Friday, August 21, 2009

Losing Sleep

On Wednesday, we had the opportunity to host the Kansas City Metropolitan Healthcare Council (KCMHA) District 2 meeting. Thank you to Julie Quirin, Council President, and to all of the executives who were able to attend.

It was great to hear updates from Tom Bell (Kansas Hospital Association), Mike Dunaway (KCMHA), Brian Woolley (Lathrop & Gage) and Marc Smith (Missouri Hospital Association). Marc will retire from his role as President and CEO this year and we wish him well in all his future endeavors. He has been a dynamic leader and a fierce advocate for Missouri hospitals and we will miss his leadership.

The featured speaker at our meeting was Martie Ross, who presented information on RAC Audits and new HIPAA regulations. For those unfamiliar with RAC, it stands for the Recovery Audit Contractor program which is charged with auditing and detecting improper payments made on claims of health care services provided to Medicare beneficiaries. RAC requests and reviews are a subject of great interest to hospital administrators, as you might guess. Our speaker noted that this relatively new program raises a great number of questions concerning procedural strategy.

How will we track RAC requests and deadlines?
What checklist will we use to gather the records?
Who will be responsible for gathering responsive records?
What format will we use to produce the records?
Where do we send the response?
How will we track the response?
What happens if we need to file an appeal?

All these questions are enough to keep a hospital CEO up nights and I have only listed a few of the ones presented!

While we all have our individual opinions on running our particular healthcare organizations, one thing remains constant – the ongoing challenges and complexities we face on a daily basis. Our number one focus will always be around providing the community we serve optimal and effective care. Thank you to our hospital and healthcare system leaders for the strength they show in managing their system’s operations.

I look forward to hearing from you and what makes you "lose sleep at night" around your business’ operations.

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