quality
Monet 1-2
The Quality, Coding & Documentation Committee focuses on quality reporting under Medicare’s Merit-based Incentive Payment System (MIPS), coding issues including inappropriate prospective down coding by commercial and ERISA plans, documentation issues, preparing for audits, and more.

State Regulatory and Insurance Committee Programming: A Simplified Approach to Successful State Advocacy
Monet 1-2
The State Regulatory & Insurance Committee identifies and develops EDPMA’s response to legislative and regulatory challenges at the state level, including limits on balance billing, Medicaid expansion, health exchanges, Medicaid copays and more. When appropriate, EDPMA takes action to advocate at the state level on these issues.

Federal Health Policy Committee Programming: The Surprises of the No Surprises Act
Monet 1-2
The Federal Health Policy Committee guides the association’s response to proposed federal rules, regulations, bills and policies on the No Surprises Act, Surprise Medical Billing, Medicare, Medicaid and other relevant legislative and regulatory issues at the federal level. It coordinates federal advocacy efforts with other EDPMA committees and reviews, edits, and approves letters to Congress, CMS and other decision makers. It also collects your experiences on the implementation of the No Surprises Act to guide our federal advocacy positions.

Welcome Remarks
Bellagio 1-4

Don Powell, DO, FACEP | Emergency Care Specialists, PC/Medical Management Specialists

Opening Keynote: Reaching the Summit: Lessons From Everest
Bellagio 1-4

Lindsay Zimmerman, MD, FACEP | Vituity

General Session: CreatEM
Bellagio 1-4

Charles Barbera, MD | Tower Health
Reginald Eadie, MD | Trinity Health of New England
Paul Sierzenski, MD | Beebe Healthcare
Moderator: John Holstein | Zotec Partners, LLC

Advocacy Lunch in Honor of Martin Gottleib: No Surprises Act Litigation Update: TMA 1, 2, 3, 4… More?
Sponsored by Ventra Health
Bellagio 1-4

Brenna Jenny, JD | Sidley Austin

Breakout 1: Real-Time Analytics in Emergency Medicine: Any System, Anywhere
Monet 1-2

Mark Laperouse, MD | Professional Emergency Medicine Management (PEMM), Professional Emergency Physician Associates (PEPA)

The talk is centered on the mechanics of sourcing and applying real-time data analytics to validate EHR data to improve emergency medicine outcomes and drive process improvement. How do you make health records work for your practice and your hospital? This speaking engagement will explore the critical data captured in an EHR, drilling it down to relatable information, and creating colorful dashboards that resonate with hospitals, administrators, and providers alike. Working with data allows us to take both big-picture and granular views of all data points to enable coaching, counseling, and/or justification for the action. Rather than using data to identify problems, we fix problems by looking at the data.

Breakout 2: US Healthcare End Game
Monet 3-4

Damian Caraballo, MD, FACEP | Excelis Medical Associates, Tampa Bay

This session will illustrate the history of health insurers in the US, and how its history has affected both the present and future delivery of healthcare in the United States. By looking at the growth of health insurers over the past thirty years, we can better understand the current state of healthcare in terms of government policies, implementation of care, documentation standards, and group reimbursement. The marriage of government entities such as CMS and large insurance companies will have an ever-growing impact to EM groups, and inability to adapt to these changes will result in multiple groups failing. This presentation will demonstrate how by better understanding the mindset of large health insurers and our government, we can better position our groups to withstand budget restraints and thrive in a rapidly evolving business environment. This presentation will discuss targeted strategies for improving revenue streams in today’s market, how to lobby US and state governments for more physician-friendly laws, and even some potential revenue streams which bypass insurers altogether. Overall, this presentation will spread an understanding on how we got to our current system, and what we must do to ensure the future survival of our groups.

The Good, the Bad, and the Ugly: What We’ve Learned from the No Surprises Act
Sponsored by Brault
Bellagio 1-4

Andrea Brault, MD, MMM, FACEP | Brault

General Session: The Future of Emergency Medicine
Bellagio 1-4

Timothy Cheslock, DO, FACOEP | American College of Osteopathic Emergency Physicians
Chris Kang, MD, FACEP | American College of Emergency Physicians
Jessica Adkins Murphy, MD | Emergency Medicine Residents’ Association
Don Powell, DO, FACEP | Emergency Care Specialists, PC/Medical Management Specialists
Moderator: John Holstein | Zotec Partners, LLC

General Session: ChatGPT States That Reimbursement, Regulation and Coding Are the Top 3 Issues in EM Revenue Cycle – We Will Cover All of That and More
Bellagio 1-4

Andrea Brault, MD, MMM, FACEP | Brault
Tony Cirillo, MD, FACEP | US Acute Care Solutions
Jeffrey Davis, MPH | American College of Emergency Physicians
Lisa Maurer, MD, FACEP | ConsensioHealth
Jamie Shoemaker, MD, FACEP | Elite Emergency Physicians, Inc.
Randy Pilgrim, MD, FACEP | SCP Health
John Proctor, MD, FACEP | Sound Physicians
Moderator: Ed Gaines, JD, CCP | Zotec Partners, LLC

General Session: If You Really Do Not Like Changes in EM Reimbursement & Regulatory Policy, Then You May Want to Go Play the Tables
Bellagio 1-4

Ed Gaines, JD, CCP | Zotec Partners, LLC
David McKenzie, CAE | American College of Emergency Physicians

Breakout 1: How to Establish a Mobile Integrated Health Program in your Community
Monet 1-2

Paul Kivela, MD, MBA, FACEP | University of Alabama at Birmingham

Breakout 2: An Arbitrator’s Thoughts on the NSA’s IDR Process
Monet 3-4

Robert Fielder | Resolution Resources, LLC

The Federal Government’s No Surprise Act (NSA) and its associated Independent Dispute Resolution Process (IDR) is a new hurdle Emergency Medicine Providers may need to navigate to secure adequate reimbursement to fund their Practices. Get an insider’s perspective on the perils and pitfalls of the negotiation and arbitration phases of the NSA from a practicing Arbitrator.

Breakout 1: The Land of Psych Obs: Setting Up a Psych Observation Billing Process Across a System of EDs
Monet 1-2

Abhi Mehrotra, MD, MBA, FACEP | University of North Carolina Dept. of Emergency Medicine

As behavioral health volumes increase and our emergency departments struggle with the evaluation and disposition of these patients, finding resources to augment care pathways has become a priority. With the updated observation criteria, some groups have begun billing observation charges for behavioral health patients in our EDs, providing both professional and facility billing opportunities. The speaker will discuss the journey to develop this process in a varied health system with multiple staffing models and how it can be implemented at your site.

Breakout 2: In Bed with the Enemy: A Married Perspective on the Passage and Implementation of the No Surprises Act
Monet 3-4

Patrick Velliky | Envision Healthcare
Katie Allen, MPH | Former Insurance Trade Association Executive
Moderator: Ed Gaines, JD, CCP | Zotec Partners, LLC

Recap of Today’s TMA III and IV Opening Arguments
Bellagio 1-4

Brenna Jenny, JD | Sidley Austin

General Session: The Golden Era: Sometimes You Have to Look Back to Determine the Best Way Forward
Bellagio 1-4

Chip Pettigrew, MD, FACEP | Pettigrew

Dr. Chip Pettigrew, in collaboration with Dr. Jeff Bettinger, will present an overview of the birth of emergency medicine and its Golden Era of Shared Stewardship. From this unique vantage point, he will identify key regulatory actions over the years that have directly impacted this model. An understanding of these regulations and their framework is a valuable asset for all emergency medicine leaders. Join Dr. Pettigrew to discover the unfortunate and unintended consequences that have brought emergency medicine from a model of shared stewardship to the crumbling infrastructure of cost-shifting we experience today.

General Session: What to Expect in US Healthcare in 2023 and Beyond: How will EM need to adjust?
Bellagio 1-4

Juli Forde Smith | Rev4ward

The potential collapse of the US Healthcare system and the “safety net” make for engaging headlines.  As leaders, we are bombarded with terms like diversification, vertical integration, and rapid-fire business building.  Movements from traditional models to non-acute care settings, accelerating shifts in profit pools, and even changes in our own payer mix leave the nagging impression, “Am I prepared?”  Indeed, staying abreast of emerging trends and ingesting pertinent fiscal information has become overwhelming.  Join Juli Forde Smith for an in-depth analysis of today’s economic drivers in healthcare, top emerging trends, and key statistical data from economists that will provide insight into how you can best anticipate the coming realities and respond with innovative solutions.

General Session: The Gathering Storm: The Uncertain Future of US Healthcare
Bellagio 1-4

Ron Howrigon | Fulcrum Strategies

The Pandemic changed many things in this country including health care and how it will be financed and delivered in the future. The big question on everyone’s mind is, “What will things look like five years from now?” Many economists now believe health care is poised for a major collapse if something doesn’t change. Ron Howrigon will provide insight into the future of health care and the changes we can expect over the next few years. With over 35 years of experience as a managed care executive, an economist, and a consultant to over 5,000 physicians, Ron brings a uniquely broad perspective on the healthcare system in America. He will explain major trends in health care today and how they are likely to develop over the next several years. Ron will discuss how these changes will impact emergency medicine physicians directly and will review strategies for the future

General Session: Blended: Yours, Mine and Ours; Medicaid Beneficiaries and Our Shared Future
Bellagio 1-4

Craig Kennedy | Medicaid Health Plans of America
Amanda Pears Kelly | Advocates for Community Health

Today, one in four Americans are insured through the Medicaid program. The American College of Emergency Physicians estimates that 40% of patients seen in the emergency department are Medicaid beneficiaries, most with complex medical histories and in need of a health care home. Rather than pointing fingers, how might we together forge a future for the most vulnerable among us while honoring the valuable role of emergency medicine. Join Craig Kennedy, President & CEO of Medicaid Health Plans of America and Amanda Pears-Kelly, CEO of Advocates for Community Health, an association of community health centers for an insightful discussion around the shared future of Medicaid, Community Health Centers, and the Emergency Department.

• Regulatory headwinds for the Medicaid program will be considered.
• Participants will gain an understanding of the challenges and opportunities facing Medicaid MCOs.
• Innovative models within the Community Health Centers will be discussed.
• Possible areas for future collaboration among stakeholders will be shared.