Conference Agenda

Conference Agenda is pending and will be updated as sessions are confirmed, please check back!

Wednesday, September 11, 2024
4:00pm-6:00pm    Early Registration

Thursday, September 12, 2024
6:45am-7:40am    Registration and Continental Breakfast

7:40am-7:45am    Welcome and Announcements

      Chairman of the Board - ABQAURP
      Medical Director - Accord Hospice

      CME Committee Chair - ABQAURP
      Vice President Population Health and Quality - Sentara Health Plans

7:45am-8:45am   Closing the Communication Gap Between Facility and Revenue Cycle Clinical Teams
      Sogol Sepehri, MD, MBA, CHCQM - Vice President of Physician Advisors - HCA Healthcare
  • Describe how hospitalist clinical documentation impacts downstream billing efforts and the challenges faced when trying to address these issues in a traditional hospital structure.
  • Identify how clinically trained denials management teams can have broader benefits in driving better transparency and education on denials-related issues to the front lines.
  • Demonstrate initial findings and considerations that HCA has identified through their efforts in this space.

8:45am-9:45am    Revitalizing Your Utilization Management Program: Lessons Learned During Development of Internal Physician Advisor Programs at Academic Medical Centers
      William J. Frederick, III, MD, PhD, CHCQM-PHYADV - Physician Advisor Medical Director - Stanford Health Care
  • Examine the current utilization management system in your hospital, including strengths and weaknesses.
  • Explore new technologies, methodologies, and processes that have been successful in revitalizing health system utilization management programs.
  • Formulate actionable strategies for implementing these solutions in hospitals considering factors such as cost, feasibility, potential barriers to implementation, and the expected impact on patient care and hospital efficiency.

9:45am-10:00am  Networking Break

10:00am-11:00am    Utilization Management vs. Utilization Review: It’s Not a Once-and-Done Process
      Kathy Seward, MD, CHCQM-PHYADV - Physician Advisor - HPIR, LLC
  • Differentiate between utilization management and utilization review.
  • Identify methods to effectively manage patient status and resource utilization.
  • Define the benefits of effective Utilization Management.

11:00am-12:00pm   Secrets to Successful Peer-to-Peers
      Melissa Buchner-Mehling, MD, CHCQM-PHYADV, FABQAURP - Associate Chief Medical Officer – Sound Advisory
  • Identify the purpose of peer-to-peer calls.
  • Describe communication styles and de-escalation techniques for peer-to-peer conversations.
  • Formulate your clinical case for peer-to-peer presentation and tips for success.

12:00pm    Closing Remarks and Adjournment

4:00pm-6:00pm    Registration
Pick up your conference materials early for Friday sessions, save time in the morning!
(You do not need to register again if you've attended Thursday sessions.)

4:00pm-6:00pm    Networking Reception
Relax and Network! Reception is open to Thursday, Friday, and Two-Day attendees. Reception is ages 21 and over only, please.

Friday, September 13, 2024
6:45am-7:45am    Registration and Continental Breakfast

7:45am-8:00am    Welcome and Announcements

      Chairman of the Board - ABQAURP
      Medical Director - Accord Hospice

     CME Committee Chair - ABQAURP
      Vice President Population Health and Quality - Sentara Health Plans

8:00am-9:00am   The Importance of Quality From a Leadership Perspective
      Richard B. Siegrist, Jr., MS, MBA, CPA - Faculty Director - DrPH program, Harvard T.H. Chan School of Public Health
  • Examine the perspective of organizational leadership on what information they should receive from members of the health care team regarding quality.
  • Describe best practices for presenting quality information.
  • Assess the value of a broader definition of quality that looks beyond the institution’s four walls to community impact.
  • Evaluate the relationship between quality and financial performance.

9:00am-10:00am    Advancing Digital Quality Transformation
      Burke Burnett - Director, Partnerships – NCQA
  • Discuss the history of traditional quality reporting.
  • Discover why digital quality is important.
  • Identify NCQA programs that support digital quality.

10:00am-10:15am    Networking Break

10:15am-11:15am    Panel Discussion: Successful Transitions for Patients to the Community
      Mary Lomberk, PharmD, BCACP, CPh - Transitions of Care Clinical Pharmacist - BayCare
      Mary McLaughlin Davis, DNP, ACNS-BC, NEA-BC - Program Manager - Cleveland Clinic
      Jacqueline Vance, RNC, BSN, CDONA, IP-BC, CDP, LBBP - Senior Director of Clinical Innovation and Education - Mission Health Communities
      Moderator: Cheri Lattimer, RN, BSN - Executive Director - National Transitions of Care Coalition

  • Outline the barriers and concerns patients face when returning home and to outpatient services.
  • Compare the roles of the pharmacist, case manager, and community health worker in transitions from acute or post-acute care to the community.
  • Identify financial payment models that support improved medication management, transition, and care coordination in support of transitions of care interventions.

11:15am-12:15pm   Reduce Reoperation Risk for Patients with Infective Endocarditis and Substance Use Disorder
      Mary McLaughlin Davis, DNP, ACNS-BC, NEA-BC - Program Manager - Cleveland Clinic
  • Describe the impact of treating patients with infective endocarditis (IE) and substance use disorder (SUD) on health systems and health plans.
  • Identify an alternative paradigm for treatment of a population at high-risk for repeat surgery and mortality.
  • Explain the benefit of comprehensive treatment for patients with IE and SUD.
  • Support the implementation of dual treatment of IE and SUD within health plans and health systems.

12:15pm-1:15pm    Networking Lunch (Buffet Lunch Provided)

1:15pm-2:15pm   SAVOR to the Max - Fuel YOUR Success with the Power of HAPPINESS
      Harjot Singh, MD - Leadership Consultant – and Faculty – American College of Healthcare Executives
  • Discuss how cultural myths of happiness are causing harm to the well-being of the health care team.
  • Determine how to integrate evidence-based well-being activities into your routine to prevent clinician burnout.
  • Employ happiness and well-being goals to provide leadership within your organization or group.

2:15pm-3:15pm    Charting the Course: Leadership Insights in Healthcare Systems
      Pranav Mehta, MD, MBA, FACHE, CPE - Chief Medical Officer American & Atlantic Groups and Vice President of Clinical Operations – HCA Healthcare
  • Define the essential components of hospital system capacity and capability, including infrastructure, staffing, and resources, and how they contribute to the delivery of quality healthcare services.
  • Explore the role of information technology (IT) and artificial intelligence in enhancing hospital system efficiency and effectiveness, focusing on care transformation and innovation, electronic health records, and data analytics to optimize patient care delivery and operational efficiency.
  • Discuss strategies for ensuring quality and safety within hospital systems, including the implementation of evidence-based practices, continuous quality improvement initiatives, and leveraging IT solutions to mitigate risks and improve patient outcomes.

3:15pm-3:30pm    Networking Break

3:30pm-4:30pm    Peeling the Onion: Why Hospital Leadership Need More Transparency into Utilization Management Data

      Keith Fulmer, MHSA, PMP - Chief Technology Information Officer - Brundage Group
  • Explain the importance of tracking key performance indicators for utilization management.
  • Identify manual processes within the clinical revenue cycle that contribute to the inefficient workflows for utilization review staff.
  • Discuss how effective utilization management processes can reduce payment denials to maintain an organization’s investment.

4:30pm-5:30pm   Anatomy of an Artificial Intelligence Model and Why it Matters to the Quality Assurance Community
      Allan S. Goldberg, DPM, CHCQM, FABQAURP - Podiatrist - Physician Affiliate Group of New York
  • Define and analyze a representative artificial intelligence model and its use in medical decision-making.
  • Highlight the expected benefits, challenges, and limitations of the use of artificial intelligence models in medical decision-making.
  • Explain how the quality assurance community can utilize knowledge of artificial intelligence models to provide expert evaluation of artificial intelligence-enhanced medical decision-making.

5:30pm    Closing Remarks and Adjournment

*Schedule, faculty, and content are subject to change.

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