Finance executives from healthcare organizations across the nation met up this summer to participate in HealthLeaders' Healthcare System of the Future virtual roundtable discussion to talk about their organizations' financial standing, strategies for maintaining margins across sites of care, and planning for a sustainable trajectory. The following are highlights from the discussion.
Where does your organization stand financially?
Several financial executives explained where their organizations stood as they emerge from the economic strife caused by the COVID-19 pandemic.
Denise Chamberlain, CPA, MAEd, CFO at Edward-Elmhurst Health in Naperville, Illinois, said, "We think we've turned the corner. We measure our results, excluding subsidies, each month to see where we’re going [so we can keep] going forward when those subsidies aren't here anymore. So, we’re looking at our volumes and our revenues and our expenses."
And Carlos Bohorquez, CFO at El Camino Health in Mountain View, California, said, "We've rebounded well from the pandemic, but that being said, I see a lot of headwinds related to revenue. We're having conversations with the payers, and the year-over-year increases we saw historically are a thing of the past. … Part of my conversations with the leaders of our organization is explaining why we've done historically well, financially speaking, but also educating the leaders about why we need to manage variable expenses and gradually become more efficient without compromising care and quality."
Staffing: A cost concern
An issue that is challenging financial leaders and was exacerbated during the pandemic is controlling costs around staffing shortages.
Anthony Colletta, CPA, CFO at Westmed Medical Group in Rye Brook, New York, said, "One of the challenges that we're going to have to deal with is this transition from furloughing staff to not having enough staff. That's become our biggest focus and that's going to be a delicate balance that we're going to have to handle as we're trying to control costs, but we know we are going to have to invest in our labor force. … We're going to invest in benefit programs, competitive compensation, and make sure we're at or above market. Those are all going to cost money. We're going to have to find savings elsewhere to ensure that we can address those issues."
Providers and payers: The shift toward value-based care
Healthcare providers found themselves working more closey with payer organizations during the pandemic to work out reimbursement. Financial executives discussed how they see the collaboration between payers and providers working in terms of shifting to value-based care models.
"I'm not convinced that [value-based care strategies are] ever going to arrive passively. There are too many tectonic plates that have to arrive to make a fundamental business model shift from fee-for-service to value. … It's incumbent on all healthcare providers—ambulatory, integrated delivery systems, and inpatient systems—to evaluate and develop an opinion on the business plan outlook of a true, purposeful, forceful shift driven by the providers into a value-based care strategy," says Brandon Clark, executive vice president of corporate development at Equality Health in Phoenix.
Freeing yourself from traditional methods, measurements, paradigms, and ideas may help in achieving nursing recruitment and retention goals.
Editor’s note: This excerpt is from HCPro’s book, Nurse Manager’s Guide to Retention & Recruitment, Chapter 11: "Power of Metrics." For more information, go to https://hcmarketplace.com/nurse-managers-guide.
Changing the Paradigm
Traditionally in healthcare, we have measured turnover and vacancy rates of staff as a measure of workforce stability, and we monitor those metrics for developing problem-based interventions. A better and more appreciative way to measure stability is to change the focus to retention and loyalty rates as a broader measure of true stability that offers a prospective ability to predict organizational health. Leading from an appreciative perspective doesn’t mean ignoring the negative; it means the opposite: working to increase stability by leading with strengths and managing the negative.
An appreciative model of leadership has been referred to as appreciative inquiry, appreciative intelligence, or appreciative leadership. Essentially, an appreciative approach is about building on strengths to overcome weaknesses through an intentional framework that emphasizes the positive and manages the negative and is value driven. The Corporation for Positive Change (2016) believes there are five elements to an appreciative leadership model that individuals need to be successful:
To know they belong
To feel valued for what they have to contribute
To know where the organization or community is headed
To know that excellence is expected and can be depended on
To know that they are contributing to the greater good
Freeing yourself from traditional methods, measurements, paradigms, and ideas may further help in assessing the reality of a changing situation. Matt Miller in his book The Tyranny of Dead Ideas (2009) challenges us to look deeper into what appear to be commonly accepted ideas or thoughts, which may actually prove to be myths. In his book, he dispels what he calls “dead ideas” about everything from schools being local matters to “your company should take care of you,” using data trends. The challenge is to understand what our dead ideas in nursing recruitment and retention may be, including negative or neutral measures.
Clipper, Cianelli, Freeman, Goldstein, and Wyatt (2016) propose a new set of competencies for nurse leaders that includes “divergent thinking, failure tolerance, agility/flexibility, risk taking and autonomy and freedoms.” These emerging competencies enhance the changing role of nurse leaders in creating environments that support innovation, boundary spanning, collaborative practice, and cultures of respect.
Proactive risk management and mitigation can seem counter to a culture of innovation that tolerates failure. In healthcare, we have low tolerance for failure due to the nature of our business: patient care. Innovation and risk management can and should live in the same space, as it is possible to hold these two realities concurrently. Innovation occurs on a continuum from incremental to disruptive innovation. Organizations may have low tolerance for innovation, as standardization, systemization, and reducing variances is the current philosophy and provides the framework for reliable care.
Changing the paradigm from problem-focused metrics and interventions isn’t easy for nurse leaders or for organizations; it’s hardwired into the industry on many levels. The first step nurse leaders can take to bring about this paradigm shift is to address their language and metrics. Instead of talking about turnover and vacancy, keep those measures but use the opposite language—retention and loyalty. For example, if you have a 9% turnover rate and a 7% vacancy rate, you can address them as 91% retention rate and 93% loyalty rate. Language is powerful, and it is human nature to focus more on the negative, especially when describing workforce outcome metrics. As nurses and leaders, we also tend to be problem, deficit, and variance focused, so changing the paradigm starts with you—introspection and then action.
From Data to Wisdom: Making Sense of It All
Changing the paradigm starts with you on many levels. You need to know the data in order to transform it to information, then knowledge (actionable information), and ultimately to wisdom (what did we learn from it?). Data sources abound, which is why we often hear “we are data rich, but information poor.” However, data can be hard to find, access, and understand, even internally within your organization. Information is power, and many people and organizations hold data close to the chest and limit access. In this age of transparency, it is necessary to have access to data, locally, nationally, and globally. Understanding our place in the global, national, and local community of data is crucial to decision-making and enhances our ability to make smart decisions.
Find out who keeps the data you need and how to get access to it. Most often, the data you need as a nurse leader come from finance (CFO), human resources (director of HR), quality/risk (quality director), and clinical data sources (chief nurse information officer or a nurse informaticist). Make it a point to know who these individuals are, and develop relationships with them before you need access to the data and outcome metrics from their departments.
External data can be more challenging to find, but it is becoming more accessible due to open records policies, public reporting requirements, and increased transparency. Most external data sources are aggregated, which offers some level of anonymity. Some of these sources include:
State level turnover data—state hospital association
Workforce data—state or national board(s) of nursing
Quality—state health departments
Financial data—hospital association
Data is most powerful when it can be turned into information. Most organizations have created and deployed dashboards of common metrics. These metrics may demonstrate relationships that exist and assist in decision-making for strategies, tactics, or deployment of resources. Dashboards assist leaders and the organizations in understanding movement toward goals or achievements of strategies by providing a view over time.
Consider sources of internal data for use or for a dashboard:
Finance—financial data, turnover cost data, salary data
Quality—clinical metrics, patient and population level data for impact, safety data
Human resources—turnover data, wages and benefits, retention data, employee engagement/satisfaction data
It is also advisable for nurse leaders to develop relationships with a nurse scientist, researcher, quality analyst, and/or biostatistician. All can be sources that help make sense of data for decision-making and action planning. Be careful to not fall into the “linearity” trap. Embracing the complexity of what we do in healthcare is a must, from clinical to human resource outcomes. Care, cultures, and outcome management are rarely linear, meaning if I do “A” and then “B,” I will get “C”. There are many other variables, and understandings that will help you design better interventions based on the data.
Complexity science is the science of systems and understanding that many components exist, interact, and change as a result of the relationships in dynamic and often unpredictable ways (Linberg, Nash, and Linberg, 2008). Complexity science also incorporates many fields of study into the science with micro, macro, and metasystems within the concept of complex adaptive systems. The truest value of embracing complexity as a nurse leader is the realization that what we do in healthcare is most often predicated on relationships and our holistic education as nurses. This gives us an advantage as we attempt to understand and work in complex environments. Creating and improving professional practice environments that are built on respect, caring, evidence, and civility that produce positive outcomes may be one of the best analogies for complexity.
Cole Edmonson, DNP, RN, NEA-BC, FACHE, FAAN, is a co-author of Nurse Manager’s Guide to Retention & Recruitment.
Recognize your staff's diversity of skills to create a satisfying and exceptional work environment for you and your team members.
Editor's note: This article is an excerpt from HCPro's book, Managing the Intergenerational Nursing Team.
The manager’s job has gotten more complicated over the past few decades. Managing three generations—Baby Boomers, Generation X, and Millennials—with different and often competing values and goals puts the manager at a real disadvantage.
No matter what your age, it is a sure bet that you will never have been a member of at least two of the generations you will now be managing, leading, and guiding. How do you gain insight to be a better manager of people whose background and upbringing are so different from yours?
Strategies for a Harmonious Workplace
You have two choices as a manager of a multigenerational staff: You can see them either as a problem you have to solve or as an opportunity you get to cultivate. If you expect to have problems and difficulties with your blended staff, you will not be disappointed. People generally seem to sense low expectations. However, if you see the diversity of your staff as an opportunity, you can create a satisfying and exceptional work environment for your team members and for yourself as well.
One way to focus on the opportunities involved in managing an intergenerational staff is to look at their strengths instead of their weaknesses. Instead of complaining about the Millennial’s need for constant praise and affirmation, focus on their amazing technology proficiency. When you look at the Gen Xer, do not see a job-hopper but see the entrepreneur who can bring a new point of view to your challenges. Your Boomers’ eagerness for retirement is certainly offset by the stability and loyalty they have shown over the years.
Changing your expectations of each generation to focus on their strengths may be easier than you think and will help make your management effort a more positive and rewarding experience.
A Strengths Model for the Workplace
“Strengths” is the longest word in the English language containing only one vowel. That fact alone makes it special. Strength is defined as great physical power or capability to withstand opposing forces. It brings to mind impregnability, durability, and power.
We traditionally focus on employee deficits and what we need to do to help them overcome and improve as managers. However, refocusing on the employees’ strengths might change the whole dynamic on your nursing unit to something much more positive.
The Strengths Management Model moves through a process where employee strengths are the centerpiece of the employment contract. The idea of focusing on strengths instead of deficits holds promise as an approach to getting the most from your generationally diverse staff. It takes the focus off how each generation is different and places it on the strengths that each generation brings to the workplace.
The model calls for three distinct actions:
Strengths engagement: Early engagement of new staff through relationships based on strengths acknowledgment
Strengths assessment: Assess individual strengths and identify generational strengths
Strengths affirmation: Focus reviews and counselling on strengths improvement
Strengths engagement: Be vocal and visible about your approach to using strengths as a basis for your unit activities. Talk to your applicants about how much you value what they can and will bring to the table, and reassure them that you will help them reinforce and improve their strengths. Ask them to tell you what strengths they bring, and share ways that you can help them expand on those strengths. Begin your relationship on this positive win-win trajectory.
Strengths assessment: Have each member of your staff take one of the strengths identification assessment surveys that are available online. Most are free. They generally give the person a list of their top strengths based on their responses to a survey.
Strengths affirmation: Use the top strengths of each person during the employee evaluation process. Start with strengths, ask how the employee thinks that strength is developing, and also ask about their needs and concerns. After you focus on the strengths, you can then move into areas of opportunity or improvement.
An Action Plan for Using the Strengths Model
Many times, employees, especially the new and inexperienced ones, see only their weaknesses when they come into the healthcare setting. They want to excel and develop confidence, but they need help. Your ability to see their potential by pointing out their strengths is a tremendous boost to their initial efforts to develop competence and comfort as a productive member of the team. Your confidence in them helps them build confidence in themselves.
The following is an action plan you can use:
When first meeting employees, talk about the strengths model and how your unit is set up to help them gain proficiency and skills to build strengths. Focus feedback on the strengths they bring.
Use identified strengths. Ask the employees to tell you their top five strengths in an early encounter. Then ask them to do an online strengths assessments to compare their self-identified strengths with the ones identified by the survey. Do the survey yourself, and share your strengths with them. Ask how you can help them improve their current strengths and gain new ones. Make their goals related to their strengths, and use them in their next evaluation to discuss progress.
Find frequent opportunities to affirm strengths and offer positive feedback and praise. All employees crave personal attention and positive feedback. Show your pride in your staff and the strengths they bring to the workplace. Make the multigenerational makeup of your unit one of your strengths.
Identify your own strengths and work to capitalize on them. Volunteer for opportunities that allow you to demonstrate your strengths. Identify areas that you want to strengthen, and take action to improve.
Staff recognition is an important component of nurse leadership, because it lets staff know that their work is valued and appreciated.
Recognition gives your staff a sense of ownership and belonging in their place of work; this in turn improves morale and enhances loyalty. Hospitals today are very stressful work environments; through recognition, leaders build a supportive culture that will improve staff retention.
Managers don’t need an overly formal process for recognition; spontaneity is also important and can send a strong message. Timing and immediate feedback is incredibly valuable: the closer recognition is to an action, the more the staff will associate that recognition with the desired/expected behavior.
Spontaneous recognition can be as simple as walking by a staff member, observing a desired behavior, and commenting on how much you appreciate it. These informal moments and interactions are invaluable, and they can reinforce your staff’s desire to do a good job.
If you make it a point to do staff rounding daily, you will have more opportunities to catch staff doing the right things and share those moments of recognition with them.
Formal Recognition
Part of the challenge of recognizing staff performance is understanding its importance and making it a priority, taking the time to think about it and doing it as often as possible. Creating a structure for formal staff recognition in organizations, departments, and units can ensure staff get recognized on an ongoing basis.
One way to accomplish this is as simple as designating a week or month of the year as a time that staff contributions are recognized. Many managers use Nurses’ Week as a yearly recognition. Including this practice as part of your monthly staff meetings is a great way to recognize behaviors that you want all staff to emulate. Develop an employee-of-the-month program or employee-of-the-year lunch or breakfast that provides an opportunity for staff members on all shifts to participate.
Recognizing Staff
When it comes to staff recognition, managers must identify what is important and meaningful to the staff member. Not all staff are comfortable with public recognition in front of a large audience and would shudder at the thought of having to walk across the stage of an auditorium; they might prefer private recognition, such as a simple handwritten thank-you note. There are many ways managers can recognize their staff members.
The following are a few ideas for formal staff recognition activities:
Public employee/organization forums
Staff meetings
Annual staff dinners
Organization newsletters
Put a plaque on a wall
Surprising them with lunch celebrations
Meet them at their car at the end of the day with a thank-you note
Special assigned parking space for a month
A poster in the lobby
A spot on the organization website
The ideas are endless, and so is the potential for creativity. Use your imagination and draw on the ideas of coworkers and those who know the staff member best. Form a council, committee, or task force of peers and team members to share their insights regarding how to best show recognition.
Some organizations also utilize resources such as staff recognition gift catalog choices, where staff members receive points through recognition from colleagues, patients, and family members. The gifts vary in type and price levels, and some can be customized to reflect specific recognition and personalized with employee names, etc. Managers must consider such costs on an annual basis during budgeting processes. The best part of these recognition programs is that employees can select a gift they prefer, instead of having something chosen for them.
Regardless of the recognition model you use, if your staff members know what is expected of them and are given the resources to do their jobs well, when you recognize them for a job well done, you will be well on your way to providing a great place to work, and staff will want to be part of your organization.
Meaningful performance reviews and peer feedback
An employee’s performance evaluation should be a team effort, not something done to a staff member by a nurse leader. Remember, the annual review should not be the first-time employees hear negative or positive comments regarding their performance. They should be able to walk into the meeting with no surprises thrown their way.
The manager should begin with having the staff submit a self-evaluation as part of the performance evaluation. Self-evaluations give staff a feeling of control and offer them the ability to have their points of view heard by management.
Sometimes, the managers may forget staff accomplishments achieved early in the annual performance review cycle, particularly if they have large teams to manage.
Other times, when there has been a change in the organizational structure and the new manager may be unaware of all of the employee’s accomplishments during the year, the self-evaluation will give the staff member the opportunity to provide specific details for the nurse manager’s awareness and review.
When submitting a self-evaluation, the manager should have the staff member include a list of previous goals, action items, and progress stated in behavioral terms. This list may give the manager insight into staff interests, talents, and professional development, while also assisting with identification of barriers and future career paths.
The employee that enjoys what he or she is doing is much more apt to be engaged in the unit and organization; they will continue contributing to the achievement of personal, professional, and unit goals, leading to organizational commitment and retention.
Additionally, the manager should seek out others’ opinions regarding the staff member’s performance. This process is called a 360° review. This type of review is helpful because sometimes a peer, co- worker, or even a client may provide additional insight into the performance picture beyond what the immediate supervisor is able to directly observe and assess.
Communicate, Communicate, Communicate
Employees need clear and consistent communication from their managers to know how their goals connect to the organization’s vision, mission, and strategic plan, along with departmental and unit outcomes.
Coaching is a very important component of your staff communication and provides an opportunity for training and development. Managers should develop skills such as active/attentive listening, observing, giving constructive feedback, providing recognition, and teaching or developing new skills, in order to provide the greatest benefit for staff from time spent with them.
Coaching should be tailored specifically to each individual with diverse learning styles and back-grounds taken into consideration. Whenever possible, communication strategies should be adjusted to fit individual staff needs.
The process of coaching involves asking questions rather than simply giving advice or instructions. The intention is not to put the staff on the defensive, lay blame, or highlight incompetence but to assist them in learning the process of problem-solving.
An effective method of coaching involves asking open-ended questions, such as, “What does this information/data suggest to you?” or “What are your recommended solutions?” Asking questions, as well as pointing out other resources, is an essential part of coaching.
This process helps managers teach staff members critical thinking, creativity, cost-benefit analysis, and consequences of actions, among other things. The final piece of coaching involves feedback—generally speaking, letting employees know what they have successfully learned and what learning opportunities lie ahead.
As artificial intelligence (AI) evolves into a must-have technology in almost every industry, health care organizations continue to develop—and even accelerate—their AI strategies in 2020.
In the 3rd Annual Optum Survey on AI in Health Care, 98% of executives across care provider, health plan, life sciences, and employer organizations indicated they currently have an AI strategy in place or are planning on creating one. Even among a trying time period, this optimism appears to be fueled by executives seeing more and more useful applications for AI for improving both health care outcomes and business performance.
While the pandemic has put extreme strain on the nursing profession, nurse leaders share best practices for addressing the mental health and emotional trauma their staff face.
As the United States tackles the next big wave of COVID-19 infections, frontline nurses who have already been stretched to their limits during the pandemic must endure continued challenges that pose serious risks to their emotional and mental health.
Nursing burnout, compassion fatigue, and moral distress have been perpetual issues in nursing for at least the past decade. But nurse leaders like Tari Dilks, RN, DNP, APRN, PMHNP-BC, FAANP, president of the American Psychiatric Nurses Association and professor at McNeese State University in Lake Charles, Louisiana, are concerned that the scale, intensity, and pervasiveness of the COVID-19 pandemic will intensify these issues.
In addition to workplace stress, nurses are dealing with pandemic-induced stressors at home, including school closures, spousal job losses, and the fear of COVID-19 infecting their families, Dilks points out. Thus, nurses' well-being and mental health can no longer be overlooked.
"It's going to be incumbent upon their employers to make sure that mental health needs are being met," she says. "If we can figure out those things that help nurses be resilient … we're going to be in a much better place emotionally."
Peer support is one of many strategies that Penn Medicine Princeton Health in Plainsboro, New Jersey, has implemented to care for nurses' mental health, says Sheila Kempf, PhD, RN, NEA-BC, the organization's chief nursing officer.
For example, staff were trained to recognize the signs of being at high risk for emotional distress, such as verbalizing specific thoughts or emotions, and when peers should be referred to the Employee Assistance Program (EAP). The hospital also contracted a trauma clinical psychologist to talk with staff and run support groups with the EAP and the Ministries department.
"In the very beginning, when no one really knew what the [COVID-19] treatments were, it was overwhelming. But you didn't have time to stop and think about it," Kempf says about the nurses' experience. "By about June, it all started to sink in: what they went through, what they witnessed."
During the spring surge in COVID-19 cases, the 231-bed hospital had over 30 patients on ventilators with a census of around 80 COVID-19 patients a day. Typically, the hospital operates a 12-bed ICU.
To offer additional support during the crisis, the hospital's nurse advisory council formed a wellness committee. The group put together "code lavender" kits to promote self-care among the entire hospital staff. The kits included stress balls, chocolates, tea bags, cards with motivational sayings, and lavender essential oil. The team assembled about 3,000 kits and distributed them to all hospital employees.
"They went department by department and gave them out, which I thought was phenomenal," Kempf says.
The organization also began holding "clap outs," where staff gathered to clap and cheer for patients with COVID-19 who had been on a ventilator and were being discharged. In addition, for all COVID-19 patients being discharged, they played the song "Here Comes the Sun" over the loudspeaker. The intent was to celebrate patients' recovery and to show staff that their hard work was paying off, Kempf says. She estimates that song has been played about 500 times.
Yet, despite these recent efforts, Kempf says healthcare leaders should view nurses' mental health and well-being as a long-term issue.
"Even now, I'll say something to a staff nurse, and they'll start crying. It still happens," she says. "[Nurses] witnessed private conversations between husband and wife, sons and daughters, where they were saying goodbye [to loved ones]. I think that's where the crux of the emotional distress and PTSD is coming from because they witnessed things they should not." In addition, the staff was worried about bringing the coronavirus home to their own families. One of the local hotels provided free rooms to staff who either had to quarantine or could not go home due to a high-risk family member.
HCPro instructor Kimberly Hoy answers questions around virtual instructor-led training needs and implications for healthcare organizations during COVID and beyond.
HealthLeaders recently sat down with Kimberly Hoy, JD, CPC, Director of Medicare and Compliance at HCPro, a Simplify Compliance brand, to discuss instructor-led training (ILT) for the healthcare workforce at hospitals and health systems and the incorporation of virtual training into the training mix.
HealthLeaders: Tell us about yourself and background.
Kimberly Hoy: I’m a former in-house legal counsel and compliance officer. I’ve been working in healthcare for almost 30 years doing everything from clinical care to negotiating contracts for hospitals. For the last 15 years I’ve focused on reading, writing, speaking, and teaching Medicare coding, billing, and reimbursement for hospitals.
HL: Remote workers and virtual learning have been part of the overall training equation for healthcare organizations, but in 2020 we’ve seen a greater increase and demand in these areas. What are you hearing from your clients and students around changes in these areas?
Hoy: Even before the pandemic, we were hearing a desire for more virtual education because of the time away from the office for traveling to in-person education. People are just so busy and wearing many hats these days, so they don’t have time to be completely away from the office for extended periods of time for education and conferences. Now, with budgets also very limited the expense of traveling is also an issue. Virtual education is a choice from both a time-saving and money-saving perspective.
HL: Live (ILT) conducted on-site at a healthcare organization’s facility has been a critical component for delivering consistent learning for years. Why is that?
Hoy: Traveling on-site to a facility allows the instructor to engage with the students to keep them involved, interested, and to ensure a good understanding of the material. We have also found that the students at an organization have sometimes not met each other because they work in different departments or in the same department but across geographically spread out campuses. Coming together allows them to network and build connections in their own organization, but also to discuss how the information being presented affects their operations and departments.
HL: With virtual ILT entering the mix in a big way in 2020, what are some key points to ensure virtual training is effective?
Hoy: We have found that training should be broken up into reasonable blocks of time to avoid screen fatigue. We have also found that allowing open communication, with students able to unmute themselves or chat at any time to the instructor, has been beneficial to ensure understanding and that all the students’ questions are answered. Chat time before and after classes and open Q&A time also helps students feel more comfortable asking questions and interacting with each other.
HL: Can virtual training supplement or even replace live, on-site ILT for healthcare groups?
Hoy: There are groups that may be better served by virtual training if they are spread out geographically throughout a system or need to have the training take place over a number of weeks rather than intense training over a shorter period of time. On the other hand, there are groups that will continue to benefit from being in a room together to discuss issues as they are presented.
HL: How can organizations take advantage of the flexibility of virtual ILT?
Hoy: One of the most important aspects of the live in-person training is the ability to spread it out to fit an organizations’ needs. For some organizations, if students had to be out of the office all day to take training, it would limit the number of students that could take the course because someone would have to staff their offices. Live virtual training allows staff to get much needed education while still being on the job each day to ensure workflow continues.
HL: Can you describe the format and scope of a recent virtual ILT for a group?
Hoy: Our recent virtual instructor-led training has mirrored the scope of content from our traditional in-person classes, with the same well-sourced outlines that students have always loved. We have used various formats, including AdobeConnect and GoToMeeting, and various time frames from one week to six weeks of training to break up the courses. So far, GoToMeeting is my favorite because it makes showing my screen and all the resources we use in class so easy. Students follow along in the materials and on websites as I teach the materials and demonstrate the research techniques I use to find Medicare information. The virtual format has also allowed me to post interesting items for downloading, such as new regulations, for discussion in class.
HL: In your opinion, what is the best overall training mix for a healthcare organization?
Hoy: I have always been of the opinion that there is no one-size-fits-all answer for any organization. There are so many factors, including budgets, availability of staffing, individual department needs, and even culture that make training an individual fit for an organization. Our live training always allowed us to customize education to meet an organizations’ needs and now virtual training gives us one more tool in finding the right fit for them.
HL: What advice would you give to a healthcare organization looking to implement training in 2020 and beyond, given the current and projected learning and operational environment?
Hoy: Organizations have to stay flexible and take advantage of the opportunities for virtual training while in-person training is limited. The approach moving forward is likely to be a combination of both in-person and virtual training to meet the needs of the organization and its learners. This transition period will be a great time to experiment with what works for them.
Kimberly Hoy is the Director of Medicare and Compliance for HCPro, Inc. She oversees HCPro’s Medicare Boot Camps® and is the lead instructor for HCPro’s Medicare Boot Camp® – Hospital Version and Utilization Review Version and an instructor for the Medicare Boot Camp® - Critical Access Hospital Version, Rural Health Clinic Version and Provider-Based Department Version. Kimberly serves as a Regulatory Specialist for HCPro’s Medicare Watchdog services, specializing in regulatory guidance on coverage, billing and reimbursement. She is a frequent expert on HCPro’s audio-conferences and has been a speaker at national conferences on patient status and observation.
Kimberly has served as a Compliance Officer and In-House Legal Counsel and has developed and implemented corporate-wide compliance programs for two hospitals. As a hospital compliance officer, she regularly provided research and guidance on coding, billing, and reimbursement issues for a wide range of hospital services. She has experience conducting billing compliance audits and internal investigations.
As In-House Legal Counsel, Kimberly has had oversight of expense contracting and regulatory compliance, including federal and state laws and regulations. Kimberly regularly provided legal advice on such complex topics as EMTALA, fraud and abuse issues, Stark, anti-kickback and anti-inducement laws, contracting, physician recruiting, and tax exemption regulations.
Kimberly is a member of the California Bar Association and the American Health Lawyers Association. Kimberly earned her Juris Doctor degree from the University of Montana School of Law, where she received the Corpus Juris Secundum Award for Excellence in Contracts. She also holds a Bachelor of Arts degree in Philosophy from Yale University. Kimberly is licensed to practice law in the state of California.
Although organizations continue to make substantial progress in managing health care costs, there’s a fast-moving tailwind on the horizon: a significant increase in the number of people who are dealing with multiple chronic conditions.
People living with chronic conditions spend significantly more on health care than those without chronic conditions. Moreover, this population is expected to grow exponentially over the next several years. Is your organization prepared for success?
The latest HealthLeaders Fact File covers:
Consumer insights to help you stay ahead of health care cost trends
In case you missed them, these interviews feature prominent nurse leaders who share valuable insights with the nursing community.
HealthLeaders interviewed five leaders in nursing about topics ranging from racism to career advancement with solutions and insights on tackling each one. These Q&As with prominent leaders are worth reading (and rereading).
