Coffee with Coker

Every month, Coker Group hosts a webinar around one of the industry’s pressing issues. With a diverse group of consultants with expertise and experience in an array of areas in finance, strategy and operations, and technology, each month our audience receives a new perspective on a fresh topic.

To see what we will be talking about in our next installment of Coffee with Coker, follow the link below to begin receiving monthly invites, or visit this page as updates become available.

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April 2018: Coffee with Coker – EHR to EHR Conversion: Streamline Healthcare Legacy Data Management

When: April 19, 2018, 2:00pm – 3:00pm EDT
Where: Register to receive web link
Speaking: Chris Torregosa, Senior Manager | Coker Group
Charlie Wood, Manager | Coker Group
Jay Cannon, Principal | Trinisys

About the Webinar: 

Today’s rapidly evolving healthcare IT environment is often further stressed by the need to address legacy clinical systems that result from acquisitions, divestitures, and the ongoing need to consolidate nonstrategic clinical systems. These scenarios create a dilemma related to the critical decisions facing an organization. Where do they begin and what are the best options for legacy systems? Other considerations must be made on how to best meet the needs of clinical team’s reliance on historical data, requirement to support existing operational processes, and compliance with data governance requirements.

This webinar will clarify the decision making process for legacy clinical systems and guide organizations to avoid the risks associated with not having a definitive plan in place.

Learning Objectives:

Attendees of this session will learn steps to successfully streamline healthcare legacy data management:

  1. Assess — Conduct a comprehensive assessment of your current clinical application environment (systems and utilization) in order to identify needs and work toward an optimal future environment
  2. Benchmark – Establish a baseline in order to measure ROI across cost savings, security compliance risk, system data accessibility, quality of data, etc.
  3. Solve — Vet solution providers to ensure the right technology and processes are selected
  4. Plan — Create a detailed roadmap that outlines resources, timelines, costs, and success criteria associated with the project phases then execute toward completion

Register Now.

Past Coffee with Coker Webinars

Coffee with Coker webinars are recorded and kept on file for healthcare provider’s who are unable to attend at the time of the event. If you are part of a healthcare provider organization and are interested in past webinars you can request recordings here.

March 2018: Maximize Your Practice Operations

This presentation reviewed, in detail, the revenue and expense aspects entailed in Maximizing Practice Operations (e.g., increasing profitability/margins). The session:

  • Reviewed why you cannot “cut” your way to profitability
    • some expenses (e.g., “investments”) enhance profitability
  • Provided readily deployable solutions to impact clinic profitability
  • Considered MACRA/MIPS and how administrators can manage to profitability under those constructs

February 2018: 2018 MACRA Updates: What Does this Mean for Providers?

The first year of MACRA data reporting showed that merely reporting information to CMS is a challenge for many provider organizations, especially small rural providers. The good news is that in response to these difficulties CMS agreed to modify some of the requirements within the MACRA quality payment programs and to be more flexible in rolling out this legislation over the years to come. Nevertheless, it should be assumed that the MACRA program will stay on track and be fully implemented by January of 2019. All providers should begin now to plan and prepare for this inevitability.

So, it is time to report on what transpired during 2017 and how to prepare for MACRA now that we are in 2018 and must prepare for full implementation in less than one year. This webinar reflected on what the success or failure of MACRA says about the transition of the healthcare reimbursement system from a primarily fee-for-service (FFS), volume-based system, to a more fee-for-value (FFV), value-based system. Webinar attendees learned to:

  • Identify the changes made to MIPS and APM quality payment programs within MACRA since their initial 2016 rollout
  • Review the implications of these changes for providers in 2018 and what this means for other value-based reimbursement changes after that
  • Discuss recommendations on how providers should proceed in 2018 as they prepare for MACRA to be fully implemented in January 2019

January 2018: Patient Panel as a Principle Element of Provider Compensation

Understanding patient panel is essential to achieving success in a value-based environment. Payers have begun providing financial rewards and penalties to providers based on panel management and associated outcomes. During this webinar, we explored the importance of identifying the patient panel as well as practical strategies for aligning provider compensation with patient panel as a means of encouraging provider and organization alignment. Participants of this session learned to:

  • Define a Patient Panel
  • Understand Why Patient Panel is Key to Achieving Success in a Value Based Environment
  • Explore How Patient Panel can be Leveraged to Gain Clinical Efficiencies
  • Understand Impact of Patient Age, Gender and Acuity on Patient Panel
  • Learn Common Panel Calculation Methodologies
  • Use Patient Panel as a Provider Compensation Strategy

December 2017: Achieve Long-Term Value Creation from Healthcare Transaction Strategies through Effective Post-Merger Integration

Mergers and acquisitions (M&A) is not a new concept for hospitals and other healthcare industry organizations, particularly during the era of hospital-physician alignment. Making M&A transactions work, however, is an entirely different exercise, and increasingly challenging in today’s marketplace.

The foundation of this discussion is to first define what we mean by “makes a transaction work”? Here we are referring to a transaction that results in long-term value creation for all stakeholders, and evidence shows that this is a more challenging achievement when evaluating hospital mergers compared to assessing short-term success. Measuring the true success of a transaction requires a look far beyond the initial perspective of fit and financial returns, focusing instead on whether the affiliation resulted in compelling value realized over an extended period.

So, how can we ensure such strategies are truly resulting in long-term value for these organizations, as opposed to just short-term tactics implemented on a reactionary basis? This is where effective post-merger integration comes into play. In this webinar we discussed the vital points organizations should follow when pursuing long-term value from transactions. This session focused on the following key objectives:

  • In-depth look at the seven key steps a healthcare organization should address when evaluating and going through a strategic transaction
  • Discuss the primary variables that make a transaction successful for healthcare organizations
  • Address the difference between simply getting a deal done and ensuring a deal creates long-term value for the combined organization after the transaction is complete
  • Diagnose major pitfalls that detract from the potential long-term value creation of transactions involving healthcare organizations
  • Introduce and evaluate case studies of healthcare transactions that resulted in varying levels of long-term value, growth, and success

November 2017: Revenue Cycle Turnaround: Rebuilding for an Advanced ROI – A Case Study

The devil is in the details when examining the health of the Revenue Cycle (RC) ecosystem. Sometimes figures and reports don’t tell the entire story. What may look like a sound days in accounts receivable (AR) measurement (e.g., 30 days), can actually mask systemic problems in processes and procedures. If data reported are inaccurate, miscalculated, or outright corrupt, leadership may not learn about the issues until revenue wanes.

 This webinar used a real-world case study to illustrate the signs of an in-danger RC that can be overlooked and how Coker helped one organization turnaround a 14 to 1 return on investment (ROI). The health system’s situation was reviewed to show their struggle with their RC as a new Chief Operating Officer (COO) wondered why things were not moving ahead smoothly for the several-hundred provider organization. Participants of this session learned to:

  • Review the dynamic of an RC and where trouble spots loom
    • Apply those concepts to a “real world” scenario
  • Understand the process for a complete review and fix (hint: it’s not all in billing and collecting)
  • Determine why numbers don’t tell the entire story and how to dig deeper into a troubled RC
  • Learn how one “fix” does not fix all RCs

October 2017: Lessons Learned from Most Infamous Security Breaches from 2017

This webinar was a conversation about the top most infamous Security Breaches from 2017 and why they matter to the Medical Industry. During this webinar we focused on best practices for how to mitigate risk from these new threats. We also explored the updated OCR regulations and notifications and how they can impact your medical specialty.

September 2017: Risky Business: Improper Documentation and Billing Practices

The advent of the electronic health record and resulting increased dependence on electronic technology impacting every facet of the healthcare continuum frequently results in a virtual quicksand of delays and frustration for providers and staff in practices across the entire country. Adapting to the documentation and quality requirements imposed by government and private payers has resulted in decreased provider productivity when the demand for healthcare services is surging to an all-time high as baby boomers flood the Medicare age bracket. In order to meet the patient demand, creative tactics and questionable shortcuts have been adopted in many practices in an effort to ease provider frustrations and put them back on track with meeting their productivity expectations and goals.  Being able to recognize potential compliance risks and making changes to correct these habits will keep your practice on the right path. A few well-placed questions can pinpoint areas in the daily workflow that may expose your practice to increased scrutiny. Participants of this session learned how to:

  • Identify internal processes that expose your practice to increased risk.
  • Recognize documentation elements that do not meet coding and compliance standards.
  • Identify the functional limitations of support staff in the documentation process.
  • Determine incongruent coding patterns between providers within your organization.
  • Understand the need for regular internal and external coding and billing reviews.

August 2017: Ambulatory Risk Adjustment Coding and Clinical Documentation

With the advent of value-based reimbursements, such as MACRA, clinical documentation and coding in the ambulatory space just got a lot more complicated and important. Risk adjustment coding, i.e., the capturing of hierarchical condition categories and other information used to risk adjust quality and cost performance, is going to be an essential way in which providers can ensure they receive credit for the severity of illness and clinical complexity of their patients. In this Coffee with Coker presentation, Dr. Ellis “Mac” Knight, an experienced physician, further explored this important topic and outlined what provider groups (hospitals and physician practices) need to do now to shore up their capabilities in this area.Participants of this session learned how to:

  • Explain how hierarchical condition categories (HCCs) and other clinical documentation is used to risk adjust performance in the MACRA Quality Payment Program and other value-based reimbursement models.
  • Define the essential components of an ambulatory clinical documentation improvement (CDI) program.
  • List those payment models within which risk adjustment factor (RAF) scores are utilized.
  • Design coding and ambulatory CDI programs that can withstand outside RAC or RACV audits.

July 2017: Strategic Planning Retreats: Kick-Start a Sustainable Strategic Plan

Strategic planning retreats are being used more frequently by hospitals and physician practices to accomplish several items, including (1) provide a forum for education, (2) assess the organization’s current strategic, tactical and operational issues, (3) vet outstanding issues that require remediation, and (4) develop strategies for both the short and long-term future. This session focused on how to prepare for a strategic planning retreat, typical topics to consider, and ways to ensure it goes beyond just one good day of planning into an actionable plan for the future. Participants of this session learned how to:

  • Define steps to take to prepare participants for the retreat, including sample “homework” assignments to be completed prior to the retreat
  • Identify key issues typically addressed during a strategic planning retreat
  • Understand how to drive toward definitive decisions as to how to address these key issues, post-Retreat
  • Evaluate methods to increase participation and engagement during the event (and tips to curtail monopolizing or tangential discussions)

June 2017: Special Edition Panel Discussion – 2017 Mid-Year Update on the Healthcare Industry: How are Organizations Successfully Responding to Value-Based Reimbursement Changes?

Through a special edition Coffee with Coker, a panel of experts discussed real world examples of how healthcare organizations are responding to value-based reimbursement changes, such as bundled payments, MIPS, and APMs. Through case studies, we reviewed impacts on hospitals, health systems, and physician practices. We highlighted challenges that affect providers, common mistakes made, and best practices that allow organizations to successfully navigate the new reimbursement structures. Participants of this session learned how to:

  • Understand the differences between value-based payment models and their strategic and financial effects on an organization.
  • Review the pros and cons of each payment model as relates to various types and sizes of healthcare organizations.
  • Evaluate different alignment strategies that may be used to take full advantage of the value-based payment models.
  • Discuss technology needs in a value-based era and how this technology can be an operational, clinical and financial asset to your organization.

May 2017: Top Health IT Trends and Innovations for 2017: What you Must Know to Stay Ahead in Today’s Market

Healthcare IT continues to see a dizzying pace of change. Computer system performance increases almost daily while costs to acquire and run these more powerful computers continue to decrease. New technologies and healthcare apps for iPads, iPhones and other mobile devices are rolling out at an incredible speed. However, concerns about digital security breaches and confidentiality also abound. This session reviewed several of these emerging trends that today’s health IT leaders must know to best position their organizations to improve patient care and reduce costs as the industry transitions to value-based care. Participants of this session learned how to:

  • Understand the key business imperatives that are driving health IT innovation.
  • Gain insight into how key emerging technologies can improve care, increase quality, and reduce cost.
  • Obtain ideas for determining which trends are most relevant to you and your organization.

April 2017: Developing Your Future Leaders

As the healthcare industry continues to shift from fee-for-service to fee-for-value, it is critical to have the right leadership in place. All too often organizations do not spend enough time to identify high potential future leaders within their teams, and more importantly lack a consistent method for developing and mentoring them. They often lose great talent to their competition, and have to hire and train new employees in a tight talent market. This webinar explored best practices for identifying high potential future leaders, and shared strategies to mentor and groom high potential employees to success transition into key leadership roles. A case study was used to illustrate how an organization identifies high potentials and develops them into effective leaders. Participants of this session learned how to:

  • Identify the keys to implementing a strategy to evaluate the current talent landscape and identify high potentials with their organization
  • Learn keys for effectively developing talent into effective leaders for the organization
  • Understand the current healthcare talent landscape, and the implications of top talent attrition.
  • Gain a perspective of how other healthcare organizations are developing their high potential team members into effective leaders.

March 2017: Prepare Your IT Systems to Embrace Future Shifts in Revenue Cycle Management

As the healthcare industry continues to shift from fee-for-service to fee-for-value, it is critical to examine the use of technology and the processes and procedures for revenue cycle management (RCM). Many organizations with currently stable information technology (IT) solutions and RCM processes will find these solutions and processes out-of-date in the context of MACRA/MIPS and bundled payments. Will your RCM and IT backbone be ready and able to administer these matters to ensure good data, sound billing, and accurate and timely follow-up? Now is the time to review your baseline and your IT system’s capability for both traditional and global reimbursement models. Participants of this session learned how to:

  • Learn how the fee-for-value shifts are affecting healthcare IT systems and the RCM process.
  • Understand the connection between technology and revenue in the context of a fee-for-value marketplace.
  • Identify the steps needed to position their healthcare organizations for success in the future landscape of healthcare.

February 2017: Bundled Payments: What All Providers Should Know About This Emerging Payment Model

Bundled Payments are becoming more and more recognized as the preferred method of value-based reimbursement by CMS and several other commercial payers. In this presentation this type of payment method will be explained in detail and real-life examples will be given of how bundled payments actually work. In addition, providers will learn ways to optimize their performance under a bundled payment paradigm and how to negotiate bundled service agreements to their best advantage. Participants of this session learned how to:

  • Explain the key components of bundled payments and how this reimbursement methodology works.
  • Describe the main differences between bundled payments and capitation payments and why one (bundles) is felt to be superior at driving higher value into the healthcare delivery system.
  • List the key capabilities that providers will need to acquire in order to optimize their performance under a bundled payment agreement.

January 2017: Adapting Hospital Employed and Private Practice Compensation Models for Clinical Integration

Physician compensation is changing as rapidly as the reimbursement environment, with practically all hospitals and medical practices asking questions surrounding “what should we change” and “when should we change”, along with many other questions. The challenges faced by both hospitals and private groups are real, with different approaches to address each. However, in the midst of the challenges are incredibly opportunities to further link the method by which physicians are compensation more solidly into the mission of the respective organization. This presentation highlighted the key challenges and then provided practice insights into how to adapt both hospital employed and private practice compensation models to the new realities of medicine today. Further, it included examples/case studies of how groups are handling these challenges. Participants of this session learned how to:

  • Identify the challenges that clinical integration and new reimbursement schemes pose to physician compensation
  • Educate on opportunities that exist to modify compensation plans, with specific case studies as to how others are approaching these changes.
  • Provide practice insights into the steps necessary to make the required modifications.


December 2016: Deciphering with is Cyber Security

Cyber security requirements for attesting to Meaningful Use and protecting your environment are rapidly evolving. Understand how your current tools, IT reports, and IT processes should be used for finding, blocking, and deciphering hacking attacks. Understand how the newest cyber-attacks work and what you can do to prevent them or mitigate the damage. With a variety of Cyber Security Risk Assessments attendees gained an understanding of what types of assessments are appropriate for their organization for 2017.

November 2016: From the Brink to Prosperity: An ASC Turnaround

Ambulatory Surgery Centers (ASCs) consist of many moving parts and a multitude of complicated regulations that must intermingle effectively for the ASC to flourish. If one of these components malfunctions, the ASC will suffer. Left unchecked, the financial health of the center will deteriorate. To maximize operational and financial efficiency it is important to understand the basic components at work and discern how well each is functioning. Only then can change occur that reverses downward trends.

Using a case study, this webinar examined the decline of one ASC and the discovery of dysfunction throughout the center. It then contemplated the “baseline” and outlined the structural components necessary to yield positive actualization by both financial and operational standards. The webinar reported on the operationalization and deployment of a broader strategic plan to situate the ASC to stabilize current success and welcome future success. Participants of this session learned how to:

  • Analyze the components of an ASC to discover areas for improvement; we discussed component pieces and examined “broken” items that pushed our client in a downward trajectory,
  • Formulate a strategic plan, and operationalize the plan, to address the ASC as a whole (operationally, clinically, financially),
  • Implement positive turnaround that will address the components of the ASC to afford shareholders both clinical, and financial, peace of mind, and
  • Use the case study presented to delineate potential pitfalls and landmines helping centers avoid issues and navigate toward success.

October 2016: The ICD-10 Freeze is Over: 2017 ICD-10-CM/PCS Coding Updates and the Impact on Clinical Documentation Improvement

This webinar provided an overview of the 2017 ICD-10 coding updates a few weeks after it went into effect on October 1, 2016. The partial ICD-10 code freeze ended with mandated code updates of thousands of ICD-10-CM and ICD-10-PCS. The code updates occurred at the same time that Medicare lifted the moratorium on issuing denials for incorrect code assignments for codes if the code selected was in the correct family of codes. The value-based payment system are based on 2017 claims data. Coding accuracy with appropriate documentation to support it is paramount to success revenue cycle management. The webinar discussed significant ICD-10 changes and how they related to documentation guidelines. Participants of this session learned how to:

  • Increase understanding of the 2017 ICD-10 coding updates and guidelines.
  • Identify documentation gaps related to the 2017 coding updates
  • Utilize concepts learned to develop education for providers

September 2016: Hospital Transaction Strategies: Creating Long-Term Value in a Changing Healthcare Environment 

The focus of this webinar was to address the fresh wave of consolidation (mergers, acquisitions, joint ventures, and physician alignment deals) and how healthcare organizations can ensure or increase the probability of reaching the ultimate result from such strategies, which is value creation. Meaning, how can healthcare organizations achieve quantifiable value over an extended period from their transaction strategies? And, how can leaders within these organizations develop transaction strategies that will result in long-term value? Participants of this session learned how to:

  • Evaluate healthcare industry transaction trends and successful strategies
  • Define what long-term value means and how it should look for healthcare organizations
  • Identify keys to successful transactions and how to avoid pitfalls
  • Outline steps and actions items that leaders can pursue in their transaction strategies
  • Discuss the critical phases of transactions and the steps to effective implementation

August 2016: The Importance of IT Support Working with End-Users to Mitigate Security Issues

We discussed the security risks facing healthcare organization and specific strategies and methods Cybercriminals use to break into an organization to capture data to sell on the black market.  This session outlined methods, tools, and routines to implement to protect your organization before violations occur. It also addressed the need and the mechanisms for gaining support from organizational leaders.Attendees gained the understanding and ability to:

  • Gather the tools for security data collections
  • Gather the technology to monitor the network
  • Create the awareness among employees
  • Develop the communications systems between IT and Staff
  • Gain support from organizational leadership to implement security changes

July 2016: Change is Here: How Value-Based Care Will Impact Medical Practices

We discussed the Care Process Design System (CPDS) and how it positively impacts the operations of practices. The webinar explained a brief history of clinical integration and the changes occurring. It examined MACRA/MIPS and the fact that it’s here. We discussed the costs of care delivery and how care process design can help groups tackle MACRA and ensure profitability under new reimbursement models. Attendees specifically gained understanding of:

  • How new reimbursement models will impact medical partners, both employed and private practices
  • Methods to prepare for MACRA/MIPS
  • How the practices can prepare for, and be, profitable
  • Time activity based cost accounting and the differences between the “old” model and the “new” model

June 2016: Medicare Access and Chip Reauthorization Act: What You Need to Know

Through a panel discussion, we highlighted issues that affect providers as well as our recommendations to providers that will allow them to take full advantage of the changing Medicare reimbursement structure. Webinar attendees learned how to:

  • Identify CMS’s changes to the Sustainable Growth Rate (SGR) and review the expected changes to the physician fee schedule;
  • Distinguish how CMS will score MIPS-eligible clinicians, and predict how those scores will affect their MIPS payment adjustments;
  • Recognize what constitutes an alternative payment model, and determine how providers can qualify to participate in an advanced payment model; and
  • Evaluate the pros and cons of participating in MIPS as well as contrast the various alternative payment models.

May 2016: Developing Effective Physician Leaders

Do you struggle to help your physician leaders with success in non-clinical, leadership roles? Would you like to know how to implement a physician leadership development program? If these questions are important for you and your organization, please keep reading. During this webinar, attendees learned:

  • The importance of strategic physician leadership in value-based healthcare
  • Best practices for implementing leadership development in your organization
  • Recognizing the unique challenges physicians face in leadership positions and how formalized leadership develop programs are essential to physician success
  • Understand how leadership skills are distinguished from the more traditional concepts of leadership
  • Discover ways to improve personal/organizational alignment within your organization

April 2016: Benchmarks and Physician Compensation: What You Need to Know

Hospitals, health systems and physicians alike rely heavily on industry benchmark data. However, improper use of the benchmark data can lead to ineffective compensation models and compliance concerns. The key to an effective compensation strategy is understanding the market trends and the impact they have on your organization as well as properly using all available resources. We highlighted issues we see within the industry as well as new issues arising in the benchmark data due to the paradigm shift from volume to value.

March 2016: Cybercrime – The New Reality

Cybercrime is an intentional attack against an organization’s proprietary data assets. It describes any illegal activity in which a computer is used as a means to commit a crime against another individual’s or organization’s computer, network or data base. Many healthcare organizations have invested millions of dollars building massive computer processors, data bases, wired and wireless networks to connect people together. But how much attention have these organizations given to protecting these investments from today’s cybercriminals? Healthcare C-Suite executives and boards must take a direct interest in protecting their organizations from cybercrime. In this timely webinar, participants got a realistic view into the current state of cybercrime in healthcare, explored several case studies and shared ideas on what an organization can do to protect itself from cybercriminals.

February 2016: Are You on the Right Path to Value?

There are two types of organizations that contemplate a population health management initiative: Those that have started one and those that will be. The failure to initiate the right program at the right time with the right objectives could result in opportunity costs that will potentially have lasting negative affects both financially and operationally. During this webinar, attendees:

  • Gained an up-to-date understanding of the current trends in the commercial and governmental payer sectors around value-based contracting initiatives
  • Reviewed and understood the core, market-oriented questions and conditions that must be addressed when deciding to develop a volume-to-value initiative
  • Understood the continuum of prevailing delivery and risk-based compensation models that accompany various population health programs and their associated challenges and opportunities
  • Learned what are the most common options that are evaluated, chosen, and the key reasons for selecting them

January 2016: Solving the Revenue Cycle Conundrum

During this webinar, we discussed the Revenue Cycle Conundrum, and attendees:

  • Understood the warning signs of a dysfunctional revenue cycle (RC)
  • Reviewed the “broken” RC management system and discuss methods and options to avoid problems
  • Learned “how bad it can be” from a recent case study