Administrative Memos

200120

FROM: Theodore O. Will, Chief Executive Officer
DATE: Nov 12, 2001
SUBJECT: Statewide Best Practices Teleconferences
IPRO CONTACTS:

Paula Monetti, Sr. Director, Program Integrity, Extension 261 and Marilyn Zumbo, Administrator, PEPP Improvement Strategies,(518) 426-3300

IPRO has entered year three of the Medicare 6th Scope of Work, Payment Error Prevention Program (PEPP). During the last two years, we have received extensive feedback from Prospective Payment System (PPS) hospitals regarding their successes and lessons learned in integrating PEPP with their ongoing process improvement initiatives and compliance program activities. To facilitate sharing this information among New York State PPS hospitals, IPRO's PEPP Liaison Workgroup has helped us plan PEPP Statewide Best Practices Teleconferences covering the four critical topics noted below. Hospital representatives will co-lead these round table discussions along with the IPRO Discussion Leader identified on page 3 of this memorandum. Each teleconference topic will be offered twice, on different calendar days/times, to enable broad hospital participation.

Linking PEPP to Compliance

Focus: Hospital processes for disseminating IPRO's PEPP project results, data reports and/or training and educational materials, formation of new payment error prevention workgroups, task forces, committees, expansion of existing compliance activities to incorporate PEPP-related matters. Target participants: Compliance Officer, Chief Financial Officer, Risk Manager, Director of Patient Accounts/Business Office, H.I.M. Director, QI/QA Managers, Medical Director, Chair of UM Committee

Utilization Management/Case Management

Focus: Hospital process improvements, clinical efficiencies, improved outcomes and/or outcome measures relating to necessity of inpatient admissions, length of stay reduction, case management, medical record documentation. Target Participants: UM/Case Management Director, Case Managers, Medical Director, Chair of UM Committee, QI/QA Managers, Social Work, Admitting Office, H.I.M. Director

MD Partnership/Buy-In

Focus: Development and implementation of successful communication strategies among physicians and hospital staff targeting medical record documentation improvement, necessity of inpatient admissions, establishment of physician/coder/case manager partnerships, identification of physician champions. Target Participants: Medical Director, VP Medical Affairs, President of Medical Board, Chair of UM Committee, Resident Faculty, UM/Case Management Director, H.I.M. Director

H.I.M. Auditing and Monitoring/Training

Focus: Development and implementation of medical record auditing and monitoring programs, Health Information Management staff training, incorporation of IPRO coding training and abstraction tools. Target Participants: H.I.M. Director, Compliance Officer, Case Managers, Auditing, Finance, Business Office.

Please distribute the enclosed copies of this memorandum to your Medical Director, other physician leaders, Compliance Officer, Director of UM/Case Management and H.I.M. Director. Please note that page 3 contains the schedule of teleconference calls, call-in information and fax back registration instructions. Feel free to make additional copies as needed.

We encourage participants to join us for more than one topic since many of the round table discussions may involve overlapping subject areas. However, it is only necessary to select one of the two available dates/times for each topic.

Should you have any questions regarding these teleconferences, please feel free to contact Marilyn Zumbo at (518) 426-3300.