2019 Reducing Hospital Readmissions Forum
Reduce Hospital Readmissions through Enhanced Discharge Planning, Improved Payer-Provider Collaboration, and an Efficient Care Transitions Program
June 20-21, 2019 • Paris Las Vegas • Las Vegas, NV

2019 Reducing Hospital Readmissions Forum

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About the Conference

Readmissions within 30 days of discharge can easily be among the most costly to hospitals, with some estimates putting it at over $41 Billion.

With the institution of new CMS regulations, hospitals & health systems now face increased exposure to penalties and general financial risk in their ever more daunting challenge to reduce preventable readmissions, and simultaneously improve quality care, performance and patient health.

By attending the 2019 Reducing Hospital Readmissions Forum, you will be able to prepare for and learn to anticipate the challenges faced in utilization management, clinical integration, patient care and reimbursement. Our speaking faculty of health industry experts from hospitals, health systems and health plans will equip you with the knowledge and strategies for 2019 and beyond. To register or get more information please visit our website at www.brinetwork.com or call us at 800-743-8490.

Register Early and Save! For Groups of 3 or more please call us for additional discounts. We look forward to seeing you in Las Vegas!

Who Should Attend?

Hospitals/Health Systems/Health Plans

  • Medical Management
  • Operations
  • Quality
  • Patient Financial Services
  • Emergency Department
  • Case Management
  • Nursing
  • Admissions
  • Care Management
  • Medical Records
  • CEO
  • CFO
  • COO
  • Finance
  • Denial Management
  • Billing
  • Compliance
  • Patient Flow
  • Public Relations
  • Administrators
  • Office Managers

Also of Interest to Consultants; Vendors; Solution Providers; TPA’s and Outsourcing Companies

Conference Agenda

Day One – Thursday, June 20, 2019

7:15 a.m.

Conference Registration & Morning Breakfast

8:00 a.m.

Chairperson’s Opening Remarks

8:15 a.m.

Transforming Care Delivery to Reduce Hospital Readmissions: Focus on Transitions Planning and Cross Continuum Interventions

With the evolving landscape of healthcare continually focusing on optimizing clinical outcomes, improving the quality of care while ultimately trying to drive down healthcare costs, CMS and other insurers have started to more intently focus on the concepts of Post Acute Transitional Care. Developing better care coordination and departmental alignment between the hospital side and the outpatient side of the continuum of care is tantamount to successfully breaking down the silos and bridging the parking lot for post-acute transitional care.

In this presentation, the following topics will be discussed:

• Operational assessment of existing Quality programs for both inpatient and outpatient
• Enhancing Transitional Care Management and Care Coordination Management
• Use of other community resources to assist in post-acute transitional care

Ron Martinson, MD, MSM-HCA, CPE, FAAFP
Community Medicine Officer
Knox Community Hospital

9:00 a.m.

Reducing Readmissions by Addressing Disparities

Health disparities can be defined as inequalities that exist when members of certain population groups do not benefit from the same health status as other groups. The evolving definition of diversity is inclusive of race, ethnicity, language preference, disability status, gender identity, sexual orientation, veteran status, and socioeconomic factors. Health care disparities impact quality of care, health outcomes and overall cost of care. For example, racial and ethnic minorities are more likely to experience medical errors, adverse outcomes, longer lengths of stay and avoidable readmissions (HRET, 2013). Disparities also impact the cost of care; a Kaiser Family Foundation report found that 30 percent of direct medical costs for African Americans, Hispanics, and Asian Americans are excess costs due to health inequities (KFF, 2012). This session will highlight one institution's journey on collecting expanded demographics and addressing a specific health disparity related to readmissions.

Lisa C. Carter, MA, RN
Nurse Administrator, Department of Nursing
Mayo Clinic, Rochester, MN

9:45 a.m.

Networking Break & Refreshments

10:15 a.m.

Innovative Interventions focused on High Risk Patients with Socioeconomic Barriers; Community Partnerships &Care Transitions

The identification of High-Risk patient populations is an opportunity to develop a robust safety net of resources designed to provide a safe transition into the community setting after an acute care stay. The Transition Clinic is staffed with Physician/Advance Practice Providers, Certified RN’s, Diabetes Education, Respiratory Therapists, and Social Work. Referrals come from multiple settings, ED, Inpatient Hospital Providers, and Nurses, Community Providers and Social Work/Case Management. Patients in the clinic are screened for food insecurity, transportation needs, Primary Care access, medications, and DME requirements. This team works to create a treatment plan focused on the patients’ needs and screening outcomes. Partnerships with local food bank, pharmacy, Community Health Care Center with PCMH, Home Provider services, Transportation and home health and post-acute facilities have been developed. Recently interventions have expanded to provide services for surgical patients who have chronic conditions that may impact their surgical recovery; diabetes, heart failure, and COPD. These can be provided pre-op or postop/discharge depending on the urgency of the surgery. Contracts have been developed which provide specific surgical procedures to patients who are unfunded yet need the surgery. The intention is to provide the surgery before the patient becomes acutely ill and has a greater risk for complications, and reduce the ED Utilization. Any patient who engages in the Transition Clinic is evaluated for PCP or PCMH needs and aligned appropriately with these resources in order to ensure ongoing care. Utilizing these transition interventions has resulted in a lower readmission rate for the patients that utilize the clinic and support services process.

Michelle Nelson
Senior Director of Health Improvement
United Regional

11:00 a.m.

Assessing SDOH in Reducing Avoidable Hospital Readmissions

Hospital readmissions are often thought to be a failure of the transitions/discharge plan or lack of patient follow through. But in many cases, the readmission may be related to a failure to assess the social determinants of health (SDOH) associated with the patient and family caregiver’s physical environment, economic stability, education, social context or even healthcare experience. Understanding and assessing these concerns is important at each level of hospital admission; emergency department, observation or inpatient.

Learning Objectives:

1) Assess the contributing factors which play significant roles in determining the health of an individual.
2) Identify the issues and barriers to assessing SDOH in the hospital prior to discharge/transition.
3) Review various assessment tools for evaluating social determinants of health
4) Reflect on ways to utilize the data from an SDOH assessment to support patient shared decision making with the collaborative care team and care coordination
5) Evaluate the ability to improve patient engagement and management outcomes through enhanced SDOH assessment

Cheri Lattimer
Executive Director
NTOCC

11:45 a.m.

Examining Multi-Interdisciplinary Strategies to Reduce Hospital Readmissions

The multidisciplinary approach to prevent 30-day hospital readmissions requires the application of a risk tool to help identify patients at high risk of readmission. Incorporating historical claims data, and the EMR, as well as social and demographic data, can improve the identification of high-risk patients. Claims data can also determine previous cost and utilization of services; incorporating claims threshold of spend is an additional risk factor.

Kasey Schnelby, DNP
Strike Team, Process Improvement
Adfinitas Health

12:30 p.m.

Luncheon for Speakers & Delegates

1:30 p.m.

How Predictive Analytics Models for Readmissions Can Assist in Reducing Readmissions

Ardent Health Services uses EPIC for their EMR. We have recently implemented Predictive Analytics which changes the way the entire team looks at preventing readmissions. Preventing readmissions should be a team approach, and the predictive analytics tools helps acute facilities provide more education including the patient and primary caregiver as a critical component to successfully preventing readmissions.

Jennifer Woolsey, BSN RN CCM
Assistant VP Case Management
Ardent Health Services

2:15 p.m.

Creating Payer and Provider Partnerships to Reduce Hospital Readmissions

Annette Kline, RN, BSN, MBA
Sr. Director, Clinical Affairs & Clinical Business Development
UPMC Health Plan

3:00 p.m.

Networking Break & Refreshments

3:30 p.m.

Improving Communication and Team Collaboration to Reduce Hospital Readmissions

Avoidable Hospital readmissions is a systemic problem plaguing healthcare facilities across the county. As Hospitals and Health systems pursue strategies to mitigate hospital readmissions impact on the bottom line and patient throughput, taking a multidisciplinary approach to patient care, and improving communication and collaboration especially around the discharge process is a pivotal part of the process. The involvement of Patient Transport Services is vitally important to the success of this approach, especially when it involves creating an effective patient-centered discharge plan. Recognizing that Patient Transport Services has minimal impact on the overall objective of the Hospital to reduce readmission, our involvement in the plan centered around the area we controlled and made the greatest impact on the throughput systems as well as those who greatly impact the charge to reduce Hospital Readmissions.

Shawn Roberts, Ysp, BA, MA
Resident Regional Director, Patient Transport Services
The Mount Sinai Health System

4:15 p.m.

Impact of Pharmacists’ Tools on Readmissions

Lucas K. Nyabero, PharmD
Pharmacist/CEO
NewSpring Pharmacy

5:00 p.m.

End of Day One

Day Two – Friday, June 21, 2019

7:15 a.m.

Morning Breakfast

8:00 a.m.

Chairperson’s Recap of Day One

8:15 a.m.

Reducing Psychiatric Readmissions

Many emergency departments across the country board psychiatric patients for days to months waiting for an inpatient bed. Psychiatric observation is one means not only to deal with boarded psych patients but to improve the care the patient receives in the emergency department. Rather than holding a bed in the ED and losing potential income hospital can bill for observational care. This presentation will discuss the means to start psychiatric observation unit and case studies of successful units.

Leslie Zun, MD
System Chair of the Department of Emergency Medicine; Chair and Professor in the Departments of Emergency Medicine and Psychiatry
Rosalind Franklin University

9:00 a.m.

Bringing Care to the Home After Discharge: Owning the Final Mile to Reduce Hospital Readmissions

With today’s focus on readmissions, the healthcare industry now understands that the ability to risk stratify a population is first and foremost in any journey to reducing discharge bouncebacks, but we also understand that social determinants like caregiver support, socioeconomic segmentation, and health literacy are just as important in risk stratification models as clinical diagnosis. What we as an industry are just now waking up to is the fact that just stratifying patients without interventions and solutions make programs limited at best in success. Ochsner Health System understands this and has developed an innovative solution to assist those patients that are both faced with high clinical acuity as well as social determents that make timely, effective follow-up care management difficult. Ochsner has developed a cutting-edge provider driven transitional care program that takes care directly into the homes of a targeted segment of the discharge population, this has turned out to be one of our missing links in the prevention of readmissions. By the end of this session, you will be able to

• Understand the concept of owning the final mile
• Be able to implement a risk stratification model that includes home care management as an option
• Review data from Ochsner Health System on outcomes
• Review a work plan document for rolling out a program of your own

Mark Green
Assistant Vice President, Transitions of Care & Post-Acute Care
Ochsner Health System

9:45 a.m.

Networking Break & Refreshments

10:15 a.m.

Examining Initiatives within Emergency Medicine Department and Patient Flow to Reduce Hospital Readmissions

An academic hospital’s ED experience with managing capacity, patient flow, and readmissions through care pathways, inter-department collaboration, alternative care spaces, and lean methodologies.

Dr. Sam Shen
Medical Director, Emergency Medicine
Stanford Healthcare

Patrice Callagy
Director, Emergency Services
Stanford Healthcare

11:15 a.m.

Pediatric Care Coordination: Best Practices to Avoid Readmissions

This children’s hospital required a strategy to reduce 7-day readmission rates by 10% over the course of a year. Evidence-based interventions known to lower readmission rates include identification of at-risk patients, clinician feedback, scheduling follow-up appointments and evaluation of the efficacy of discharge planning. This session will provide an overview of focused improvements that resulted in a 13.7% reduction in the 7-day readmission rate rolling average. Case management surveys in the emergency department, garnering and sharing feedback on the quality of discharge plans, technical improvements in arranging follow-up appointments and follow-up calls have proven to be effective interventions.

1. Demonstrate the effectiveness of a collaborative approach to reduce pediatric readmissions
2. Discuss the involvement of parent partners in readmission prevention
3. Share tools for readmission review that enhance effectiveness in metrics reporting

Cyndi Fisher, RN, MSN, CPNP, ACM
Director, Case Management & Care Connection
Children’s Hospital of The King’s Daughters (CHKD)

12:00 p.m.

Examining Innovations to Decrease Hospital Readmissions

Sonya Streeter
Senior Researcher
Mathematica Policy Research

12:45 p.m.

Conference Concludes

Workshop – Friday, June 21, 2019

1:00 p.m. – 3:00p.m

Incorporating Effective Strategies on Hospital Readmission Reduction – Examining Current Regulations and Value-Based Initiatives

Featured Speakers

Ron Martinson, MD, MSM-HCA, CPE, FAAFP

Ron Martinson, MD, MSM-HCA, CPE, FAAFP

Community Medicine Officer

Knox Community Hospital

Lisa C. Carter, MA, RN

Lisa C. Carter, MA, RN

Nurse Administrator, Department of Nursing

Mayo Clinic

Michelle Nelson

Michelle Nelson

Senior Director of Health Improvement

United Regional

Cherri Lattimer

Cherri Lattimer

Executive Director

NTOCC

Kasey Schnelby

Kasey Schnelby

Strike Team Process Improvement

Adfinitas Health

Jennifer Woolsey, BSN, RN, CCM

Jennifer Woolsey, BSN, RN, CCM

Assistant VP, Case Management

Ardent Health Services

Annette Kline, RN, BSN, MBA

Annette Kline, RN, BSN, MBA

Sr. Director, Clinical Affairs & Clinical Business Development

UPMC Health Plan

Shawn Roberts, Ysp, BA, MA

Shawn Roberts, Ysp, BA, MA

Resident Regional Director, Patient Transport Services

The Mount Sinai Health System

Sam Shen, MD

Sam Shen, MD

Medical Director, Emergency Medicine

Stanford Healthcare

Leslie Zun, MD

Leslie Zun, MD

System Chair of the Department of Emergency Medicine, Chair and Professor in the Departments of Emergency Medicine and Psychiatry

Rosalind Franklin University

Mark Green

Mark Green

Assistant Vice President, Transitions of Care & Post-Acute Care

Ochsner Health System

Patrice Callagy, RN, MPA, MSN, CEN

Patrice Callagy, RN, MPA, MSN, CEN

Director, Emergency Services

Stanford Healthcare

Cyndi Fisher, RN, MSN, CPNP, ACM

Cyndi Fisher, RN, MSN, CPNP, ACM

Director, Case Management & Care Connection

Children’s Hospital of the Kings Daughters (CHKD)

Lucas K. Nyabero, PharmD

Lucas K. Nyabero, PharmD

Pharmacist/CEO

NewSpring Pharmacy

Sonya Streeter

Sonya Streeter

Senior Researcher

Mathematica Policy Research

Gerald Rupp, PhD

Gerald Rupp, PhD

Chief Innovation Officer

Fusion5

Venue

Paris

Paris Las Vegas
3655 S. Las Vegas Blvd.
Las Vegas, NV 89109
702-946-7000

Sponsors and Exhibitors

TBA

FAQ

Are there group discounts available?

  • Yes – Register a group of 3 or more at the same time and receive an additional 10% off the registration fee

Are there discounts for Non-Profit/Government Organizations?

  • Yes – please call us at 800-743-8490 for special pricing

What is the cancellation policy?

  • Cancellations received 4 weeks prior to the event will receive a refund minus the administration fee of $225. Cancellation received less than 4 weeks prior to the event will receive a credit to a future event valid for one year.

Can the registration be transferred to a colleague?

  • Yes – please email us in writing at info@brinetwork.com with the colleague’s name and title

Where can I find information on the venue/accommodations?

  • Along with your registration receipt you will receive information on how to make your hotel reservations. You can also visit individual event page for specific hotel information. The conference fee does not include the cost of accommodations.

What is the suggested dress code?

  • Business casual. Meeting rooms can sometimes be cold so we recommend a sweater or light jacket

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