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Summer 2018 Newsletter


Farewell 2017/2018 President’s Message Marcus Armstrong


Welcome 2018/2019 President’s Message Dana Y. Lujan


Member Spotlight

Featured Article 7. Evolution of Health Care: Bridging Clinical, Administrative & Financial in a Value-Based Care Environment By: Frazer Buntin, President, Value Based Services, and Kate Rollins, Vice President, Clinical Programs and Performance, Evolent Health

David Schweer Dignity Health


Events Calendar


Thanks for the Memories!


HFMA NEVADA CHAPTER - 2017/2018 SPONSORS The companies listed here helped to make it possible for the chapter to deliver events, programs and other resources to members in 2017/2018.

CHANGE Healthcare Collection Consultants Nevada Navient ProAssurance


Bonnie Barnett

Contributing Editor

Richard Bennett

Contributing Writers

Frazer Buntin Kate Rollins


Questions and Comments

2017/2018 Board of Directors Chapter Directors

Chapter Officers President

Marcus A. Armstrong, FHFMA, CPA, MBA WipFli, LLP

Bonnie R. Barnett Collection Consultants Nevada Felipe Danglapin


Dana Y. Lujan, MBA DYL Consulting Group

Karla Gebo Leidos Health

Vice President

Glenda Hill Fore-ward Healthcare Solutions

Tim Myers Clark County Collections


Joe Herman, MBA, FACHE, FHFMA Fallon Paiute Shoshone Comm HC

Osmin A. Hernandez KPMG LLP


Lawrence M. Preston, MBA, FHFMA Professional Medical Consultants, Inc

Past President

David J. Schweer, FACHE Dignity Health Central CA Service Area 2

Christie Johnson Nevada Hospital Association Peter Sabal Anthem Blue Cross Blue Shield George Wiley Desert Springs Hospital

A Farewell President’s Message Marcus Armstrong 2017/2018 President

Thank you for being part of the HFMA Nevada Chapter. It has been my honor to serve as your chapter president over the last twelve months.

Annual charity golf tournament on June 24th at the Red Rock County Club – Arroyo Course. As always, both events were quite successful with 100% of the net proceeds going to organizations supporting local veterans. Finally, we showed good improvement on our member satisfaction survey and hope this demonstrates that we are listening to you.

FY 17-18 Results We had a very successful fiscal year, meeting nearly all of our target metrics. We met or exceeded our goals in education hours, education quality (event surveys), networking, innovation and even target market growth, and only fell slightly short on member retention for a final score of 90%. We hosted our second annual Women’s Leadership Breakfast in Las Vegas and cohosted a similar event in Reno. We also joined the Northern California chapter in cohosting our first annual Joint Fall Conference at Squaw Creek (Lake Tahoe) and plan to hold a similar event there again this September. We continued to partner with other professional associations on the Nevada Health Care Forum, our popular Meet the CEO series, other educational sessions and minor league baseball networking events. We also recently held our 2nd Annual Northern Nevada Joint Association Charity Golf Tournament on May 19th at Red Hawk Golf Course and Resort in Sparks and our 7th

Members responding indicated an interest in more programs, more finance-specific topics, and programs in northern and rural Nevada. Join us for upcoming education and networking events! Please see our list of upcoming events at in both northern and southern Nevada, beginning with the 11th Annual Nevada Health Care Forum on Oct. 9th at the Enclave Event Center in Las Vegas. The Western Symposium, comprised of Regions 11 and 10, will return to the Paris Hotel next year in January 13-16, 2019. Please mark your calendar for these events and plan on attending these, as well as other HFMA regional and chapter education events. For more information, go to: 3 or

Also, be sure to volunteer and get involved to help make them a reality.

Get more from HFMA Take advantage of all that HFMA has to offer. From education programs including virtual conferences and webinars to online resources and the hfm magazine, HFMA has resources to help you face the challenges of our industry. HFMA also has career resources with current regional and national openings on the HFMA Job Bank.

Welcome to our new Chapter President and Board! Please welcome Dana Lujan, our incoming president. Please see Dana’s message and the list of our new board members. Please thank the new team for their important work in the year ahead.

We need your help! Share your ideas … get involved! The Nevada Chapter is a small chapter, comprised solely of volunteers, who help offer programs, educational and social events, and services. If you have ideas on new programs or events, please feel free to reach me at

Very truly yours,

Marc Armstrong, CPA, MBA, FHFMA 2018/2019 Past President HFMA – Nevada Chapter



A Welcome Message From the Incoming President Dana Y. Lujan 2018/2019 President

Hello Nevada HFMA Chapter Members! Welcome to our 2018/2019 chapter year. We have a lot to look forward to and it’s time to get busy on an exciting and productive new year. First, I would like to thank our 2017/2018 President, Marcus Armstrong, for his tireless dedication and innovative ideas over the past year. Under his leadership we met and exceeded our goals in education hours, education quality, networking, innovation and even target market growth, which in turn led to our chapter receiving the following awards: • Hottum Award for Educational Performance Improvement • Platinum Award for Education • Silver Award for Certification • 3 Yerger Special Recognition Awards • 3 Multi-Chapter Yerger Awards. I have some big shoes to fill. I’d also like to thank the incoming 2018/2019 Officers and Board members for volunteering their time, hard work and efforts to the chapter and to assisting me as your Nevada Chapter President. Please help me welcome our incoming Board of Directors, comprised of the following new and returning volunteers: President-Elect Vice President Secretary Treasurer Ex Officio Student Adviser

Dave Schweer Joe Herman Tim Myers Larry Preston Christy Johnson, NHA Perry Richardson

FY17--19 Director FY17-19 Director FY17-19 Director FY18-20 Director FY18-20 Director FY18-20 Director


Bonnie Barnett Karla Gebo Pete Sabal Holly Ames Richard Bennett Osmin Hernandez

Your 2018/2019 Nevada Chapter leadership team started its fiscal year with new officers and board members attending the HFMA National Leadership Conference in New Orleans, in mid-April. HFMA’s National theme this year is “Imagine Tomorrow”. The Nevada Chapter is proud to be introducing a few new educational events scheduled this year, including Region 11 Webinars, Revenue Cycle Management Sessions in the Fall at UNLV for students and early careerists, and a Spring Road Show. As President, I encourage everyone to consider how you can get more involved with the chapter, whether through a committee, activity or networking event. Our chapter is 100% led by volunteers, which means the chapter needs the input and support from all members to ensure you receive the information and benefits you want and deserve. Please feel free to contact any of our chapter leaders if you have ideas for new programs or events, have questions, or just want to know how to get more involved. You will find contact information, as well as additional information and a list of upcoming planned events, for both Northern and Southern Nevada, on the chapter website at: So, let’s “Imagine Tomorrow” together and continue to build, support and work together on making HFMANevada Chapter have another successful year!

Imagine Tomorrow!


Dana Y. Lujan, MBA President

VISIT US ONLINE www.HFMA-NV.ORG 2017/2018 Website Sponsor



Evolution of Health Care: Bridging Clinical, Administrative and Financial in a Value-Based Care Environment

By: Frazer Buntin, President, Value Based Services, and Kate Rollins, Vice President, Clinical Programs and Performance, Evolent Health The new skills required to operate a value-based care business successfully are vast, and the financial return becomes viable only if a provider can go at-risk for enough lives to scale their investment. This reality is a major inhibitor to providers who want to move up the risk continuum and for those who tried and failed. Unfortunately, many value-based care (VBC) initiatives fall at the lower end of a spectrum of accountability, amounting to little more than glorified pay-for-performance tasks that check the box for bonus dollars. This doesn’t drive accountability into the care delivery system in the same way that taking on both upside and downside risk does. To effect lasting change, providers are moving up this continuum of risk-taking through mechanisms that allow them to capture more of their generated savings, but also hold them financially accountable for losses—such as Next Generation ACO or Medicare Advantage for Medicare populations. Providers making the move toward risk are balancing the in-sourcing of new skillsets with outsourcing to third parties. Those who are seriously committed to VBC as their path forward are looking for partners that can help them rethink and redeploy their clinical model for effective population health, get technology in place to enable clinicians and administrators to operate effectively, and, for the most sophisticated, run the back-office administrative components that are culprit cost drivers, but which providers must own if they want to capture the maximum financial gain from the value they’re creating. The way the industry is evolving, and where providers are innovating in the space, is bridging the clinical, administrative and financial: 1. Clinical: •

CARE TEAM PERFORMANCE: Using a care team to support high-risk patients is not a new concept but has traditionally been challenging to directly measure impact/ROI. Having a concrete process and key performance indicators for care managers helps providers identify exactly what tasks correlate to


improved health outcomes and lower costs. It also helps identify high and low performers so teams can replicate the best practices of the highest performers and deploy skills training for those who need coaching. Getting smarter on how to orient expensive clinical resources and directing that attention to where the care team can make the biggest impact is a different construct than yesterday’s disease management programs. •

COMMUNITY HEALTH WORKERS: In one program, a provider deployed Community Health Workers as part of an extended care team for Medicaid populations. In a preliminary analysis of the impact on the care team’s workload and productivity, early data suggest that care managers can nearly double their case-loads after successful introduction of Community Health Worker support. This could have major implications for how the industry thinks about creating capacity for both doctors and nurses, what roles are needed in the healthcare workforce at large, and the benefits of a community-centric approach to operationalize and deliver care. It also has implications for avoiding physician burnout. The more productive the care team is that supports that primary care practitioner (PCP), the more that PCP can trust that patients are followed and continually engaged outside of the point-of-care office visit. This helps them succeed at population health without taking essential time away from other practice areas and sets them up for a better relationship with the patient when they’re face-toface.

CLINICAL PROGRAM INNOVATION: The same provider is also engaged in a partnership within which some of their partners are piloting new clinical programs for targeted populations. One in particular is a pilot to prevent chronic kidney disease from escalating to end-stage renal disease. What’s interesting about this partnership is that the provider is helping their partners take the best academic models and determine how to operationalize them on the front lines. The provider is working to iterate, test and titrate at population and disease-specific levels to drive a better patient experience and health outcomes. The goal is to refine the approach and then scale it to the provider’s numerous partners located nationwide.

2. Administrative: •

THIRD-PARTY ADMINISTRATOR (TPA) CAPABILITY: To capture the value that providers can create through clinical impact and savings, they need to be able to administrate claims, run effective utilization management and pharmacy benefits management, and in some cases support member services with call centers and staff. These aren’t traditional areas of expertise for a provider but helping them take on these administrative services is beneficial.

POWER OF CLAIMS PLUS CLINICAL: One provider successfully integrated its claims administration platform last year into Identifi℠, its core population health data analytics technology. This means that their partner now has claims processing and data operating on the same scalable platform as their clinical and financial workflow tools. Claims traditionally have months of lag time before they can be used to help identify patients who may need care management support. With the stratified clinical platform, knowledge about which patients may be high risk for an acute event can be quickly spread across the care continuum, and lead to accelerated conversations with the patient and his or her PCP. This helps achieve the ultimate goal of intervening before a medical event occurs.


3. Financial: • FINANCIAL METRICS ARE DIFFERENT FOR VBC: When providers effectively learn the new clinical and administrative skills they need to be successful in risk, it drives financial performance, as well. Providers benefit from having reporting and analytics on the same infrastructure as their clinical and administrative tools. In the value-based care world, they need to be able to track, report and manage based on contract terms that work differently than fee-for-service. •

FINANCIAL PERFORMANCE READINESS: Providers participating in Next Generation ACO are faced with a complex financial situation. They need to monitor performance on clinical outcomes for a specific group of Medicare beneficiaries throughout the year to know if they’re on track to achieve savings or not. Knowing the financial trend of the value business early on creates opportunity to change approaches mid-year for a better chance at achieving savings targets. However, to do this effectively, providers need to get started before their performance year begins with CMS. They can deploy tools several months prior to the performance year to start analyzing and assessing the probable risk of their Medicare panel, get people in early for preventive care, and jump-start the clinical program design process so that the entire care team can make a difference on day one of the performance year.

KEY TAKEAWAY: Any given provider could pull all of these levers and still not see an ideal return if they’re only doing it for a few thousand patients. Once infrastructure and process is in place and there’s a roadmap for success via a smaller population test case, providers are then ready to place more risk lives under management. How they accomplish this depends uniquely on the dynamics of their local markets, which drives the wide variety of business strategies across the country. For instance, some take their PSHP to new geographies to get more membership; some create alliances with other provider groups to get more patients attributed to a successful ACO; some have immediate scale if they’re granted the opportunity to manage hundreds of thousands of Medicaid beneficiaries. Regardless of which strategy providers choose to navigate the shift to value-based care, it’s clear that they’re on the right track to serving a common goal of improving health.

Frazer Buntin is the President, Value Based Services, and Kate Rollins is the Vice President, Clinical Programs & Performance, at Evolent Health.

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Becoming HFMA certified distinguishes you as a leader and a high-level professional in the healthcare finance industry. HFMA’s strategic vision characterizes the current healthcare business environment as the transformation of care to achieve value. Providers, physicians, and payers are all confronted with new business challenges. Earning a HFMA certification is a designation of your knowledge, achievement and professionalism.


Member Spotlight David Schweer Senior Director, Strategic Planning & Market Analysis Dignity Health

Dave is a long-time HFMA and Nevada Chapter member. He joined HFMA as a student member at the University of Minnesota. He moved to Reno and worked to Saint Mary’s in clinic and finance roles and then was with Renown Health for many years in business development, decision support, and strategic planning roles. Three years ago, Dave joined Dignity Health as the Senior Director for Strategic Planning & Market Analysis for the Central California Service Area, and for the past year he has worked part-time remotely on a couple of key projects while looking for new opportunities and taking some time to travel and ski. Dave got more involved with the Nevada Chapter about ten years ago. Over those years he has served as the chapter’s Secretary, Vice President, President-Elect, President, Past President. He is now filling a vacancy in the role of President-Elect. He has volunteered to help coordinate and run numerous events including the Nevada Health Care Forum, HFMA Western Symposium, joint fall and spring conferences, and HFMA national Annual Conference. “I’m obviously a strong believer in HFMA and in professional development, education, and networking,” Dave stated. “One thing has certainly led to another for me with HFMA and I value the relationships and professional contacts that HFMA and the Nevada Chapter have connected me with. I would encourage people to attend chapter, regional, and national events and get involved with the chapter.” COLLECTION CONSULTANTS NEVADA Healthcare Collections 702.940.0724

Outside of work and HFMA, Dave enjoys the outdoors in the Reno-Tahoe area and beyond. He and his wife are avid trail runners and downhill skiers. They also enjoy backpacking, waterskiing, traveling, and sports. Dave is also a part-time certified ski instructor.



HFMA members are welcome and encouraged to attend events hosted by ACHE, MGMA, HIMSS and other associations listed here … we are all working together for the benefit of the Nevada healthcare leadership community!

September 21 Morning meeting Session: Employing Social Media to Build Customer Satisfaction and Community Outreach Host: ACHE – Las Vegas

July 19 Face-to-Face Education (3 Credits) Sessions: 1. Telemedicine 2. Organ Procurement Host: ACHE – Las Vegas

Sept. 26, Oct. 25, Nov. 29 Revenue Cycle Sessions - Students/Early Careerist UNLV Host: HFMA Check HFMA-NV.ORG for more details

July 19 Face-to-Face Education (3 Credits) Remote Broadcast Sessions: 1. Telemedicine 2. Organ Procurement Host: ACHE - Reno

October 9 Nevada Health Care Forum Conference Hosts: ACHE, HFMA, MGMA, HIMSS Nevada Health Care Forum

August 15 Webinar Using Health Intelligence Technology to Improve Patient Outcomes Host: HFMA Region 11

December 6 Las Vegas Holiday Mixer Sierra Gold Restaurant Host: Nevada Healthcare Forum

August 15 Free Luncheon Meet the CEO – Adam Rudd, CEO Southern Hills Hospital Host: ACHE – Las Vegas

December 12 Reno Holiday Mixer Freight House, Downtown Reno Host: Nevada Healthcare Forum

August 28 – August 31 Nevada Hospital Association Annual Meeting BUILDING A HEALTHY NEVADA Hyatt Regency Lake Tahoe Resort


Thanks for the Memories! 2017/2018 Events Encore

At the 2nd Annual Women’s Leadership breakfast, hosted by University Medical Center in southern Nevada, a stellar panel of women leaders from the Las Vegas healthcare community shared their stories with the 87 attendees who gathered to hear how the panelists had built their respective careers. Proceeds from the event were donated to Safe Nest, a domestic abuse treatment center in Clark County.

Event Sponsors: ❖ ❖ ❖ ❖ ❖ ❖

Collection Consultants Nevada Grant Thornton Morgan Consulting Resources Regenexx United Realty Group University Medical Center



115 women from the northern Nevada healthcare community were treated to an exciting and informative discussion featuring a panel of inspiring female leaders who shared their life stories on their journey to fostering change in their professions. Event Sponsors: â?– Clark and Associates â?– The Nevada Insurance Agency





2017/2018 Year in Review - SUMMER 2018 Newsletter  

Healthcare Financial Management Nevada Chapter Summer 2018 Newsletter

2017/2018 Year in Review - SUMMER 2018 Newsletter  

Healthcare Financial Management Nevada Chapter Summer 2018 Newsletter