Blog, The Hospital Finance Podcast®

Recap from AHLA [PODCAST]

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In this episode, we’re pleased to welcome back Randi Deckard, BESLER’s SVP of Client Engagement, and Kristin DeGroat, BESLER’s Compliance and General Counsel Officer to provide us with a recap from the recent AHLA show in Baltimore.

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Highlights of this episode include:

  • AHLA, Medicare and Medicaid Institute
  • What the attendance was like this year
  • How this year’s conference content and events stacked up to those in the past
  • Sessions/Speakers recap
  • BESLER’s luncheon

Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome back Randi Deckard, BESLER’s SVP of Client Engagement, and Kristin DeGroat, BESLER’s Compliance and General Counsel Officer. In this episode, Randi and Kristin will provide us with a recap from the recent AHLA show in Baltimore. Welcome back and thank you for joining us, Randi and Kristin.

Randi Deckard: Thanks for having us.

Kristin DeGroat: Yes.

Kelly: All right, well, let’s jump in, ladies. Let’s start with Randi. In the past few years, we heard that the number of attendees at the AHLA, Medicare and Medicaid Institute, seemed to be lower than usual. What was the attendance like this year?

Randi: I think the attendance this year was strong. I think the one thing that everyone has to realize in healthcare is that budgets are being cut for education. For reimbursement staff that I spoke to, they said to their boss, “If I have to go to only one, this is the one that I want to go to.” So, I think that’s why there was such a strong turnout. I did actually meet a few people that this was their first time, even though they’re a VP of reimbursement level. And they’re like, “I didn’t realize what I was missing.” So, if you’re in reimbursement or being impacted by government programs, this is one of the premier events conferences to go to network with your peers and really learn about the regulations and what’s going on in the space.

Kristin: And I was super excited to see the level of CMS participation because in the last few years, they’ve either been prohibited from coming or they tried to do it virtually when everyone else is live, through a recording. Some of them didn’t– it didn’t work very well. So, I was happy to see that they were back and they all showed up to speak. It was good. I thought it was really good.

Kelly: Sounds like you had a great turnout. And I mean, that’s quite the testament, Randi, what you said, what you heard from someone. So, it does seem like this is the premier event to attend if you’re in reimbursement.

Randi: Absolutely.

Kelly: Yeah, let’s direct this one to Kristin. I understand that you’ve attended this conference for many years. How did this year’s conference content and events stack up to those in the past?

Kristin: Yes, this was actually my 20th year to go to the AHLA conference.

Kelly: Wow. That’s impressive.

Kristin: Yes, it’s been a while. And although it’s varied widely from what’s the content that has come out, what they’ve really focused on, this year, I thought it was much more geared towards reimbursement. I mean, it really is a reimbursement contract. But in the years past, they kind of drifted off more into what I would call high operations, and really not so much in cost reporting and the basics really that underlie with Medicare, the cost reports, right? And yes, we still have the claims that you still need to look at, but I thought they did really good about bringing them all together. They had some provider-based stuff, but they referred back to the graduate medical education and how that would flow in. So, I thought they did a really good job this year of keeping it more directed towards the reimbursement professional, which to Randi’s point, that’s really who comes to this conference. You have a lot of the Medicare administrative contractor people there. And the presenters and having them there, I think it was really tooled better as more of an educational this year, as opposed to in years past.

The presenters would oftentimes say things about CMS or the MAC that maybe wasn’t appropriate or nice, for lack of a better word. And this year, it seemed more cordial. And everyone seemed to be more interested in getting to the end result as opposed to let’s fight about it and then get to the end result. So, I thought it was much better streamlined. The content was efficient, and I think right on point. And then the events. I loved the fact that this year, AHLA, at the end of the day’s presentation, they did a little social. And normally it’s in one of the ballrooms. But this year, I liked it on day two, they actually said, “You know what? We’re going to have the little bonding event, if you will, out in the foyer.” So, we were able to interact with the exhibitors and the sponsors. And I thought that that was a much better use of– if you’re going to exhibit and be a sponsor, you get to get involved now, and they’re right there seeing your booth and what you have to offer. So, I really, really liked the event this year. I would say in my 20 years of going, it’s probably in my top five.

Randi: And the thing I would add – and I totally agree with, with Kristin – is there are off-site kind of like micro events associated with this. If you’re in the appeal business, Ropes & Gray, King & Spalding also have events. And BESLER hosted an off-site luncheon. And it gave people who were customers and who are not customers another opportunity to network with their peers. And I heard people from Tennessee talking to people from Pennsylvania, which I thought was great. So, reimbursement, yes, there are specific state issues, but the feedback that I got was it’s always great to come to events like this and where there’s curated networking, like the socials and off-sites also kind of help people maximize their time at an event like this.

Kelly: Wow, it sounds like this was the year to be there then. So back over to Kristin, this conference offers a lot of sessions impacting both reimbursement and revenue cycle. What sessions did you attend?

Kristin: Actually, I would say for the first time, I attended both. A little bit of revenue cycle side and, of course, a lot of the reimbursement and appeals. But as I mentioned earlier, I thought they did a really good job of trying to bridge the gap between the two. Just like I said about the provider-based. So, the provider-based status has a lot to do, obviously, on the operations side and getting that set up and doing the chow and reporting all of that. But then they talked about how you have to report that on the cost report, and that equates to reimbursement you may receive as it flows through for other issues that a provider-based status might impact, as, for instance, the graduate medical education or resident FTE issue. So, I was super excited that I found interest in both sides because honestly, I lean towards the reimbursement side coming from the cost report appeals background.

But the other session that I thought was the best session ever, and I do not recall them ever doing this before, they had a key elements of cost reporting course. For someone who is just getting into the reimbursement world that maybe isn’t the cost report type, someone like me who is a lawyer by trade, who then made their way into consulting, and just so happened, got into appeals because of the law degree, and it just built on that. I had to have someone train me at least a good six months to at least give me the basics of what even is in a cost report, then, of course, to dive into it deeper. That was a perfect course. It gave you just enough that you could understand what was going on if you’re a reimbursement professional. And because it’s a law conference, I thought that that was the perfect way to open up the conference and offer that type of course I thought was invaluable. And even maybe for revenue cycle people, that maybe they’re just starting to be pulled into issues. They’re really never worked on a cost report, but the cost report people need their input. And understanding how that flowed, I thought was invaluable to whoever attended the conference.

Kelly: Sounds like you had some great sessions there. So, what were some of the things you heard at the conference from speakers and/or peers? We’ll start with Randi and then we’ll go over back to you, Kristin.

Randi: Sure. So, one of the things that I heard was, first off, if you have your CPA, oh, thank goodness, I can get my credits because they need those, the professional credits. And then for those specifically in reimbursement cost report appeals, the update from the PRB, the fact that there are MACs as well as legal firms there is awesome. Being able to network with your MAC and actually have someone who knows who you are and shares contact information feels like you won the lottery.

Kristin: Yes. Definitely.

Randi: And then overall, the networking, “Hey, this is what we’re doing. How are you doing it?” And even at our luncheon, like I said, creating a sense of community if you’re in reimbursement and appeals or the coding compliance more on the RevCycle side. But having a network for your peers and knowing who to go to, just to ask questions, bounce ideas. That’s what I heard from a lot of people; it was helpful for them. And then, of course, the topic always with reimbursement for the last few years is how are you handling staffing? There’s been a lot of staff aging out. And I’ve heard everything from we’re hiring people out of college, we have training programs to we’re making decisions to outsource. So staffing was still a hot topic from the commercial side.

Kristin: And I agree with Randi. I did talk to quite a few of the MAC representatives that were there. And few of them I’ve known for many years, but quite a few of them have retired. And I think the overwhelming discussion that I was involved in when talking to them was the amount of people that are now in the reimbursement cost reporting world on the MAC side that are auditing. They are so new that most of them don’t have the level of expertise that we’ve consistently had in the past. And that’s only because people are retiring, people are moving on. Post-COVID, a lot of people said, “Oh, I’m going to retire. I’m going to move out of here.” So there really weren’t people to train them either. And then similar to the provider folks, they weren’t able to come. They didn’t have the budgets to come to the AHLA conference. And so those that I were talking to, they said that this is invaluable, that now they’re able to get back out and come and bring those younger auditors to something like this and really see how it works and network and understand that it’s not just what’s printed on the paper.

They’re people, just like you are, like Randi said, to the credit, you get to network and they don’t usually get to see that. They’re in their office doing their auditing on paper, looking at the cost report, talking to people on the phone, and not really interacting and seeing the day-to-day, what the hospital professionals are doing, what the consultants are doing. And likewise, they don’t get to see that for the MAC side. So, like Randi said, that is ideal is that you can network with all the different, whether it be the provider folks, with consultants, or with the lawyers, or with the MACs, or even with the board people and the CMS people. I think that those are great. There were really, really good events that they offered. And like Randi said, the law firms had their socials, AHLA had theirs, and it just seemed like there were plenty of events to go and network.

Kelly: Those were some great insights. Thank you for sharing those. Randi, you mentioned earlier the BESLER hosted an off-site luncheon, and you told us a little bit about that, but can you tell us more about it and why do you think it was so well attended?

Randi: Yeah, so I think that people, especially reimbursement people are hungry for community. And I define community as being able to lean into your peers, bounce ideas off like this is how we’re doing something or asking questions. And regardless whether you’re in the same state, whether you’re not profit, for profit, that doesn’t matter. It’s really truly about reimbursement to reimbursement and how you’re handling the cost report or looking at issues, looking at IPPS, how is this impacting, how you’re handling staffing, what other changes may be going on, what you think the proposed rules might be based on comments in the past, and creating a sense of– creating the community where people are exchanging information who’ve never met before. Like I said, I think that they’re craving that. And there aren’t very many conferences where it’s really you have that high of a concentration of reimbursement. So, I think that’s why this conference and the off-site was so popular because it really did give people an opportunity to create this little community and network. And we were transparent about who was attending and introductions would be made. And because it was the first day that we had the luncheon, I saw people afterwards mingling because they’d met. And so, they knew a face, they’d had a conversation. I saw contact information shared, which is exactly what we want, right?

Kelly: Yeah. That’s awesome.

Randi: Yeah, BESLER wants to create a community. And of course, we’re SMEs in that area, but helping drive the reimbursement community is something we’re really proud of.

Kelly: Definitely. Sounds like it was a great event. Well, thank you both for joining us today, Randi and Kristin, and for sharing your insights from the recent AHLA event. We really appreciate it.

Randi: Thank you.

Kristin: Thank you, Kelly.

Kelly: And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…


[music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit The Hospital Finance Podcast is a production of BESLER | SMART ABOUT REVENUE, TENACIOUS ABOUT RESULTS.


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