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High Quality and Affordable Care through Accountability
8 CME Credits
8 CE Credits
ABQAURP sub-specialty credits: Managed Care 6.5, Patient Safety/Risk Management 6.5, Case Management 8.0, Transitions of Care 3.75, Physician Advisor 8.0
Health care entities and providers are grappling with the fact that the care delivery landscape continues to evolve and reimbursement is now clearly tied to “outcomes, value, and customer service” versus the traditional “productivity and volume”. As readmission and value based purchasing penalties hit the bottom lines of hospitals and health systems across the country, it has also become clear that the continuum of care responsibilities are stretching beyond traditional boundaries and forging many new, and previously unimagined, collaborative partnerships. Health care delivery is now a community responsibility with growing emphasis on population health improvement.
With a few years of experience now under our belts, health care systems and providers are getting a better idea of what is expected of them by payers and consumers. Professional responsibility and quality improvement efforts are clearly tied to effective communication and coordination of care. Providers are now in a position to better identify gaps in quality, safety, and customer service; in turn allowing them to provide high-quality, cost-effective care on a consistent basis. The bottom line appears to be holding ourselves, and each other, accountable for every transaction of care. The formation of the Accountable Care Organization (ACO) fosters the concepts of providing quality, safe, financially secure care; as such fulfilling the ethical responsibility the AMA requires for practitioners.
At the conclusion of the activity, attendees will be able to:
Determine the value of models of performance excellence for improving efficiencies and providing world class customer service
Discuss reimbursement for patient engagement
Reiterate lessons learned from high performing ACOs and the value of physician alignment
Recognize underlying legal framework needed for successful Accountable Care Organizations (ACOs) and Clinically Integrated Networks (CINs)
Discuss population health focus and innovative collaborations
Leverage the legal risks of the Medicare Shared Savings Program
Express the importance of documentation, particularly with the increasing rate of adoption of the EMR and impending implementation of ICD-10
Evaluate the impact of inadequate behavioral health services on our communities
This course is intended for Physicians of all specialties, Nurses, and Other Health Care Professionals with appropriate CME credit and nursing contact hours offered for each profession.
The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
ABQAURP designates this enduring material for a maximum of
8.0 AMA PRA Category 1 Credits™
. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 8.0 contact hours through the Florida Board of Nursing, Provider # 50-94.
This program is approved for Category 2 credit by the American Osteopathic Association.
All participants must achieve a final assessment score of at least seventy percent (70%) for recertification and continuing education credits. You have 60 days to complete the course after ordering. Please note: Exam candidates taking the Core Body of Knowledge and Diplomates renewing their certification may have less time to complete, as determined by deadlines imposed.
This activity is valid from June 15, 2015 through March 15, 2018.
Attention!! THIS COURSE REQUIRES the Adobe Flash Plug-in for Windows and iOS based browsers.
Please read the ABQAURP
and we suggest strongly that you read the
COURSE FEES: Diplomate $230.00 Member $270.00 Non-Member $330.00
About The Authors
Members of the CME Committee, Planners, and Faculty have disclosed to ABQAURP any relevant financial relationships. No relevant financial relationships or conflicts of interest exist in regard to the content of this activity.
Lisa Pickett, MD, FACS
Dr. Lisa Pickett is Chief Medical Officer for Duke University Hospital and is an Assistant Professor of Surgery and Medicine at Duke University. Her primary focus is physician development and alignment in safety, quality, and patient satisfaction, as a part of the Duke University Hospital core value of caring for our patients, their loved ones, and each other.
Harry S. Hertz, PhD, FAAAS, HFACHE
Dr. Harry Hertz is recently retired from the National Institute of Standards and Technology where he served as the Director of the Baldrige Performance Excellence Program since 1995. He has been the primary architect of the Baldrige Criteria for Performance Excellence for over 15 years, including the addition of health care, education, and nonprofits. Dr. Hertz is a Fellow of the American Association for the Advancement of Science and an Honorary Fellow of the American College of Healthcare Executives. He currently serves on the Advisory Group for VHA’s Center for Applied Healthcare Studies.
Craig Deao, MHA
Mr. Craig Deao has been a member of the senior executive team for Studer Group since 2006. In addition to his full-time work with Studer Group, he has served as faculty for the Institute for Healthcare Improvement, the American College of Healthcare Executives, and dozens of healthcare systems across the US and Canada. Craig served as one of the key leaders of Studer Group’s Baldrige journey and now spends most weeks inside of healthcare organizations working with boards, medical staffs, and executives to help architect their own journeys to excellence. Craig now lives in Pensacola, FL where he serves on the quality committee of the board of his local health system.
John Timmerman, PhD
Dr. John Timmerman is Gallup’s Senior Strategist in Customer Experience and Innovation, and is an expert in creating outstanding customer experiences by building and integrating business cultures, systems, and technologies. A recognized thought leader in the science of service, John has presented hundreds of lectures and consulted on designing customer-centric organizations across a diverse range of industries. John previously held positions as the Quality Advisor for The Cleveland Clinic Foundation, Chairman of the American Society for Quality, and is a former senior examiner for the Malcolm Baldrige National Quality Award. John also served in the U.S. Marine Corps as a 2nd Force Reconnaissance Marine.
Edward A. “Ted” Peck, III, PhD, ABPP-CN
Dr. Ted Peck divides his group practice at Neuropsychological Services of Virginia among clinical and forensic related services in neuropsychology and research for the management of dementia and other neurologic disorders. He is board certified in Clinical Neuropsychology; with a vast amount of experience in psychology, psychiatry and neurology beginning at Boston Children’s Hospital and Harvard Medical School. He consults nationally on the business aspects of private practice, is the author of numerous articles, book chapters, and presentations.
Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA
Lynne Thomas Gordon is the Chief Executive Officer of The American Health Information Management Association. AHIMA is the respected authority for professional education, training, and Health Information Management knowledge. Lynne’s hospital-based background includes Children’s Hospital at Rush University Medical Center, Houston Medical Center in Georgia, Children’s Hospital of Michigan, and Shands in Florida; providing management and operation leadership for clinical support and patient support in a variety of roles. Lynne has set AHIMA’s course to train clinicians to manage data so it can be transformed into information and knowledge.
Christopher J. Laney, JD, CHCQM
Christopher Laney is Corporate Counsel for Baptist Health in Louisville, Kentucky, a full-spectrum health system consisting of eight hospitals, more than 170 outpatient facilities, and a network of 450 employed physicians and more than 1,600 independent physicians. Mr. Laney advises the Population Health Department on the development of an ACO and participation in the Medicare Shared Savings Program, the development and implementation of a statewide clinical integration program, and other value-based purchasing initiatives. He also advises all business units on HIPAA security and privacy issues.
Richard Kaine, MD, CHCQM
Dr. Richard Kaine is the Director of Consulting Services for Quality Management Resources, a nationwide consulting firm and the Medical Director for Health Practice Management. Dr. Kaine has been certified by the American Board of Pediatrics, the American Board of Family Practice, the American Board of Internal Medicine, and is a long-standing, valuable member of ABQAURP’s board of directors. He is a former HMO Medical Director and Executive Director; building provider networks and credentialing thousands of physicians for national insurers. He lectures nationally about quality, utilization, credentialing, and compliance issues.
Ronald S. Walters, MD, MBA, MHA
Dr. Ronald Walters is the Associate Vice President of Medical Operations and Informatics at The University of Texas MD Anderson Cancer Center here in Houston. He also serves as Medical Director for the Managed Care and Case Management Programs. MD Anderson began preparing for Meaningful Use and ICD-10 requirements with their implementation plan several years ago, we are eager to gain from their experience.
D. Keith Fernandez, MD
Dr. Keith Fernandez is President and Physician-in-Chief of MHMD, the Memorial Hermann Physician Network, the largest clinically integrated physician organization in Texas. Dr. Fernandez is the Memorial Hermann Health System Physician Champion for computerized physician order entry and has led prominent efforts in electronic ordering and evidence-based order sets for the Memorial Hermann System.
Leslie Kelly Hall
Leslie Kelly Hall combines experience as a former hospital administrator and vision as a consumer/patient advocate to fuel patient engagement in health care. As senior vice president of policy at Healthwise, she guides policy efforts for health IT, standards, interoperability, privacy, and security that will help people engage in their health care. Her previous and current appointments with several US Health and Human Services Federal Advisory Committees gives her ongoing insight on emerging IT requirements.