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AHVAP Shines at the 2016 Fall IDN Summit

Posted By Administration, Tuesday, October 18, 2016

AHVAP members have attended the IDN Summit at the invitation of the organizers for the last few years.  Lisa Ponssa, Executive V.P. of Healthcare Business Media, first contacted AHVAP because the suppliers who attend the Summit Conference were requesting additional information about Value Analysis and how best to engage in the process.  As a result of this collaboration, AHVAP has had the opportunity to provide education on value analysis for the past couple years and hopefully for many more to come.

We attended the educational sessions and it was a pleasant surprise to recognize the following members who presented or moderated sessions:

  • Sandra Achee, RN, CNOR, Manager Purchasing Product Analysis, Ochsner Health System
  • Kathy Chauvin, RN, Health System Director, Resource Utilization and Value Analysis, FMOL Health System
  • Gloria Graham, DNP, RN, CVAHP, Clinical Materials Specialist, Cincinnati Children’s Hospital Medical Center, President AHVAP, AHVAP Representative
  • Dee Whittington, RN, CEO DKW Consulting
  • In addition to presenters, the following members attended as representatives of their organizations:
  • Becky Severson, Clinical Resource manager, Avera Health
  • Georgia Robson, Clinical Supply Program Director, Banner Health
  • Jennifer Grabski, Value Analysis Manager, Centegra Health System
  • Sandee Schoby, Director Contracting and Resource Utilization, CHRISTUS Health
  • Mark Preston, Director Supply Chain, Confluence Health
  • Cheri Berri Lesh, Value Analysis Manager, Group Health
  • Robert Pimentel, Value Analysis Coordinator, University Health System
  • Jeffiny Shutts, Director of National Accounts, MedApproved, LLC
  • Robin Lane, Senior Manager Value Analysis, Pensiamo, AHVAP Representative
  • Susan Toomey, Value Analysis Coordinator, Lehigh Valley Health Network, AHVAP Representative
  • Mary Potter, AHVAP, Past President, Independent Value Analysis Consultant, AHVAP Representative

Thanks to all of our members for their contributions to Healthcare Value Analysis and helping shed light on what we do and the benefits of our organization.  We hope to welcome soon those that we met as new members as well.

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Message from the President - October 2016

Posted By Administration, Tuesday, October 18, 2016
Gloria Graham

The opportunity to be President of AHVAP has afforded me such an amazing experience, which I will be forever grateful.  As I begin to collect my thoughts for the last newsletter of this year, I would first like to take the opportunity to express my sincere gratitude for all of the hard work and dedication by so many over the past nine months. Your tireless efforts have been inspiring and it has truly been an honor and privilege to work a long side each and every one of you.

As the summer season comes to an end and the earth begins cooling off to slowly prepare for the upcoming fall and winter season, there is an excitement building around the colorful transformation on the horizon.  Soon the trees will be crowned with vibrant hues of crimson, gold and glowing orange that will shortly fall from their branches dancing among the crisp autumn air.  Samuel Johnson said, “No man can taste the fruits of autumn while he is delighting his scent with the flowers of spring”.  It is these seasonal changes that provide the ability to survive during the freezing winter months that rapidly follow autumn. 

So in your pursuit of value for your organization, are you prepared for the ever evolving seasonal changes within the landscape of healthcare? In order to survive the ongoing budget reductions, decrease in reimbursement, pursuit of quality and outcomes, value analysis processes are now more critical than ever to the success of surviving the cold harsh “winter” of healthcare.  Value analysis professionals have the opportunity to be at the forefront of their healthcare organizations, leading and influencing the countless supply chain decisions made every day.  It is crucial for us to prepare for the continual ebb and flows of the various seasons we encounter yearly within our organizations.  Take advantage of this “cooling” down time of the year to reflect and review your process and shake lose the “dead” leaves that might be clogging up the system.  Attending our Annual Education Conference and Supplier Showcase October 19th through the 21st in Scottsdale, Arizona will provide a wonderful opportunity to network, recharge and gain new insights that will help you transform your value analysis program. 

There have been so many incredible accomplishments this year and we look forward to the continued growth and success of AHVAP.  However, in order for our organization to remain relevant and sustainable, we need action by all of our members.  Martina Navratilova said “The difference between involvement and commitment is like ham and eggs. The chicken is involved; the pig is committed”.  Are you the ham or the egg? I encourage you to take this opportunity to figure out how you can be involved and committed as the rewards you reap will be tremendous. 

Thank you again for this remarkable journey and I look forward to seeing everyone at the conference!

Kindest Regards,
Gloria Graham, DNP, RN, CVAHP
President, AHVAP

Tags:  ahvap  message from the president  october 2016 

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Conference Sneak Peak - Summer 2016

Posted By Administration, Tuesday, July 12, 2016
Untitled Document

AHVAP Annual Conference and Supplier Showcase - Value Analysis: A Team Effort

Susan D. Knapp, RN, MS, CVAHP

We are back to Scottsdale, Arizona for the AHVAP 13th Annual Conference and Supplier Showcase. The Chaparral Suites has always been a superb venue for our conference. Your reservation at the Chaparral includes a true 1-bedroom suite with refrigerator and microwave, an American breakfast each morning as well as a cocktail reception in the evening.  

Within walking distance is Fashion Square Mall which has over 255 stores including Kate Spade and Louis Vuitton to name a few. Old Town is not far away along if you want to shop and walk around. Chaparral provides free transportation to local shopping and dining experiences and to the casino. It is also a golfer’s paradise plus there is plenty of history, nightlife, restaurants, and things to do. Come early and take a day trip to the Grand Canyon. I highly recommend it. If you take a guided tour, you will make stops at the Red Desert, Sedona, plus see the different scenery of the Arizona climate zones.

After you have explored the offerings of Scottsdale and Phoenix, we have an impressive lineup of presenters.  You are not going to want to miss this conference. Terry Foster is back by popular demand.  His humorist views on healthcare do not fail to entertain. Participants of the 2015 conference commented that they laughed till they cried.  He was hysterically funny. The keynote speaker is David Jon Bowman, actor, management consultant, thought leader, author, entrepreneur, educator and speaker.  He will engage you with his worldly experience and knowledge. He is an expert on productivity, career management, sales, finance and operations. He has been associated with Fortune 200 companies as well as public service organizations. We are excited to have him speak on team building.

We have many awesome presenters; some who have presented at previous conferences and some who have not. Wini Hayes will be there. She never fails to deliver a presentation that keeps us totally transfixed with her knowledge on applying evidence to resolve clinical problems. Past AHVAP President Barbara Strain will also be speaking on a new topic based on her work in identifying strategies health care has adopted in response to the Accountable Care Act. Bob Yokl is another past presenter back again to talk about creating your own internal evidence based system.  And additional speakers will be lecturing on topics about physician engagement, decision making, communication, value analysis processes and so much more.

Don’t miss this conference! This experience and the networking with like-minded professionals are well worth it.  We are planning several receptions and cocktail parties including one for new members-first time attendees. You will meet up with old friends and make new friends. 

Please join us in sunny Scottsdale in October.

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Ask the Experts - Summer 2016

Posted By Administration, Tuesday, July 12, 2016
Untitled Document

Last month we posed a question to five experts in Value Analysis, and the responses were phenomenal.

What do you feel having the CVAHP certification will do for you, your career, or others?

Gloria Graham

“The CVAHP and underlying knowledge demonstrates your level of experience and capability within the field of value analysis.  A certification shows that you’re capable of learning along with retaining knowledge which are fundamental elements for continued professional development. The degree of dedication and time necessary to obtain a certification validates that you’re committed to your chosen profession.  The CVAHP can be the stepping stone to help you advance or align your potential for the next promotion within your role or onto to the next level of professional development.”

Wanda Dupree-Lane

“The CVAHP certification illustrates a validation of the work, effort, and creativity born from a relatively small group of healthcare professionals striving to provide quality work product for their organizations. Value Analysis is on the cusp of emerging as a separate and unique discipline within healthcare. This certification signifies mastery of this discipline and denotes a desire to grow and expand the profession.  Holding this certification elevates the level of respect afforded to those who have committed themselves to stellar performance in their field”

Sue Knapp

“I have always supported being certified in the field of nursing or business that I am working in as a matter of personal growth and achievement.  I like to learn as much as I can and I like to test myself.   In my efforts to be the best I can be, personally and professionally, CVAHP validates my knowledge and expertise in Value Analysis.  I believe it lends credibility to my position at the hospital and substantiates the work I do.  People don’t always understand what Value Analysis is or what I do. Sometimes they think I just buy stuff for them.  Being certified tells them that there is a specific body of knowledge and skills needed to perform in this position. 

I also feel that by being certified, the bar has been set for those that may come after me in my facility as well as future employment.  CVAHP will be recognized throughout the nation as the leading Value Analysis certification.   Employers will be looking for this certification when they recruit VA professionals.  I see it as being part of the requirements to hire for Value Analysis positions.  Wherever I go in the future, I will have the credentials and skillset sought after by employers.  I am so proud to be a part of the AHVAP organization as well as having had a hand in the creation of CVAHP.  I will always cherish this relationship and accomplishment.”

Jane Torzewski

“The CVAHP certification is a significant outcome and metric of an important process that health care facilities use to manage expense reductions in an efficacious way. The certification gives credence to the discipline of Value Analysis (VA) and provides a benchmark for achieving excellence to those individuals who are VA professionals.

The certification process is meaningful in its own right; professionals who utilize VA procedures will enhance and deepen their understanding of the concepts and key steps in the process.  Engagement with fellow CVAHP professionals provides essential networking on both a professional and personal level; peer to peer dialogue and interaction stimulates creativity, curiosity and builds skills for all who are willing to participate.”

Susan Toomey

“Although my organization does not currently recognize the CVAHP certification, becoming CVAHP certified was a personal professional goal that I established for self-enrichment.  The CVAHP certification affirmed my knowledge of having quality Value Analysis skills by testing my ability to perform objective assessments and provide logical conclusions to support the growth and development of products, services, and technologies across my organization’s continuum of care.  As an increased number of Value Analysis professionals become CVAHP credentialed, it will set precedent to the value of providing optimal patient care and establish career incentives for Value Analysis professionals that may not be occurring in today’s health care environment.”

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President's Corner - Summer 2016

Posted By Administration, Tuesday, July 12, 2016
Untitled Document

Hello AHVAP members!

Summer is here and hope you have the opportunity to enjoy the outdoors and the warm weather.  I am happy to report there are many sizzling activities happening for AHVAP!  I would like to thank all of the committee members, chairpersons and the Board members who have been diligently working towards achieving our goals to increase AHVAP’s influence in the industry, grow our memberships and strengthen the AHVAP community.  Here is what’s going on at AHVAP!

Certification Updates
We are very excited to report that AHVAP along with AMP, the testing agency, are in the final stages of completing the validation process for scoring of the certification.  We are very appreciative of your patience while we journey through this new endeavor.  To the brave pioneers who have already taken the exam, be on the lookout in the very near future for information regarding your scores.  For those who have not taken the exam, what are you waiting for?  The CVAHP elevates your professionalism to the next level!  Thanks to Cheri Berri-Lesh, Shannon Candio, Beth Potter and Cindy Christofanelli for their leadership throughout the certification process. 

Quarterly Webinars
The first two webinars so far this year have been outstanding!  On March 10th, Brenda Lambert, Director of Clinical Services for Medbuy, presented on “Risk Identification and Mitigation in Healthcare Procurement”.  Medbuy is one of Canada’s leading healthcare group purchasing organizations which is a not for profit organization levering clinical expertise and maximizing buying power to offer quality products at the best price.  She provided great insight on how to incorporate risk anticipation within the healthcare supply chain.  On June 9th, Wanda Dupree-Lane, Southeast Regional Director, shared with us about “Value Analysis - New Challenges, New Solutions: Insights from the AHVAP Southeast Regional Conference” which was held on March 4th in Charlotte, North Carolina.  The Southeast Regional meeting had 11 in attendance where a “think-tank” atmosphere provided the opportunity for those attending to walk away with valuable tips & tricks, and left them excited for more interaction and information. 
Be sure to mark your calendar for the upcoming webinars hosted by the Central Region on September 8th and by the Northeast on December 8th.  More information to follow!

Industry Business Education Collaborative (IBEC)
AHVAP is on the move influencing the industry through education of healthcare based industry suppliers, organizations and associations about the principle concepts of value analysis.  AHVAP was well represented at the Spring IDN Summit where myself, Sue Knapp, Melanie Miller, and Cindi Christofanelli were able to enjoy great dialogue with the attendees, educating them on value analysis and AHVAP.  We were delighted to have the opportunity to engage with other AHVAP members such as Nila Getter, Jeffiny Shutts, Sue Toomey and many others who were there representing their organizations.   In addition to the IDN Summit, AHVAP has contributed to increasing the healthcare supplier community knowledge through several presentations with associations such as the Independent Medical Specialty Dealers Association (IMDA).  Shannon Candio and I shared how value analysis professionals are the bridge between the clinical and financial worlds within healthcare organizations.  Additionally, they were pleasantly surprised to learn how the goals of value analysis professionals and IMDA are parallel - to ensure optimal patient outcomes through clinical efficacy of healthcare products and services for the greatest financial value.  Looking forward to the exciting IBEC opportunities in the near future!

Annual Education Conference & Suppler Showcase
Don’t forget to mark your calendars for the upcoming Education Conference and Supplier Showcase in Scottsdale, Arizona October 19th – 21st, 2016!  The Conference Committee has been putting together the final details for this amazing and exciting opportunity to learn up-to-date information in the world of value analysis as well fabulous networking opportunities!
There are so many fantastic activities occurring within AHVAP! I am so proud and honored to be a part of this incredible association serving as your President.  I encourage you to be engaged and share your knowledge and expertise through your involvement with the various committees, as well as sharing on our website.  Don’t forget to connect with AHVAP through Facebook, Twitter and LinkedIn!  As a result of the hard work and dedication among the countless individuals within AHVAP, we are destined to experience a tremendous growth and so glad you are a part of this journey! 

Kindest Regards,
Gloria Graham, DNP, RN, CVAHP
President, AHVAP

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President's Corner

Posted By Administration, Tuesday, March 8, 2016
Updated: Tuesday, March 8, 2016

Greetings!  I am so excited about everything that is about to happen for AHVAP in 2016 and beyond!  

First, I want to take a few minutes to reflect on the past year to gain perspective on where we are going.  History is made in the present and didn’t happen on its own.  Our history happened as a result of our hard working, dedicated members who contributed to all of the phenomenal accomplishments we have seen over the past several years. Understanding the past helps us to build our future – it provides the foundation for our continued success; additionally it is an important vehicle that shapes our approach to the critical issues we face today and is a factor in our future decisions.  

For example looking at our Annual Education Conference & Supplier Showcase.  In 2007 in Phoenix we had 52 registrations with 12 exhibitors/sponsors growing to 117 registrations and 38 exhibitors/sponsors in 2015!

Now let’s look at the trends with our membership.  In November of 2014 there were 230 members with a loss of 17 members and had a 60% annual retention rate.  In December of 2015, we had 303 members, gaining 66 for that month and a steady retention rate at 78%! 

Last but not least, AHVAP introduced the industry’s first and only healthcare value analysis credential which is known as the Certified Value Analysis Healthcare Professional (CVAHP).  

All three of these astounding accomplishments are the foundation and leverage needed to keep the momentum and the passion alive within the association to help us achieve even more substantial achievements in the future. 

We heard numerous times at the conference about the shift to reimbursement based on value versus volume and the importance of value analysis contributing to healthcare organizations to avoid reimbursement cuts without forsaking the delivery of safe and quality patient care.  As a result, it is more apparent than ever how value analysis is on the minds of healthcare professionals who facilitates the delivery of outcomes-driven; patient-centered care.  Our plan is to increase AVAHP’s influence in the industry, grow our membership levels, and strengthen our community.  Each and every member is a vital part of making that a reality. It is about the collective strength we have together as a whole, than it is just one or two working together.  John O’Leary stated: Friends, real victory isn’t about what we can do for ourselves, but what we can achieve together”.

What does it take to get us there and ensure these three areas truly drive impact? 
Our plan is built on three, key initiatives:

  • In order to influence we need to leverage our members - that means you!! Yes, AVAHP is primed to provide industry best-practices to help increase the impact of value analysis within healthcare across the country.  However, our organization cannot sustain itself without the involvement and engagement of all members and we need your help to create rich and engaging original content.  It is imperative for AHVAP to increase its visibility by being in the forefront of leading best practices within Value Analysis which is our Vision – “Value Analysis is recognized as an essential component of the delivery of healthcare. Healthcare Value Analysis Professionals is nationally recognized as the preeminent clinical resource in providing education and resources and networking to its membership and promoting Value Analysis in the healthcare community”.
  • In order to grow we need to get social in a whole new way. Leveraging social media avenues such as LinkedIn, Facebook, and Twitter can spread our message and attract new members.  However, we need to hear from our membership what content and activities will bring the most value to you as a member.  What are the essential programs or information which will increase your knowledge and skill level which leads to increasing your value as an expert in your organization?  If social media is not your forte, we need your ideas on how to grow the association through other avenues.  In this day and age of multi-generational work cultures, we need members from all generations involved like we never have before. We need to learn from each generation how to effectively collaborate resulting in growth within the organization. 
  • In order to strengthen our community, we need to use value analysis best practices and apply them to our own organization.  Just as it is important to have clinician involvement and engagement within the value analysis teams, we need our members to be engaged and communicate among themselves. This sharing of knowledge and data among our peers empowers us to build a stronger value analysis community and helps us make decisions improving our organization.  Think of the power we have among ourselves to strengthen and grow AHVAP if each member would recruit one person to join AHVAP – we could double the size of our organization in just one year! 

Let’s use what we know, to get where we need to be.
Our goal for 2016 is to prepare for the future by developing, documenting and deploying operational policies, procedures, and guidelines to help us influence, grow and strengthen the association!

Thank you for allowing me to have this opportunity to share my thoughts with you. Based on the words of the late John F. Kennedy, “ask not what your country can do for you, ask what you can do for your country”, I challenge each and every one of you to take a few minutes to reflect how you can become involved and engaged with AHVAP!

Kindest Regards,
Gloria Graham, DNP, RN, CVAHP
President, AHVAP

Tags:  AHVAP  grow  membership 

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Theme: What is truly innovative technology

Posted By Administration, Thursday, March 3, 2016

By Laura L. Polson, RN, BSN, CVAHP

Value Analysis teams are continually bombarded with requests for “new technology”. But when do you consider a medical device or capital equipment acquisition as a “new” innovation versus something substantially equivalent?

When a buyer gets a new item request, and you do not have this item in your purchasing system, it is not necessarily new. If the vendor exists in your database, chances are this is just another version of a current item, and if it’s merely a variance in size or formation, the VA team will not need to review this for approval.

When vendor partners design upgrades for current items, the VA team may need to review and see if the improvements and benefits outweigh the conversion/training efforts or potential increase in costs.

There are many variations on the criteria each Value Analysis professional may use to identify topics for their teams to review, but here are a few questions to consider which may indicate what’s new for you:

  • Does this device perform a function which you’ve not been able to do previously?
  • Does this device perform a procedure which has no current reimbursement codes?
  • Does this technology offer a significant innovation for an existing intervention?
  • Has your facility hired a new clinician with expanded skillsets, and how will you deal with all these additions if they leave?

There are technology conferences held every day showing new innovations. While we’ve seen amazing improvements with wireless, smaller batteries, robotics, treatment surfaces and physician preference items, hospitals still seem to function pretty much as we did in the past.

We must be able to look at the development cost and comprehend where to focus our future efforts. Will robots be educating patients with discharge instructions while texting new physician’s contact information to a cell device and scheduling a follow up appointment? Will advanced wound care grafts be printed in 3D to precisely fit while in the OR as a complete stem cell replacement? Will patient medications wirelessly communicate when they’ve been swallowed and chart their effectiveness? Can we watch our family member’s surgical procedure live on our smart phones? Will each bed function as a transport, lift/position, chair, therapeutic and bactericidal surface integration unit with sound interface and telemetry continuously monitoring all vital signs? You know it! Now, ….what will it cost, and how do we calculate its value?

Tags:  bactericidal  calucuate  clinician  cost  criteria  CVAHP  device  effectiveness  facility  family member  function  Laura L. Poison  professional  skillsets  teams  technology  therapeutic  Value Analysis 

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Bridging the Gaps between Pharmacy and Finance

Posted By Administration, Thursday, March 3, 2016

By Kathy Schwartz, Solutions Owner, AVP Strategic Messaging, Craneware

Healthcare industry trends are squeezing provider margins through payment cuts and value-based reimbursement models. In response, these providers’ clinical teams are recognizing the need to collaborate and communicate more closely than ever before with their business office, finance and revenue cycle counterparts.
The pharmacy and its purchase history and formulary data can be low-hanging fruit for organizations looking to better manage cost, improve charge capture, and reduce compliance risk. But where to start? Both Heidi Larson, Pharm.D, Pharmacy Business Manager for Hennepin County Medical Center in Minneapolis and Tara Hunuscak, Business Director of Pharmacy Service for OhioHealth’s network of 11 hospitals and other health services in Ohio chose to partner with Craneware to help address these challenges.  
Hennepin knew that there were gaps and issues going undiscovered because of silos in their organization. “Like many organizations, pharmacy was viewed as separate from the hospital and clinics,” said Larson. “People didn’t communicate regularly and frequently across departments. Information was scattered, duplicative and unclear. The electronic health record (EHR) information needed ongoing review to be clean, current and complete.”

Prior to OhioHealth embarking on a major health information system (HIS) conversion for 7 of its hospitals, outpatient clinics and owned physician practices, it took the opportunity to ensure its revenue cycle and pharmacy charge processes were operating as a cohesive unit to minimize financial risks.  “We recognized the need to align critical business functions for optimal financial performance and risk mitigation as 55% of pharmacy charges were impacted by the HIS conversion changing from charge on dispense to charge on administration. Effective checks and balances for ongoing accuracy was paramount considering the complexities inherent to the pharmacy chargemaster and the revenue loss and/or costly penalties if billing units or HCPCS code assignments are incorrect,” said Hanuscak.

People, Process, and Technology

Both Hennepin and OhioHealth saw the need for technology investment to gain visibility across pharmacy and finance, prevent gaps and manage exceptions. Both organizations chose Craneware as the vendor to help them achieve their goals.

Hennepin brought together teams to validate information and educate physicians and staff about compliance and financial aspects of care. With everyone understanding their part in the larger process, Hennepin County Medical Center was able to identify and remove redundancies, obsolete NDCs, and other mismatches. “The Pharmacy and Therapeutics team are helping to educate about the impacts of formulary choice and the best practices during the occasional industry-wide drug shortages,” said Larson. “Building pharmaceuticals correctly into the EHR, and validating NDCs, billable units, and HCPCS helps to keep Hennepin current with coding changes and to ensure that compliance requirements are met ongoing.

OhioHealth hired a pharmacy charge analyst to serve as the primary end user of the Craneware software, followed by a pharmacist coordinator to focus on work requiring clinical expertise (e.g. diagnosis coding/ treatment indications; reconciling orders, and medical necessity.) Customized HIS training was provided for these individuals to ensure full access to relevant pharmacy, charge analysis and revenue cycle functionality. Finally an enterprise-wide, multidisciplinary advisory committee was formed to ensure successful HIS conversion in both short- and longer-term perspective, and to enhance net operating income amidst industry shift from volume to value based reimbursement.  

“With representation from pharmacy, revenue cycle, compliance, charge analysis, finance, coding, information services, internal audit and nursing, our group served as the decision making forum addressing pharmacy revenue items impacting the HIS build, testing and go-live. Among our objectives were to standardize price updates, align charge methods across hospitals, and automate data integrity process controls throughout the HIS conversion. This pharmacy led team complemented the system-wide focus on revenue integrity and helped build momentum for pre and post go-live initiatives,” said Hanuscak.

Craneware’s pharmacy validation software helped Hennepin and OhioHealth identify common issues with pharmacy reimbursements that often remain hidden and unaddressed:  

  • Incorrectly Coded Drugs
    In order to receive proper reimbursement, a hospital must enter the correct procedure and revenue codes for the drugs. Doing that completely and correctly is nearly impossible manually. Further complicating the task are constant changes to coding rules. For example, Medicare changes its pharmacy coding rules quarterly, and Medicare rules do not always align with commercial payor rules. Missing, inaccurate and incomplete coding is a common source of both missing revenue and compliance risk. Charge items missing HCPCS codes often go undetected and can pose a serious but hard-to-detect reimbursement risk.

  • Charge Capture Issues
    Volume reconciliation analytics – whether purchased from a vendor or built in-house – can shed light on often significant differences between the volume of drugs purchased and the volume of the same drugs billed. In some cases there are good reasons for discrepancies, but large discrepancies are usually traced to issues in charge capture. For example, a typographical error in an automated dispensing cabinet would go undetected without some form of automation to provide visibility into the missed or incorrect charges. A recent survey by Craneware identified that fewer than 5% of health systems can perform volume reconciliation. This is mostly because the way hospitals bill for drugs and how they dispense drugs is very different.

  • Newly Purchased Drugs Missing from the Formulary or Chargemaster
    With the volume of specialty and new drugs coming onto the market, it is imperative for providers to have visibility into these purchases. A provider must be able to quickly and accurately identify these drugs: descriptions, procedural codes, revenue codes and billable units of measure all ideally would be integrated into the chargemaster. Purchases not identified in the formulary build often lead to missed charges.

  • Incorrect Multipliers
    One complexity that is unique to pharmacy is the need to calculate the correct units of measure (UOM.) Medication dosages administered to patients are rarely the same units of measure allowable on claims. Because of this fact, pharmacy charge items require multipliers that translate dosage units to the correct number of billing units. The validation of these calculations can be difficult to perform manually, particularly across different clinical order systems and staffs. Unless a hospital has an automated method of tracking those multipliers, maintaining and applying them requires manual calculations that can result in over or underpayments. Using automation, Hennepin uncovered two ocular drugs that had mismatched purchases compared to volumes dispensed – accounting for $384,641 in missed charges that would have been lost revenue.

  • Inappropriate NDCs Captured on Claims
    Purchase and use of medications is an important aspect of managing costs, and accurate National Drug Codes (NDCs) improve cost management and claims processing. Often formularies are set up with a default NDC but gradually become out-of-sync with purchases, and NDCs reported on claims eventually do not match the drugs purchased and administered. What is purchased and used often isn’t what is billed, creating a substantial compliance risk as well as undermining the quality of data used for clinical efficacies in population health management. “Inaccurate documentation can lead to a double loss for your hospital. If you are not charging for the medications administered, you are losing revenue. And if you are not able to track accumulations in a split billing system, you end up purchasing on the more expensive wholesale acquisition cost (WAC) account,” notes Larson. “For 340B facilities like ours, there needs to be close management and communication on purchase practices and formulary changes.”

With frequent pricing changes and new drugs always being added to the market, it is increasingly difficult for provider organizations to stay on top of pharmacy charges, and many organizations wind up leaving significant revenue on the table. It’s never too late to start bringing together the right people, ensuring those people clearly understand the processes involved, and providing them with the tools and support needed to proactively identify and fix issues. While pharmacy has unique challenges, correctly aligning costs and reimbursement in pharmacy is an important first step for small hospitals to a larger health systems in navigating the transition away from fee-for-service into value-based reimbursement.

Tags:  AHVAP  Craneware  formulary data  Healthcare  Hennepin  history  hospitals  Kathy Schwartz  Minneapolis  OhioHealth  pharmacy  Tara Hunuscak 

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A Tribute To Some Incredible Professionals

Posted By Administration, Wednesday, December 16, 2015

Tonight, I had a “WOW” moment.  One of those times when you actually pause, breathe deep, and savor the moment.  For the fun of it, I “googled” my name, and added the letters CVAHP. And in just a second, my image appeared on the computer screen.  But that image was not what I saw! What I saw was me, surrounded by images of some of the most persevering, visionary, dedicated TRAILBLAZERS that I’ve ever met!
I looked at those faces, actually I stared at those faces.  One face at a time.  And I thought of bits and pieces of conversations from the last 2 ½ years.  Conversations about the history of AHVAP, about the vision of earlier members, the hunger in the healthcare world for what we do and what we know. Conversations about our membership and the quest for a certification…. that we could not get this certification “thing” wrong - we could not fail!    

As I stared at these images, I thought of all the volunteer time these trailblazers freely gave to this organization and to our profession, to get us to where AHVAP stands today. Sometimes they showed up literally, with feet in trauma boots, on crutches, or in wheelchairs, pushed along by another AHVAPer. Sometimes late, tired, and hungry from travel that didn’t go as planned.  But they showed up!

Getting to know these incredibly talented, steadfast, caring trailblazers has been an honor.  Working with them to advance AHVAP and Value Analysis has been a privilege.  Now, through all this work, I’ve earned the right to call them my friends AND colleagues – how incredibly awesome!

If I hadn’t gotten involved and stretched myself, this “WOW” moment couldn’t have - wouldn’t have happened!  Get involved in AHVAP!  Stretch yourself and join a committee!  Push yourself to participate!  I’m telling you, the WOW”moment is so worth it!!!

By Julie Ware

Tags:  AHVAP  caring  images  Julie Ware  thoughts  trailblazers  visionary  Wow moment  writing 

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2015 AHVAP Annual Conference Healthcare Value Analysis: Patient Centric and Outcome Driven

Posted By Administration, Monday, December 7, 2015

By: Susan D. Knapp, RN, MS, CHVAP

Wow, was that not a great conference?  117 Value Analysis professionals attended plus 38 suppliers/sponsors over the 3 days of the conference.  The lineup of speakers was exceptional.   The lectures were stimulating, timely, and valuable.  Many participants described the conference as “wonderful”, “the best ever”, “great”.  The conference committee is very proud to have been able to provide a quality program to our membership. 

Our annual conference is always a fun and exciting encounter.  VA professionals from across the country come together and network; creating new friendships, reuniting with old friends,
sharing their successes and disappointments.  One thing about Value Analysis folks that is universal is that we like to share.  We will share whatever we can: information, contacts, experiences, outcomes.  One way to do that is to submit an entry to the Wall of Experience, formally known as the Wall of Success.  Seven professionals displayed their projects for all to review and those submissions are now available on the website for the membership to view. 

Each speaker, each lecture provided a learning opportunity for someone in the audience.  Some of the participants are new in their Value Analysis positions.  Some have been in the profession for some time yet were able to find tidbits of new information. “Great mix of basic and advanced topics.”  Using Excel to Effectively Utilize Large Healthcare Supply Chain Data….. presented by Erin Laird was a great start to Wednesday. Erin provided the attendee’s some insights of what Excel skills are needed and how to organize your data for presentation.

Gloria Graham’s presentation on Clinicians’ Lack of Knowledge on Value Analysis was a synopsis of her doctorate study and evoked responses from attendees to want to implement “education from leadership to end users” and “add value analysis team activities to nursing professional clinical ladder/leader”.   Dr. Fernandes and Brenda Lambert presented a timely topic on clinical risk assessment in their presentation, An Innovative Scale to Anticipate Risk and Reduce Error within the Healthcare Supply Chain. “This was completely new information and I will definitely implement (risk assessment) at my hospital.”

Dr. Jimmy Chung returned this year and presented Physician Leadership in Supply Chain: A Model for Patient-Driven Value Network.  As the medical director for Medical Products Analysis at Providence Health Systems, Dr. Chung provides a perspective on physician engagement we all love to hear about and want to implement in our own facilities.  “I found Dr. Chung’s presentation extremely helpful.”

Several presentations focused on lean, quality and patient outcomes, and waste including Value Analysis – a Lean Approach presented by Kimberly Baker closely followed by Barbara Stain’s Reverse Engineering Value Analysis: Patient Centric and Outcome Driven.  The Future of Value Analysis: Evidence Outcomes and Interventions by Liz Fackina.    Attendees remarked on practice changes they might implement in their program such as “look at ways to combine PI, Quality initiatives with CVA projects” and “…..attend more meetings internally such as Quality”. 

Pathway to Provider-Supplier Collaborations presented by Dennis Orthman provided a lot of food for thought as he encouraged the attendees to look at ‘turning suppliers into cost cutting allies.’  LaTammy Marks and Amin Mokrivata provided some insight into Advancing Your Value Analysis Program: The Power of Data, Integration and Automation.  Amin provided a nice Finance perspective. 

Then there was Wanda Lane’s Everything Old is New Again: Reclaiming conservative approaches to patient care.  Using her wonderful sense of humor Wanda reviewed some ‘old’ practices that have resurfaced and proven to be effective as well as how the generational mix of physicians, nurses and patients pertains to care, products and outcomes.  The take away for some attendees was to try and fill any generation gaps on their VA teams. 

The closing presentation of the conference was Terry Foster, RN.  Terry is an Emergency nurse with a wonderful sense of humor.  He provided a light, entertaining closing based on his experiences in the emergency department.  It was non-stop laughter throughout the room.  “Terry Foster was AWESOME.”  “Loved Terry Foster!”  “Terry was hilarious – I cried!”  The conference ended on a high note as everyone went on their travels to home. 

Each year is a learning experience for the attendees as well as the conference committee.  The committee values the comments attendees give during and at the conclusion of the conference and we use them to make adjustments and improvements to the conference experience the following year.  In particular we added a new feature this year thanks to Owens and Minor University. THE OMU conference app was well received and we learned a great deal from its use.  “LOVE the app”.   “….app was helpful for engagement and agenda…..”  We plan to bring it back next year.

 Our increasing membership and attendance at the conference provides the organization the resources to continue to deliver high quality speakers and educational opportunities to the membership.  The conference committee will continue to canvas for speakers and topics that will help you to advance your Value Analysis program as well as foster your personal and professional growth. ‘

Thank you to those who attended this year and please let your colleagues know the value you received from the conference presentations and networking opportunities.  If you couldn’t attend this year, there is always next year.  We will see you all October 19-21, 2016 in Scottsdale, Arizona. 

Tags:  2016 Conference  AHVAP  Arizona  CHVAP  committee values  foster personal growth  high quality speakers  MS  October 19-21  products and outcomes  professional growth  RN  Scottsdale  Susan D. Knapp 

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