Knowledge Expansion

An MGMA DataDive user’s guide to Nashville

Insight Article

Benchmarking & Forecasting

Data Analytics & Reporting

Provider Compensation

MGMA Staff Members

Nashville owns the title of “Music City, U.S.A.” and a reputation for country music, but it’s no surprise to most of us that Nashville is also a big city for healthcare. 

The Bureau of Economic Analysis in December pointed to the healthcare industry accounting for $11 billion of the city’s economy in 2018, or roughly $1.50 of every $10 of total economic value, per number-crunching done by Civic Analytics. That same report puts Davidson County, Tenn. — home to Nashville — first among the largest 100 counties in the nation in terms of healthcare as a percentage of total gross domestic product (15.3%, to be precise). 

There are big names in healthcare in Nashville, to be sure — too many to mention here. But consider that Nashville was home to Brad Smith, who recently was appointed to lead the Center for Medicare & Medicaid Innovation (CMMI)

That seems like just the place for MGMA20 | The Financial Conference, March 5-7, at the Renaissance Nashville Hotel. 

For MGMA DataDive users, the conference brings together leading financial experts to share the secrets to thrive during challenging times by digging deep into data, payer contracting analysis and negotiation, business intelligence and revenue cycle management best practices. 

Hear more about the conference on the MGMA Insights podcast

Here are a few of the can’t-miss sessions at the upcoming conference: 

Navigating the unknowns of an underperforming revenue cycle 

The move to value-based care has created headaches for many healthcare organizations, especially when it comes to realigning expectations and strategies for revenue. But according to Harold McDonald, MBA, vice president of revenue cycle, Medi-Centrix, the right analytic tools and a fresh mindset can dramatically transform the notion of revenue cycle management.  

“A key consideration is to ask, ‘How are you actually measuring performance?’ You need to get [over] the idea of measuring based on your budget or your financial projections and more naturally look at your actual yield,” McDonald said. “I think people are being seduced by the bright, new shiny object, which is the whole idea of value-based care. The reality is that probably 90% of your business is still really driven by the fee-for-service world, so you can’t ignore it.” 

McDonald will discuss revenue cycle strategy along with two executives from New Jersey’s Jefferson Health: Jennifer Lucas, MBA, senior director of finance and decision support, and Carmen Ciervo, DO, FACOFP, chief physician executive and executive vice president. 

Using analytics to streamline the revenue cycle 

Manual data processing in your revenue cycle is an area prone to things going wrong. From something improperly keyed to the difficulty of maintaining dozens of spreadsheets, there’s ample opportunity for error. 

When it comes to smaller medical practices, those minor errors become compounded when billing staff take vacations, call in sick and otherwise cause the work to pile up. Finding the right degree of automation will be the focus of a session co-presented by Andrea Vitalich, clinic administrator, Pacific Rim Orthopaedic Surgeons, PLLC, and Matt Seefeld, executive vice president, MedEvolve. 

Vitalich and Seefeld will identify administrative pain points that impact a practice’s bottom line, as well as point out opportunities exist to improve billing, collections and claims. 

Transforming primary care 

The rapid transition to a risk-based model has many healthcare providers searching for strategies to make the best of new payment directives from the Centers for Medicare & Medicaid Services (CMS). As five new payment models have been introduced as part of the CMS Primary Cares Initiative under an umbrella of two new tracks (Direct Contracting and Primary Care First), it’s even more critical to think ahead on how to embrace the changes.   

Clive Fields, MD, with VillageMD, and Jim Daniel, JD, MBA, Hancock, Daniel & Johnson, P.C., are experts on what providers can expect as the new payment models are rolled out, as well as the specific impacts they may have on primary care. Succeeding in a largely risk-bearing payment model requires a comprehensive and committed approach — from the top down, according to Fields and Daniel. 

“If a CFO or a risk-bearing entity can’t change culture inside an organization to truly be primary care, they’re going to fail,” Fields said. “I would look at it as a very challenging cultural place where people have moved away from a fee-for-service, fee-driven, procedure-oriented environment. Once you have truly embraced risk, it needs to be adopted culture-wide.” 

What else to watch for 

  • Before the conference officially kicks off, consider joining one of the two preconference sessions: 

  1. PRE101: The Payer Contracting Processing: Negotiating and Managing Like a Pro, with Penny Noyes, CHC, President, Health Business Navigators 
  2. PRE102: Measure and Evaluate your Revenue Cycle Model, with Shawntea Moheiser, CMPE, CMOM, Owner, ITS Healthcare, LLC; and Kem Tolliver, CMPE, CPC, CMOM, President, Medical Revenue Cycle Specialists 
  • On the final day of the conference, join MGMA Government Affairs’ Mollie Gelburd, JD, associate director, for CON703: The Evolving Medicare Payment Landscape, for valuable insights on MACRA implementation to date and how to compare the potential upside and downside of participation in MIPS and APMs. 

Join us in Nashville 

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