PYA partnered with the Montana Hospital Association (MHA) to present on Rural at Risk™ topics during the MHA Healthcare Conference. Our team of thought leaders and subject matter experts from the PYA Center for Rural Health Advancement presented on critical issues including cybersecurity, telehealth, price transparency, health equity, compliance, and more.
Speakers included PYA experts Shannon Sumner, Martie Ross, Barry Mathis, Jane Jerzak, Kathy Reep, and Traci Waugh.
Sessions include:
One Size Doesn’t Fit All—Leading Practices in Effective Compliance Programs
– Shannon Sumner, PYA Principal and Chief Compliance Officer
– Traci Waugh, PYA Senior Manager
While the Office of Inspector General (OIG) and the Department of Justice (DOJ) have clearly outlined their expectations for a healthcare entity’s compliance program, one size does not fit all! In this session, PYA will share leading practices in effective compliance programs for organizations of all shapes and sizes. In fact, one of the most mature compliance programs recently assessed by PYA is a Montana Critical Access Hospital. We provided specific, actionable activities any organization—even those with limited resources—can implement to demonstrate it meets the government’s expectations for an effective compliance program. We provided tools, checklists, thought leadership, and advice to compliance officers who are wearing “multiple hats” in their organizations.
Post-PHE Telehealth and Virtual Services
– Martie Ross, PYA Principal
The end of the COVID-19 public health emergency (PHE) also means the contraction of expanded telehealth coverage. In addition to detailing what services will remain covered for how long and under what conditions, this session explained how providers can use virtual services to fill the gaps left by the telehealth rollback. At the end of this session, attendees were able to list the key components of successful telehealth and virtual services programs in rural communities and develop a sustainability plan for telehealth and virtual services programs based on adequate reimbursement.
Price Transparency—Requirements, Outcomes, and Using the Data in Contracting
– Jane Jerzak, PYA Principal
– Kathy Reep, PYA Senior Manager
As of January 2021, hospitals are required to comply with price transparency requirements issued by the Centers for Medicare & Medicaid Services (CMS). These requirements include posting a machine-readable file containing payer-specific negotiated rates and a second file with at least 300 shoppable services. This session explored the requirements for posting data as well as compliance concerns, including identified errors in current reporting, and what the data is showing as it pertains to hospital charges and negotiated rates. In addition, the session looked at the use of this data in managed care contracting.
Pursuing Health Equity Through Regulation and Reimbursement
– Kathy Reep, PYA Senior Manager
– Martie Ross, PYA Principal
CMS made health equity the first pillar of its latest strategic plan. The agency is committed to “designing, implementing, and operationalizing policies and programs [to] eliminate avoidable differences in health outcomes experienced by people who are disadvantaged or underserved.” PYA Principal Martie Ross and Senior Manager Kathy Reep explained those policies and programs and discuss their impact on providers. Martie and Kathy addressed CMS’ definition of health equity, health-equity-related quality reporting requirements, patient screening for health-related social needs, the impact of Z-codes, and the incorporation of health equity into strategic plans.
Cyber Security: Big Fish, Small Fish…Sharks Eat Them All!
– Barry Mathis, PYA Consulting Principal
Rural hospitals are breached at nearly the same rate as large hospitals. Information Technology (IT) and Cyber Security continue to challenge rural healthcare as outside attacks grow at an alarming rate. Additionally, federal requirements are undergoing an overhaul that will likely result in more unfunded IT security mandates that could bring rural hospitals to a financial breaking point.
This session covered:
- The current cyber security environment in rural healthcare, including what is expected and what is ahead for cyber security requirements.
- Information for starting and developing a program to reduce and manage cyber security risks, as well as common practices.
- Tips and best practices to assist in the execution of a cyber security risk assessment.
The conference took place September 21-23, 2022, in Billings, Montana.
If you would like additional guidance with cybersecurity, telehealth, price transparency, health equity, or any matter related to compliance, valuation, or strategy and transactions, one of our executive contacts would be happy to assist. You may email them below, or call (800) 270-9629. Learn more about the PYA Center for Rural Health Advancement here.
