Agenda

Session Description: Learn about the Practice Management Committee and its work. Through breakout groups, crowdsource solutions to common practice management problems. Connect with others in the practice management space to build your network.

Faculty:
Alan Eisman | d2i
Douglas Brosnan, MD, JD | Vituity
Mark R. Jones | Pettigrew Medical Business Services

Session Description: Engage with State Regulatory and Insurance Committee members to develop a plan and approach for advocating at the state level, arming you with the knowledge and power to achieve success.

Faculty:
Shanna Howe | Ventra Health
Dave Friedenson, MD, FACEP | Omega Healthcare

Session Description:  Understand EDPMA’s update on current Federal Health Advocacy Initiatives. Identify EDPMA’s FHPC priorities, approaches, and resources to high focus advocacy objectives for our members.

Faculty:
Randy Pilgrim, MD, FACEP  | SCP Health

Session Description:  Hear just-in-time updates from experienced, well-regarded authorities on the No Surprises Act

1. Updates on the status of key judicial proceedings impacting the NSA
2. Practical implications for EM practices
3. IDR experiences from an IDR Entity’s viewpoint:  successes, challenges, and implications for EM practices
4. Views on CMS’ pending IDR Operations Rule

Faculty:
Randy Pilgrim, MD, FACEP  | SCP Health
Brenna Jenny, JD | Sidley Austin LLP
Jim Bobeck | Federal Hearings and Appeals Services

Andrea Brault, MD, MMM, FACEP | EDPMA Chair

Session Description: Prepare to be taken on a journey. With her insightful view inside the patient experience, Allison Massari’s riveting and informed keynote illuminates the immense value that healthcare professionals have upon a patient who is suffering. This dynamic and poignant program offers real solutions to the struggle of how to keep the patient first despite limited time and other practical constraints. By weaving her remarkable journey with potent life-lessons, Allison highlights the integral nature of person-centered care and fortifies audience members, reigniting their passion for why they went into healthcare in the first place. She explains, “The power of what you do goes far beyond the technical part of your job. You are healing the places medicine cannot touch. In fact YOU are the medicine.” Hailed as “life-changing”, Allison’s content rich and deeply moving keynote offers a sincere and direct approach to transcending life’s difficulties and always finding a way to be the healer in the room. Audience members are revitalized, with applicable tools for managing change, adversity, and the everyday challenges of being human.

Session Objectives:
1. Integrate the knowledge that patients are deeply impacted and are receiving great healing even if they are not responding verbally with gratitude to your compassionate care.
2. Identify the relationship between compassion, kindness, and patient satisfaction.
3. Interpret the patient experience at a deeper level.

Faculty:
Allison Massari | AllisonMassari.com

Session Description: Gain perspective on how technology, transformation efforts, and other changes have affected payers, health systems, healthcare services, technology, and pharmacy services.   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 to best anticipate the coming realities and respond with innovative solutions.

Session Objectives:
1. Attendees will be able to model how the growth of the managed care dual-eligible population (individuals who qualify for both Medicaid and Medicare) offers both challenges and growth opportunities for Emergency Medicine.
2. Groups will identify healthcare market segments poised for growth and those likely to decline.
3. Participants will understand how to apply key statistical trends to their own practice realities.

Faculty:
Juli Forde Smith | Rev4ward, LLC

Rep. Kim Schrier, MD (D-WA-08)

Prior to being elected to Congress on November 6, 2018, Rep. Schrier spent her career as a pediatrician in Issaquah, working with children across the Puget Sound region and helping families navigate the health care system. In Congress, Rep. Schrier uses this expertise to inform her work on issues that improve the lives, health, and wellbeing of children. As the first pediatrician in Congress, Rep. Schrier brings a critical voice to issues related to health care. Through her own experience as a patient living with Type 1 diabetes, Rep. Schrier understands the very real fear of health care costs and access for people living with preexisting conditions. And as a physician who has worked in a broken health care system, Rep. Schrier understands what changes need to be made to make it work better for both patients and providers. Rep. Schrier grew up the daughter of a public school teacher and an engineer. Her father, an engineer, instilled in Rep. Schrier a love for science, a passion that led her to a degree in Astrophysics at U.C. Berkeley and then to medical school. Her mother taught her the value of education and teachers, and the importance of unions and collective bargaining. As a child, Rep. Schrier watched her mother’s union successfully negotiate for increased school funding, smaller class size, and improved benefits. The product of public education from elementary through medical school, Rep. Schrier is passionate about helping every child
thrive in school. After graduating from U.C. Berkeley Phi Beta Kappa, Rep. Schrier spent a year working at the EPA before attending medical school at U.C. Davis School of Medicine. She completed her residency at the Lucile Packard Children’s Hospital at Stanford University. In 2013, Rep. Schrier was named Best Pediatrician in the Greater Seattle Area by Parents Map Magazine. She lives in Sammamish with her husband, David, and son, Sam.

In Congress since: 2019
Committees: House Energy & Commerce Committee – Health Subcommittee
Occupation: Pediatrician
Education: University of California, Berkeley (B.S.), University of California, Davis (M.D.)

Sponsored by HaloMD

Session Description: The hallmark of emergency care is our remarkable impact on acutely sick and injured patients. However, recent data on Social Determinants of Health (SDOH) point to another critical opportunity for patient care, especially for those treated in emergency departments. Together with increasing attention to value-based reimbursement and health equity, SDOH considerations are rapidly gaining traction. Amid the patient care opportunity, the reality is that new demands will befall emergency departments soon. This session will articulate how SDOH affect patient outcomes, even when excellent care was initially delivered in the ED. Hear why hospitals, payors, and policymakers are determined to include SDOH in patient care processes, documentation requirements, incentives, and payment models. Most importantly, we will review practical suggestions for how EM practices, revenue cycle systems, and hospitals can prepare in a timely fashion for this emerging domain, perform well in the change, and avoid adverse consequences.

Session Objectives:
1. Describe the significant contribution of Social Determinants of Health (SDOH) to patient outcomes (especially emergency department patients). – Include the disproportionate impact in rural and underserved communities, and the impact on acute, unscheduled care.
2. Communicate recent and accelerating trends to address SDOH, including screening, care transitions, and inclusion in value-based models. – Recent policy directions by CMS, PTAC, CMMI, and others. – Likely inclusion of emergency departments in new proposals and solutions – Discuss implementation time frames that may guide preparation by EM practices.
3. Preview one value-based model that affirmatively includes SDOH for emergency medicine practices – A model that rewards physician participation, addresses patient needs, and affirms the critical role of SDOH in health care – Describe how documentation, data flow, and ED processes promote success – Describe the implications of failure or lack of preparedness.

Faculty:
Randy Pilgrim, MD, FACEP| SCP Health

Session Description: There is tremendous timeliness in the development of Community Paramedicine programs on this continent, as an alternative for patients with ongoing unscheduled care needs. Community paramedicine dates to an expanded scope program in New Mexico, called the “Red River Project” in the early 1990’s (1). Similar programs were developed that offered alternate destinations or treatment in place for callers to the 911 system. These programs were facilitated by improvements in communications technology, particularly videolinking services, that allowed active exchange of patient information and better documentation of the patient encounter. A program developed in Dayton, Ohio called CareNow was one of the model programs in the mid 1990’s, in concert with the local Anthem payor. The model was shared across the country, and various elements of it were incorporated into programs that continue to serve. Fire EMS agencies have funded programs that address gaps in community services, and better align patients with community resources other than a hospital emergency department. These programs were expanded dramatically during the pandemic, when many forces combined to develop alternate sites of care outside the hospital. Fire EMS agencies now have implemented hundreds of programs that deliver important service to serve community needs. Those programs continue to expand, and now has multiple delivery arms to assist persons who are high volume users, are in palliative care programs, have ongoing substance use challenges, and to bridge patients to more effective care systems. Many programs have successful medical direction by emergency physicians, and those programs will be highlighted.

Session Objectives:
1. Attendees will be conversant on the evolution of care programs that reduce ED visits by providing care outside the hospital with EMS-based programs.
2. Attendees will be able to convey elements of three CP programs that provide services for at least ten years 3.Attendees will be able to recite possible economic.
3. Attendees will be able to identify four elements of strategy associated with medical direction of enduring CP programs.

Faculty:
James Augustine, MD, FACEP |  US Acute Care Solutions

Session Description:  In the era of shrinking reimbursement, having an analytics strategy is critical to helping you understand your practice’s business performance. This session will discuss strategies for measuring group and provider-level metrics, analyzing your payer mix, and forecasting your future cash flow.

Session Objectives:

• Discuss KPIs for group and provider-level metrics
• Examine best practices to analyze your payer mix and determine true CPV by payer
• Learn strategies to help forecast future cash flow

Sponsored by

Session Description: NASA’s astronaut selection process long relied upon a solitary question: do you have what it takes to fly to space? Aligning incentives to exclude candidates from flightworthiness led to a fascinating and harrowing history of astronauts circumventing NASA leadership (and often their own doctors!) to preserve their ability to travel to the final frontier. We will explore some of these fascinating historical anecdotes, how a fundamental change in the philosophy of space medicine is empowering innovation in the new era of commercial spaceflight, and how “getting to a yes” can transform your own practice.

Session Objectives:
1. Establish a conceptual framework for the historic and emerging paradigms underlying medical screening and emergency response for expedition medicine and human spaceflight.
2. Understand appropriate use cases for exclusion-based vs inclusion-based approaches to expedition clearance.
3. Demonstrate the broader applicability of the “Getting to a Yes” mindset beyond human systems development and medical clearance.

Faculty:
Luke Apisa, MD | Massachusetts General Hospital

Session Description: In this session the ACEP President, EMRA President and EDPMA Chair will discuss the following:

1.  Issues they are each passionate about today
2.  What are the outside forces impacting the specialty?
3.  What does emergency medicine look like in 5 years?
4.  What will define your legacy?

Session Objectives:
1. Breakdown the critical issues facing emergency medicine today.
2. Isolate and discuss outside forces impacting the specialty today and forecasted for tomorrow.
3. Predict what the specialty will look like in 5 years.

Faculty:
Andrea Brault, MD, MMM, FACEP | EDPMA Chair
Blake Denley, MD | EMRA President
Aisha Terry, MD, FACEP | ACEP President

Moderated by: Derise McLean Woods, MHSA | TeamHealth

Session Description: Join Ed Gaines, JD, CCP and David Mackenzie for an open and insightful conversation covering over twenty-five years of stewardship, leadership and friendship developed against the backdrop of emergency medicine. Learn more about the coin of the realm, how to build, deploy and trust a team and to strategically negotiate on behalf of the greater good. David and Ed will also share their perspective on the future of emergency medicine reimbursement.

Session Objectives:
1. Learners will observe authentic leadership and be able to identify it within their organizations
2. Participants will consider key criteria for recruiting, developing and deploying a successful team
3. Attendees will be able to discuss emerging trends for the future of emergency medicine reimbursement

Faculty:
Ed Gaines, JD, CCP | Zotec Partners, LLC
David McKenzie, CAE | ACEP

Moderated by: Juli Forde Smith | Rev4ward, LLC  (Moderator)

Session Description:  As more medical groups participate in risk bearing reimbursement models, the opportunity to partner with ED groups becomes more valuable. ED Safe Discharge and Documentation Accuracy programs showcase how this partnership can reduce risk, improve throughput, and lay a framework for potential deeper financial partnerships (e.g., gainshare) with risk-bearing entities.

Session Objectives:
1. Understand the structure and incentives of risk-bearing medical groups.
2. Understand the shared interests of risk-bearing medical groups, ED groups, and hospitals
3. Understand example program models and how they may further opportunities in value-based care for Emergency Medicine.

Faculty:
Jamie Chang, MD | Optum
Alex Mohseni, MD | AskTheHive
Ruthanne Small | Optum

Session Description: Historically, physician practice groups have had the luxury of time to first evaluate staffing opportunities and then months to prepare for the transition to go-live. More recently, opportunities to staff EDs have recently been coming and going at lightning speed. In some cases, practice groups have only a matter of days to weeks to assess new opportunities and implement a complete go-live. This includes the vetting and retention incentives for existing staff, transition plans for departing staff, and possible new hires or outsourcing. In order to provide seamless, high quality care for patients and maintain viability of practice groups, coordination between the practice group and their RCM partner is paramount. There are specific best practices that each entity should be aware of in order to support this type of transition, which is now occurring repeatedly in our industry across the country. Leaders of the practice group EMS and their RCM partner, ConsensioHealth, will review their experience of expanding from seven sites to 17 sites in the matter of several months, recounting the keys to success and challenges that could have been avoided in retrospect. Preparation is the only way that practice groups will be well positioned to be in the running to take advantage of the next rapid-fire opportunity that comes their way, and hopefully the recommended solutions from EMS and ConsensioHealth will help prepare the Solutions Summit attendees.

Session Objectives:
1. Outline best practices for recruiting and retaining emergency physicians in the setting of rapid growth.
2. Outline strategies for recruiting and retaining RCM staff to support growth.
3. Summarize best practices (and lessons learned) from rapid growth and system integration.

Faculty:
Beth Griffin, MD | Emergency Medicine Specialists
Cara Friedrich, CPC-I, COC, CPC | ConsensioHealth LLC

Session Description: The “transitional” period following discharge from the Emergency Department (ED) is high-risk. Published studies estimate only 40% of Medicare beneficiaries can secure outpatient follow-up within 7 days of ED discharge. At 30 days of ED discharge, 30% still had not secured post-discharge care. Without adequate follow-up care, ED patients are prone to adverse drug events, treatment non-compliance, increased costs, medical complications, ED revisits, and unplanned hospital readmissions. Telehealth is a tool that can be used to increase patient access to healthcare services after an acute health episode. The expansion of telehealth has been supported by improved reimbursement as a result of regulatory changes implemented during the pandemic. In addition, the growing emphasis on cost and quality is increasing emergency medicine physician accountability for healthcare dollars spent beyond the initial ED visit. To extend the convenience of rapid access to emergency-trained providers to patients after the ED visit has ended, the virtual ED After Care Clinic was launched. The aim of the initiative was to, a) offer rapid access to outpatient follow-up care after ED discharge in a cost-effective manner, b) ensure the virtual clinic was fully integrated into the existing electronic health record to preserve a consistent patient story and, d) optimize the billing strategy for outpatient, virtual care visits and c) apply learnings and outcomes from the clinic to develop a conceptual shared risk model to propose to a major payor. This session will describe the collaborative strategy, lessons learned, patient characteristics, operational processes, and billing approach used to launch a virtual ED follow-up clinic in a large integrated health system.

Session Objectives:
1. Analyze the approach to launching a 100% virtual clinic to provide follow-up and transitional care for discharged emergency department patients.
2. Evaluate billing and reimbursement trends and the implications for a sustainable staffing model.
3. Discuss clinic patient characteristics, outcomes, and lessons learned.

Faculty:
Todd Chassee, MD, FACEP | Emergency Care Specialists
Stephanie Mullennix, MSN, RN, AGNS-BC, CEN, CPHC | Emergency Care Specialists
John Throop, MD, MBA, FACEP | Emergency Care Specialists

Session Description: The loss of a hospital contract presents an often sudden and disruptive event to a physician group.  This session will explore the effects of the contract disruption from the emotional and professional status of the physicians and Advanced providers as well as from the financial, legal, and malpractice coverage standpoint.  The session will describe the pitfalls and challenges that moving forward with a new employer as well as how differing employment models affect the group

Session Objectives:
1. Navigating the sudden termination of a contract.
2. Understanding different provider group models
3. Understanding the financial, legal and malpractice affecting physicians and APP’s during disruption.

Faculty:
Bill Freudenthal, MD | Vituity

Session Description: EDPMA and EMPI and embarked on a public relations strategy to embolden the future of emergency medicine through an artfully crafted EMTALA Safety Net Narrative. As a first phase, exploration of current media chatter was completed via AI technologies to understand the current environment. Patrick Velliky will review their findings, offer an overview of our potential audiences and suggestions of how you may influence others on behalf of emergency medicine providers and patients.

Session Objectives:
1. Attendees will be able to name key stakeholders on behalf of emergency medicine
2. Participants will gain an understanding of the current narratives, anti narratives and their utilization across platforms.
3. The audience will identify possible strategies for successfully influencing their own sphere of influence on behalf of emergency medicine.

Faculty:
Juli Forde Smith | Rev4ward, LLC

Session Description: You may be familiar with its siblings Privacy and Security—but what is HIPAA Administrative Simplification and how can it help emergency physicians? This session will explain transactions, operating rules, unique identifiers, and code sets, followed by examples of potential payer and clearinghouse violations. Attendees will learn how physician groups can utilize Administrative Simplification to reduce burdens and operational pain points, save time, and increase revenue. The session will also share real-world examples of Administrative Simplification wins and understand how ensuring payer compliance can impact not only your ED group, but also all providers.

Session Objectives:
1. Understand what HIPAA Administrative Simplification is and how transactions, operating rules, unique identifiers, and code sets help streamline and standardize operational processes.
2. Identify potential Administrative Simplification violations and submit complaints.
3. Work within the existing rules to relieve operational pain points and increase revenue.

Faculty:
Kathryn Beard | R1 RCM

Session Description: For so long, we’ve accepted that the 30% commercial subset of our patients would fund 70% of our revenue for provided federally-mandated services.  As that purse string tightens, we must push forward with ensuring fair reimbursement for providing care to our communities’ most vulnerable.  Learn about how to increase the Medicaid fee schedule in your state, counter nefarious payor practices from Medicaid departments and managed care organizations, and place value on emergency services to Medicaid enrollees outside of the fee-for-service world. 

Session Objectives:
1. Learn Medicaid’s Funding and Structure.
2. Understand risks (and solutions) created by the interplay of EMTALA and Medicaid to emergency patients and physicians.
3. Explore novel ideas improving access to emergency care involving Medicaid.

Faculty:
Lisa Maurer, MD | ConsensioHealth
Tom Sugarman, MD, FACEP, FAAEM  | Vituity