The Executive Connection of North Texas: Summer 2012

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SUMMER 2012

CONTENT President’s Remarks

Registration Now Open for the Third Annual ACHE of North Texas Case Study Competition!

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Caleb O’Rear, FACHE

What Are the Effects 5 of the Individual Mandate?

How the Health Care Law is Making a Difference for the People of Texas

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Welcome New Members and New Fellows

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Supreme Court Ruling on the ACA

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See page 15 for more information or visit our website www.northtexas.ache.org northtexas.ache.org

What Are Members Saying 11 About the Supreme Court Ruling on the ACA News from National

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Committee Update: Advancement

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Registration Now Open

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Event Encore

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Calendar

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The ACHE of North Texas e-magazine, The Executive Connection, is published quarterly (Spring, Summer, Fall and Winter) and includes information on the latest regulatory and legislative developments, as well as the quality improvement and leadership trends that are shaping and influencing the healthcare industry. Readers get indepth reporting on the issues and challenges facing hospital and health system leaders today. We make it our job to tell you about the great things the organization and Chapter are doing every day to ensure the health of our community. If you have any news and updates that you want to share with other members, please e-mail your items to info@northtexas.ache.org. Microsoft Word or compatible format is preferable. If you have a graphic or picture that you’d like to include, please send it as a separate file. The following are the types of information that our members shared in past ACHE of North Texas magazines: Advocacy Issues, Legislative Issues, Educational Opportunities, Awards / Achievements, Promotions (Members On the Move), Committee Updates, journal submissions, conference submissions, and workshop participations, sharing mentoring experiences, etc.

ACHE of

North Texas

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

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2012 Board of Directors Teresa Baker VA North Texas Health Care System Co-Chair, Advancement and Mentoring Britt R. Berrett, PhD, FACHE Texas Health Presbyterian Hospital Dallas Ex-Officio, Regent

Editor-In-Chief

Susan Edwards, FACHE

Managing Directors

Joan Shinkus Clark, DNP, RN, FACHE Angela CJVincent, MHS

Contributing Editors

Contributing Writers

Felicia McLaren Lisa Cox Forney Fleming Ashley Wise, MBA Joan Shinkus Clark, DNP, RN, FACHE Charmaine Christiansen, MBA

Production

Kay Daniel

Advertising/ Subscriptions

info@northtexas.ache.org

Questions and Comments:

ACHE of North Texas Editorial Office, c/o Executive Connection 511 John Carpenter Frwy, Suite 600, Irving, Texas 75062 p: 972.812.1154 | f: 972.570.8037 e: info@northtexas.ache.org | w: northtexas.ache.org

2012 Chapter Officers President Caleb F. O’Rear, FACHE Denton Regional Medical Center Secretary Winjie Tang Miao Texas Health Harris Methodist Hospital Alliance Co-Chair, Sponsorship Treasurer Pam Stoyanoff Methodist Health System

Lisa Cox The Health Industry Council ACHE Coordinator Beverly Dawson, RN, CCM, FACHE ElderCare Chair, Advancement and Mentoring J. Eric Evans, FACHE Lake Pointe Medical Center Chair, Education Forney Fleming University of Texas at Dallas Ex-Officio, Faculty Josh Floren, FACHE Parkland Health & Hospital System Co-Chair, Membership and Networking Dresdene Flynn-White JPS Health Network Chair, Communications Jay Fox Baylor Medical Center, Waxahachie Co-Chair, Advancement and Mentoring Jonni Johnson, CPSM RTKL Associates Inc. Chair, Sponsorship Matt van Leeuwe Parkland Health & Hospital System Ex-Officio, Student Council Ashley McClellan, FACHE Medical Center of Lewisville Co-Chair, Education Demetria Wilhite The University of Texas at Arlington Ex-Officio, Faculty Bethany Williams ZirMed Chair, Membership and Networking Chip Zahn, FACHE Las Colinas Medical Center Co-Chair, Sponsorship

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

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President’s Remarks

Caleb O’Rear, FACHE Dear Chapter Members, It is an exciting time to be a part of the healthcare industry and to serve the North Texas Chapter as President. I am looking forward to the challenges and opportunities that come with the changing face of healthcare and ways to support our members navigate through these historic times. This Fall, all eyes will be on the election and the topic of healthcare. Regardless of affiliation, reform is, and will be, upon us in some capacity. As leaders in the industry, it is still incumbent upon us to continue to challenge ourselves to be more efficient, more transparent to consumers, and to capitalize on synergies amongst providers. And to that end, we are bringing you timely and relevant information on the recent Supreme Court ruling on the ACA in this issue of the North Texas ACHE Chapter newsletter. This subject is certain to be on the forefront of healthcare issues and we will continue to keep you informed.

As we continue to strengthen and grow as a Chapter, we are looking for new leadership nominations for Board membership which reflect the professional needs of our membership. Our goals as a Chapter are to find new and inventive ways to further engage members, improve communication, and provide more real-time programming to meet the professional development needs of our membership. I hope you will take a moment to consider someone for nomination for 2013. It is an exciting time to a part of this great Chapter! You can find more information on the nomination process and criteria on page 13 and also on our website.

Until next edition, sincerely, Caleb O’Rear, FACHE

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

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What Are the Effects of the Individual Mandate?

Beginning in 2014, the Affordable Care Act of 2010 (ACA) requires most Americans to have health insurance or face financial penalties. This individual mandate has become enormously controversial. Supporters say the mandate is necessary to ensure that nearly all Americans have health care access and coverage and to help keep insurance premiums and government costs stable. Opponents see the mandate as a financial burden and an unconstitutional encroachment on individual liberty.

CRITICAL COMPONENT OF ACA Insurance experts say the mandate – or some mechanism to get most Americans, including younger and healthier people, into the insurance pool – is an essential part of the ACA’s insurance market reforms. If health plans must take all comers, cover preexisting conditions, and not charge older and sicker members much higher premiums, people can’t be allowed to sign up only when they need health care. Otherwise plans would experience what’s known as adverse risk selection and suffer very high costs.

The Congressional Budget Office estimated that keeping the ACA’s insurance reform rules but removing the mandate would lead to the enrollment of less healthy people on average. Overall nongroup premiums would increase by 10-25 percent.

Under the individual mandate, most Americans will have to obtain health coverage or pay a penalty that will be collected through the Internal Revenue Service. The penalty is phased in over three years beginning in 2014. By 2016, the penalty for not obtaining coverage will be $695 per adult, and up to $2,085 per family or 2.5 percent of family income, whichever is greater.

The ACA made other changes to help Americans acquire this mandatory health insurance. Eligibility for the Medicaid program was expanded to include families with higher incomes and adults without children. Health plans must accept all applicants without regard to preexisting medical conditions, and must offer comprehensive coverage. State-based health insurance exchanges will offer a menu of health plans. Individuals and families with incomes up to 400 percent of the federal poverty level will receive sliding-scale refundable tax credits for buying coverage through the exchanges.

IMPACT ON COSTS Urban Institute researchers estimated that overall individual and employer spending for health coverage would increase by

• The individual mandate is an integral but controversial part of the health insurance reforms under the Affordable Care Act. • Studies show the mandate will reduce the number of uninsured Americans, lower premiums for people buying insurance in the individual and small-group markets, and reduce the government’s cost of subsidizing coverage for newly insured individuals.

• Suggested alternative approaches have appeal but are expected to be less effective and potentially more costly to the government than the individual mandate.

$11 billion each with the mandate mostly because of higher premiums and increased enrollment in employer health plans driven by greater demand for coverage in an environment where everyone is expected to have insurance. Without the mandate there would be decreases in government, employer, and individual spending as a result of lower coverage. However, costs do not decrease proportionally with declines in coverage, and the government would only spend about 3 percent less without the mandate for less than half the increase in coverage.

ALTERNATIVES TO THE MANDATE A primary goal of the ACA is to reduce the number of Americans without health insurance. According to the Congressional Budget Office, the mandate and other features of the law will reduce the number of non-elderly Americans without health insurance in 2019 from 55 million to about 23 million—raising the insured rate from 80 percent to 92 percent. If undocumented immigrants, who are not eligible for Medicaid or to purchase coverage through the exchanges, are excluded, the insured rate is expected to be 95 percent. More than two-thirds of the reduction in the uninsured rate can be attributed to the individual mandate. The Congressional Budget Office estimates that if the mandate were eliminated, 16 million more people would be uninsured in 2019.

Reproduced with permission of the Robert Wood Johnson Foundation, Princeton, NJ

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

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How the Health Care Law is Making a Difference for the People of Texas For too long, too many hardworking Americans paid the price for policies that handed free rein to insurance companies and put barriers between patients and their doctors. The Affordable Care Act gives hardworking families in Texas the security they deserve. The new health care law forces insurance companies to play by the rules, prohibiting them from dropping your coverage if you get sick, billing you into bankruptcy because of an annual or lifetime limit, or, soon, discriminating against anyone with a pre-existing condition.

All Americans will have the security of knowing that they don’t have to worry about losing coverage if they’re laid off or change jobs. And insurance companies now have to cover your preventive care like mammograms and other cancer screenings.

The new law also makes a significant investment in State and community-based efforts that promote public health, prevent disease and protect against public health emergencies.

Health reform is already making a difference for the people of Texas by: Providing new coverage options for young adults Health plans are now required to allow parents to keep their children under age 26 without job-based coverage on their

family coverage, and, thanks to this provision, 3.1 million young people have gained coverage nationwide. As of December 2011, 357,000 young adults in Texas gained insurance coverage as a result of the health care law.

Making prescription drugs affordable for seniors Thanks to the new health care law, 22,1395 people with Medicare in Texas received a $250 rebate to help cover the cost of their prescription drugs when they hit the donut hole in 2010. Since the law was enacted, Texas residents with Medicare have saved a total of $223,382,540 on their prescription drugs. In the first five months of 2012, 41,500 people with Medicare received a 50 percent discount on their covered brand-name prescription drugs when they hit the donut hole. This discount has resulted in an average savings of $629 per person, and a total savings of $26,119,155 in Texas. By 2020, the law will close the donut hole.

Covering preventive services with no deductible or co-pay In 2011, 2,208,969 people with Medicare in Texas received free preventive services – such as mammograms and colonoscopies – or a free annual wellness visit with their doctor. And in the first six months of 2012, 1,134,612 people with Medicare received free preventive services. cont. on p 7

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

Because of the law, 54 million Americans with private health insurance gained preventive service coverage with no costsharing, including 3,836,000 in Texas. But for women especially, it’s a new day. Beginning August 1, women in Texas can now get coverage— without cost-sharing—of even more preventive services they need. Approximately 47 million women will now have guaranteed access to additional preventive services without cost-sharing for policies renewing on or after August 1, 2012, including 3,412,175 in Texas.

Providing better value for your premium dollar through the 80/20 Rule Under the new health care law, insurance companies must provide consumers greater value by spending generally at least 80 percent of premium dollars on health care and quality improvements instead of overhead, executive salaries or marketing. If they don’t, they must provide consumers a rebate or reduce premiums. This means that 1,516,721 Texas residents with private insurance coverage will benefit from $166,975,840 in rebates from insurance companies this summer. These rebates will average $187 for the 895,000 families in Texas covered by a policy.

Scrutinizing unreasonable premium increases In every State and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Texas has received $1 million under the new law to help fight unreasonable premium increases.

Removing lifetime limits on health benefits The law bans insurance companies from imposing lifetime dollar limits on health benefits – freeing cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment because of their lifetime limits. Already, 7,536,000 residents, including 2,771,000 women and 2,094,000 children, are free from worrying about lifetime limits on coverage.

The law also restricts the use of annual limits and bans them completely in 2014.

Creating new coverage options for individuals with pre-existing conditions As of April 2012, 5,684 previously uninsured residents of Texas who were locked out of the coverage system because of a preexisting condition are now insured through a new Pre-Existing Condition Insurance Plan that was created under the new health reform law.

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Supporting Texas’s work on Affordable Insurance Exchanges Texas has received $1 million in grants for research, planning, information technology development, and implementation of Affordable Insurance Exchanges. $1 million in Planning Grants: This grant provides Texas the resources needed to conduct the research and planning necessary to build a better health insurance marketplace and determine how its exchange will be operated and governed. Learn how the funds are being used in Texas here.

Preventing illness and promoting health Since 2010, Texas has received $38 million in grants from the Prevention and Public Health Fund created by the Affordable Care Act. This new fund was created to support effective policies in Texas, its communities, and nationwide so that all Americans can lead longer, more productive lives.

Increasing support for community health centers The Affordable Care Act increases the funding available to community health centers in all 50 states, including the 381 existing community health centers in Texas. Health centers in cont. on p 8

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

Texas have received $162.3 million to create new health center sites in medically underserved areas, enable health centers to increase the number of patients served, expand preventive and primary health care services, and/or support major construction and renovation projects.

Strengthening partnerships with Texas The law gives states support for their work to build the health care workforce, crack down on fraud, and support public health.

Examples of Affordable Care Act grants to Texas not outlined above include: • $2 million for health professions workforce demonstration projects, which will help low income individuals receive training and enter health care professions that face shortages.

• $150,000 to support teaching health centers, creating new residency slots in community health centers.

• $2 million for the expansion of the Physician Assistant Training Program, a five-year initiative to increase the number of physician assistants in the primary care workforce.

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• $3.8 million for school-based health centers, to help clinics expand and provide more health care services such as screenings to students.

• $1.8 million to support outreach to eligible Medicare beneficiaries about their benefits.

• $191,000 for Family-to-Family Health Information Centers, organizations run by and for families with children with special health care needs.

• $2.8 million for disease demonstration projects, to test approaches that may encourage behavior modification among Medicaid beneficiaries and determine solutions.

• $21.1 million for Maternal, Infant, and Early Childhood Home Visiting Programs. These programs bring health professionals to meet with at-risk families in their homes and connect families to the kinds of help that can make a real difference in a child’s health, development, and ability to learn - such as health care, early education, parenting skills, child abuse prevention, and nutrition.

Article reprinted from a federal government website managed by the U.S. Department of Health & Human Services

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

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Welcome New Members APRIL Karen Allen, Southlake Esmeralda C. Castillo, Flower Mound Dominique Clayton, Fort Worth Derin Colvin, Plano Colby Craig, Dallas Anna-Marie Gass, Westworth Village Ben Harris, Plano Gil M. Marques, Fort Worth Jim Murphy, Irving Joy J. Parker, Waxahachie Tammy Phillips, Waxahachie Lawrence Picchiotti, Dallas Kishore Potti, Richardson Carol Silverthorne, Dallas Kellye M. Stephens, Desoto Brian Stone, Dallas Brent Treichler, MD, Ennis Michelle M. Underwood, Argyle Kelly Walz, Flower Mound Adrienne Wheatley, Lewisville

Pamela J. Duffey, Fort Worth Jason A. Durrett, Arlington Mary Lou French, Dallas Christopher M. Gallagher, MD, Richardson Brent Glover, Dallas Amy Goliszek, Corinth Warren Irwin, Dallas Marilyn C. Jackson, Frisco Kumbia Lewis, Richardson Brittany J. McKibbin, Dallas Francia Pache, Flower Mound Jennifer Pflughaupt, Flower Mound Christina Price, Dallas James A. Scott, Flower Mound Justin L. Smith, Dallas Nergis Soylemez-Sayed, Dallas Kim R. Spivey, Flower Mound Shon Tackett, Dallas Ross Teemant, Fort Worth Suzette Weast, Irving Brandon Wilcher, Trophy Club

MAY Sophia Babu, Fort Worth Janice E. Baldwin, Coppell Brandy A. Blue, Fort Worth Katherine C. Casey, Fort Worth Kristaizell Darby, Mesquite Ashley Dias, Dallas Brenda Doughty, Hurst

JUNE Nimie Bruno, Garland Brian Carr, Grand Prairie Robin M. Carter, Grapevine Cassandra Cooper, PhD, Crowley Philip L. Day, Ovilla Colt Hatcher, Fort Worth Stacy L. Kimbell, Dallas Ryan M. Moore, Dallas Justin Mourning, Fort Worth

Jennifer B. Rainer, Dallas Nikki Ralston, Decatur Julie Rogness, Dallas Patricia L. Santos, RN, Thornton John Walker, McKinney Bruce Ware, Dallas Megan Way, MD, Carrollton JULY Emily Allen, Dallas Michelle Brost, Keller Jason S. DePlanty, RN, Dallas Brianne Huedepohl, Addison Mallory M. Johnson, Fort Worth Sheeba Kuriakose, Irving April R. Malone, Cedar Hill Jason E. Pritchard, Plano Norman Rice, Dallas Steven Schroeder, Dallas Janelle Shepard, Fort Worth Michelle Tompkins, Weatherford AUGUST Cortney Asberry, Fort Worth Patrick M. Casey, Frisco Jamie Jackson, Arlington

Congratulations to the following members who advanced to Fellow status Monte K. Parker, FACHE, Dallas | David K. Orcutt, FACHE, Granbury | Kelley Baldwin, FACHE, Dallas Kelly P. Dunavant, FACHE, Fort Worth | Corey G. Wilson, FACHE, Euless

Recently Passed the Board of Governors Exam Nancy C. Cychol, Fort Worth | Brian Craft, Plano | David A. Helfer, Dallas

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

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In light of the recent Supreme Court ruling to uphold the Affordable Care Act (ACA), many health care professionals are working to assess the impacts this law will have across the board, include the impact on physician private practice. Although there will continue to be significant debate in the months to come over how the new law will impact specific states and markets, understanding and preparing for the following impacts to private practice will be essential for their long term success in the reform era.

Increased patient volumes Physician practices will need to address issues surrounding increased demand and problems with patient access and come up with a strategy to protect their revenue and ensure optimal access for their core patient population.

Higher percent of Medicaid patients For states that expand Medicaid coverage, practices may see significant growth in this segment of their patient base. Knowing how to capitalize on the growth of the insured population while not stifling access for other insurance plans is an issue that physician practices will need to focus on.

Supreme Court Ruling on the ACA:

Impact on the Physician’s Private Practice

By Ashley Wise, MBA Consultant for the Physician Strategy Group

Declining reimbursement for Medicare Advantage plans and reductions to Medicare reimbursement for non-compliance with other federal programs The ACA legislation is partially funded by planned reductions to Medicare Advantage reimbursements and penalty cuts to Medicare rates for nonparticipation in various CMS programs. Physician practices will need to develop and implement a plan to stay in compliance with these programs and to anticipate and minimize the effects of any Medicare rate cuts.

Rising pressure for EMR use, and the tracking and reporting of quality measures One of the primary ways the government intends to control healthcare costs is by encouraging the use of EMR technology to track and report data. EMRs can help doctors to avoid medical errors and redundant testing and they provide data to help with the advancement and monitoring of evidence based medicine.

One of the biggest questions raised by the Supreme Court ruling is that of how state participation in the expansion of Medicaid will affect the practices. Congress initially intended the new law to mandate that states loosen their requirements for Medicaid eligibility in order to bring more lives into the insurance system. The Supreme Court struck down this mandate, stating that congress could not threaten states with the elimination of existing Medicare funding in order to force their participation in the new legislation. Specifically, the ruling stated that states must, “voluntarily and knowingly accept the terms of such programs” and that, “the constitution simply does not give Congress the authority to force states to regulate.” A recent study by the Congressional cont. on p 11

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

Budget Office (CBO) suggested of the 33 million people expected to receive coverage through the under the new law, about 6 million live in states that are likely to opt-out of the program.

Some of these individuals will still be eligible for coverage through other means, but the CBO believes that giving states the opt-out option will reduce the total number of insured lives by about 3 million. Physician practices in states that do opt-out of the Medicaid expansion will obviously face somewhat different market dynamics than those in states that opt-in.

For the State of Texas, legal and political debates continue on the subject of the individual mandate. Texas Health and Human Services Executive Commissioner, Tom Suehs, stated in a press release following the Supreme Court ruling on the Affordable Care Act: “We’ll work closely with Gov. Perry, state leaders and the Attorney to fully analyze the ruling, but I’m pleased that it gives states more ability to push back against a forced expansion of Medicaid. The court clearly recognized that the Affordable Care Act put states in the no-win situation of losing all their Medicaid funding or expanding their programs knowing that they would face billions of dollars in extra costs down the road.

I remain concerned that expanding Medicaid without reforming it only multiplies the tremendous budget pressure the program puts on states. Medicaid already consumes a quarter of the state budget in Texas, and enrollment and costs would mushroom under the Affordable Care Act.” Undoubtedly, how the individual mandate’s Medicaid expansion will continue to play out at the State level. As it does, Texas physicians can anticipate some volume increases and will be able to benefit from other portions of the ACA that were upheld including; creating new coverage options for individuals with pre-existing conditions, removing lifetime limits on health benefits, covering preventive services with no deductible or copay, and providing new coverage options for young adults.

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What are Members Saying About the Supreme Court Ruling on the ACA In my opinion the ruling is a crucial milestone in addressing the United States burden of a large uninsured population that often financially encumbers the healthcare industry. Although the expansion of the Medicaid provision was not upheld, the ruling still upheld a key element of the law-that the government mandate to financially penalize those individuals who remain uninsured is constitutional. I believe this in turn will bring about movements towards a reduction of delayed care (hence reducing a cost burden to the industry), improved statistics of morbidity and mortality data, disease management initiatives, better coordination, and delivery of care through new mandates by states towards compliance.

- Alvera Mandavia, MHA The US Supreme Court allowed this law to stand as a TAX. This is not at all how it was presented to the American people. Congress said they had a right to regulate healthcare under the Commerce clause of the US Constitution.

The Court should have ruled this law unconstitutional. If allowed to stand, it will destroy many physician private practices, private insurance companies, many businesses who cannot afford either insurance for their employees or the fines, elder care, and innovation in surgical implants and devices.

- Priscilla E. Neils, DHSc, FACHE ,BSN, RN, CNOR, TNCC The implementation of the Affordable Care Act and the Supreme Court’s affirmation undoubtedly represents a milestone in the evolution of healthcare in the United States. Much like the development of Social Security in 1935, Medicare in 1965, and even DRGs in 1982, this legislation is a “game changer,” and has the potential to reshape all healthcare delivery models and all providers across the entire continuum of care.

- Caleb F. O’Rear, FACHE If the individual mandate is a tax, why wasn’t the Anti-Injuction Act invoked?

The greatest surprise (and the decision which has the greatest impact) was the Medicaid ruling.

- Forney W. Fleming, III

A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

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NEWS FROM NATIONAL Exam Online Community Offers Interactive Learning Platform

ACHE Healthcare Reform Resources With the signing of the Patient Protection and Affordable Care Act (PPACA), historic legislation is drastically changing the healthcare landscape. As healthcare reform seeks to provide greater access to care, increased quality and affordability, the imposed implications for healthcare providers and their respective organizations is immense.

Exclusively for ACHE members, ACHE Healthcare Reform Resources are intended to provide the knowledge and insight necessary to lead your organization through the challenges that come with any major reform initiative. This resource guide is not intended to be all-inclusive, but rather an ever-evolving tool to address healthcare leaders’ concerns, develop your skills and meet the demands of the changing environment.

Visit HealthCare.gov for more information and a detailed timeline of healthcare reform provisions.

Members preparing for the Board of Governors Examination can access the Exam Online Community as a complimentary and supplementary resource that can boost their confidence and help them succeed. The Online Community is an interactive platform to learn and glean study tips from other members taking the Exam. Also, participants have the opportunity to discuss Exam topics with experts for better understanding and can participate in study groups. Interested members can join the Exam Online Community at http://bogcommunity.ache.org.

Online Postgraduate Fellowships are a Vital Resource

Tuition Waiver Assistance Program

Postgraduate fellowships are essential to attracting highly qualified healthcare management professionals and developing future leaders.

ACHE offers robust online resources on postgraduate fellowships at ache.org/Postgrad for organizations seeking to develop a postgraduate fellowship or find the best candidate for their fellowship offerings. The site includes the Directory of Fellowships in Health Services Administration for organizations to post their fellowship opportunities and for students to find opportunities they want to pursue. Resources for organizations looking to start a Fellowship include sample manuals, templates and checklists. Visit ache.org/Postgrad for more information.

To reduce the barriers to ACHE educational programming for ACHE members experiencing economic hardship, ACHE has established the Tuition Waiver Assistance Program. ACHE makes available a limited number of tuition waivers to ACHE Members and Fellows whose organizations lack the resources to fund their tuition for education programs. Members and Fellows in career transition are also encouraged to apply. Tuition waivers are based on financial need and are available for the following ACHE education programs:

• Congress on Healthcare Leadership

• Cluster Seminars

• Self-Study Programs

• Online Education Programs

• Online Tutorial (Board of Governors Exam preparation)

• ACHE Board of Governors Exam Review Course All requests are due no less than eight weeks before the program date, except for ACHE self-study courses; see quarterly application deadlines.

Incomplete applications and applications received after the deadline will not be considered. Recipients will be notified of the waiver review panel’s decision not less than six weeks before the program date. For ACHE self-study courses, applicants will be notified three weeks after the quarterly application deadline. If you have questions about the program, please contact Teri Somrak, associate director, Division of Professional Development, at (312) 424-9354 or tsomrak@ache.org. For more information, visit ache.org/Tuitionwaiver.

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Help Eliminate Disparities in Care Addressing disparities is no longer just about morality, ethics and social justice: It is essential for performance excellence and improved community health. Last year ACHE, the American Hospital Association, Association of American Medical Colleges, Catholic Health Association of the United States, and National Association of Public Hospitals and Health Systems collectively made a call to action to eliminate healthcare disparities. The goals of the initiative are to increase the collection of race, ethnicity and language preference data; increase cultural competency training for clinicians and support staff; and increase diversity in governance and management. To learn more about the tools and resources available to help eliminate disparities in care, visit equityofcare.org.

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A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2012

COMMITTEE UPDATE: ADVANCEMENT

Call for 2013 Nominations

ACHE of

North Texas

Our Chapter Bylaws require that the Nominations Committee annually recommend individuals to serve on the Board of Directors. Prior to the finalization of a slate of nominees, the Nominations Committee must issue a “call for nominations”. All affiliates of ACHE of North Texas, in good standing, are eligible for election. Affiliates may nominate themselves or others for the board of directors.

Sponsorship: Board members are required to assist in fundraising efforts and are expected to individually raise at least $5000 annually for the Chapter.

The Nominating Committee will meet in October to begin final deliberations, and will complete recommendations with a ballot to be presented at the General Membership Meeting on November 15, 2012.

Service/Availability: Board members must be able to attend six board meetings per year, as well as commit to attending one chapter event per quarter and two committee meetings per year as a committee chair/co-chair.

The following is a list of preferred attributes for director consideration. These attributes will be used in screening the candidates for the final slate that will be proposed to the membership for election.

Mentorship: Board members must commit to serve as a mentor in the Chapter’s Mentorship Program.

Membership Status: Directors must be active members in good standing with the American College of Healthcare Executives. “Active” means participation in chapter events in the form of attendance and/or participation on committees. Preference will be given to those nominees that have at least two years of active membership.

“Good standing” means the nominee is current on his/her annual membership dues and has not violated the ethical standards of the American College of Healthcare Executives.

Basic Knowledge of ACHE: Directors must have basic knowledge of the purpose and structure of the American College of Healthcare Executives at both the national and local level.

Education: Directors must hold a graduate degree in healthcare administration, business administration, or other discipline with a healthcare focus (for example, Health Management Systems, Architectural Design of Healthcare Facilities).

Fellow Certification: While not required, it is highly desirable that board members are Fellows of the American College of Healthcare Executives (FACHE). Preference will be given to those individuals that are Fellows.

Board Composition: The Nominations committee will do its best to assure that our Board is broadly representative of our membership.

We will achieve this goal by maintaining a culturally diverse board, as well as looking for healthcare executives from all segments of the industry (i.e., payer, pre and post-acute care, consulting, physicians, information technology, architectural design, etc.).

Procedure for Nomination: The “call for nominations” form for the 2013 ACHE Board of Directors is below. Complete all information on the form and include a personal statement as to why the nominee is a suitable candidate for membership on the board.

Additionally, please include a resume or biographical sheet for the nominee. Interested individuals may nominate themselves or others. Call for Nomination forms should be sent via email to Lisa Cox at info@northtexas.ache.org. If mailing the form, please send to ACHE of North Texas, 511 E. John Carpenter Freeway, Suite 600, Irving, Texas 75062. Questions and concerns should be directed to the Nominating Committee at the aforementioned email address.

The deadline for nominations is September 15th.

Please visit our website, northtexas.ache.org for nomination form.

ACHE Application Reimbursement Don’t miss the opportunity to take advantage of our application reimbursement offer! ACHE of North Texas will reimburse you for the $250 application fee, if you take the exam and successfully pass.

The North Texas Chapter implemented its’ first online Board of Governors review course. Thanks to the creation, facilitation and moderation of Teresa Baker, Co-chair of Advancement, we had 43 participants complete the 10 week course and are now ready to sit for their exam.

Keep an eye out for another review course in the Fall.

A Publication of the American College of Healthcare Executives of North Texas Chapter | WINTER 2012

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EVENT ENCORE

Emergency Department Service Standards:

A Best Practice Approach

Submitted by Charmaine Christiansen, MBA/MHSM, Administrative Resident The Heart Hospital Baylor Plano

On Thursday, April 19, 2012 Scottish Rite Hospital for Children hosted the Emergency Department Service Standards: A Best Practices Approach educational event for the North Texas ACHE chapter. The event was organized by Eric Boon, Director Business Development, Doctors Hospital at Withe Rock Lake; Crystal Kilburn, HIM Data Integrity Informacist, Parkland Health & Hospital System; Ashley McClellan, FACHE, CEO, Medical Center of Lewisville; Stephan Moore, FACHE, VP Transplant, Methodist Dallas Medical Center. It was moderated by Brad Simmons, FACHE Senior Vice President, Medicine, Surgical and ED/Trauma Services Parkland Health & Hospital System and the event was well attended.

Moderator, Brad Simmons, FACHE

Cary Garner, Managing Principal and Senior Project Manager of Perkins + Will, Dave French, M.D. of Stadium Physician, Dallas Cowboys, Baylor & EmCare Staff Physician, ED (EmCare), Baylor Medical Center Medical Director/Staff Physician, ED (EmCare), Lake Pointe Medical Center and Michelle Underwood the Assistant VP of Freestanding Emergency Operations for Medical Center of Lewisville all presented their perspective on Emergency Departments best practices.

Cary started the session off with a very intriguing presentation on the architectural plans for the new ED at Methodist Dallas that is targeted to be completed in September 2014.

He explained that instead utilizing the normal pod model to build the ED, Methodist would be combining models. The plan outlined several small pods of beds within a linear layout. The use of this combined model in essence will aid in providing the patient with an effective and efficient level of care because each pod will be customized to the level of care needed. Then Dr. French spoke on the importance of fulfilling the patient’s expectations and the role accountability plays for a physician. He explained that clear communication and positive reinforcement are vital parts of the patient experience because together they produce a higher level of patient compliance.

Panelists Brad Simmons, Cary Garner, Michelle Underwood and Dave French

Furthermore, Michelle spoke about the important role that free standing Emergency Departments plays in the surround communities. She explained that free standing ED’s not only allow ease of access but they assist in providing a more streamline experience for the patient. Patients receive the benefit of being seen promptly by a physician who has all the tools needed readily available without the worry of overcrowding or lack of radiology access.

Overall, the event was a great success. The audience was very engaged and gained some valuable take aways about what the future has in store for Emergency care. ACHE of North Texas extends appreciation to the hosts at Scottish Rite and the 51 members that participated.

For more information on upcoming events, please visit us at www.northtexas.ache.org or contact us at info@northtexas.ache.org.

Panelist Cary Garner, Perkins + Will

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Registration Now Open for the Third Annual ACHE of North Texas Case Study Competition Registration is now open for the 3rd annual ACHE of North Texas Case Study Competition. The competition is open to all students currently enrolled in a graduate level health care administration program.

Teams must consist of between 3 and 10 members and each team must submit a completed application form to Info@northtexas.ache. org by September 30th, 2012. All registered teams will receive a copy of the case study by email on October 1st and will have until October 31st to complete and submit their entry. Each team will be assigned an Executive Coach to assist in the development of their response and will present their findings to a panel of judges at the General Membership Meeting on Thursday, November 15th.

The winning team will be awarded a cash prize, be invited to attend an event with the Board of Directors, have their annual ACHE Membership dues paid, and be recognized in Chapter publications.

To enroll in the competition, read the competition rules and complete the registration form found at northtexas.ache.org. All registration forms must be submitted via email to Info@northtexas.ache.org no later than September 30th, 2012.

EVENT ENCORE-EXTRAS Spring General Membership Meeting

Martha Beary and Kellye Stephens

Steve Whitson, UTSW and Eduardo Calderon, SSR

Christine Hammons, CBRE and Gail Maxwell and Mike Sanborn, Baylor

Board Member, Teresa Baker, VA and Jessica Panko, Tx Health Presb. Dallas

Organizers Charmaine Christiansen, THE HEART HOSPITAL Baylor Plano and Marcus Marshall, Doctors Hospital at White Rock Lake

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EVENT ENCORE

Patient Centered Medical Home Submitted by Joan Shinkus Clark, DNP, RN, FACHE

On July 19, 2012, Children’s Medical Center of Dallas hosted an educational program on the Patient Centered Medical Home. The program was moderated by Cheryl Camin Murray, shareholder with Winstead’s Corporate Section and Health Care Industry Group Law Firm, and panelists were Peter Roberts, Executive VP Population Health, Children’s Medical Center; Dr. Ray Tsai, Medical Director for MyChildren’s, a network of clinics subsidiary to Children’s Medical Center; and Lister Robinson RN, BS, MBA, CPHQ, Director of Nursing and Clinical Services for Medical Clinic of North Texas.

Mr. Roberts provided an overview of the Children’s Medical Center Foundation Population Health strategy, based on a Medicaid population of approximately 70%. He spoke to the biggest challenges as moving from rewards for volume based care to full risk capitation, which takes a process that includes education of the physicians as well as the patients being served. He spoke to the importance of data to manage effectively and spoke to the collaboration between Children’s and UT Southwestern and the challenges faced in moving from a volume-based to a value-based culture.

Panelist Dr. Ray Tsai

Dr. Tsai gave an overview of MyChildren’s, with its mission to cover underserved areas of the metroplex, providing open access to patients to provide same day appointments.

They are about 1.5 years into NCQA accreditation as a medical home.

Lister Robinson RN, provided the background on Medical Clinics of North Texas, with 42 locations in the greater DFW area. Their model for Patient Centered Medical Homes is based on NCQA standards they use RN Care Coordinators, who work with high risk patients to coordinate their care. Physician performance is also tracked on quality measures, referrals and testing, and use of clinical management tools. Their patient portal, called NEXTMD has 77,000 patients registered and the tool is used for two-way communication between patients and staff. The investment in close monitoring of patient outcomes is making a difference in care of their chronically ill patients, demonstrated by an impressive reduction in HBA1Cs of diabetic patients enrolled in their diabetes management program over the past two years. The availability of data to assist in the management of patients was considered by all panelists as a critical factor in successfully managing populations in medical homes.

Members Leon Nguyen, Eric McDaniel, Tom Peck and Lynne Meers

Panel - Lister Robinson, Dr. Ray Tsai, Peter Robers and Cheryl Camin Murray

Organizer Mia Johnson and Members Laura Rowley, Frank Avignone and James Souders

Panelist Lister Roberts

2012 CALENDAR

Wednesday, September 12th Breakfast with the CEO Time: 7:30 - 9:00 am Host: Dan Moen, LHP Hospital Group

September 18th Executive Women’s Breakfast Panel Time: 7:30 - 9:00 am Location: TBD

Thursday, September 20th Education: Physician Integration Approaches (Part I) Time: 5:30 - 7:30 pm Location: Texas Health Dallas

TBD Early Careerist Event

Thursday, October 11th After Hours Networking Event Time:

5:30 - 7:30 pm

Location:

Los Vaqueros, Fort Worth

Host:

Joseph Casper, Sand Lot Solutions

Thursday, October 18th Education: Physician Integration Approaches (Part II) Time:

5:30 - 7:30 pm

Location:

Methodist Dallas

We are currently working on new educational and networking opportunities for 2012.

For the latest updates please check our website or watch your inbox for the event guide.

ACHE of North Texas thanks the following Corporate Sponsors for assisting the organization’s mission. By sponsoring various events throughout the year, these sponsors are provided local and national exposure with an opportunity to showcase their organization, brand, career opportunities, products and services to the ACHE membership and its affiliates.