Archive for the ‘Operational Excellence’ Category

Pyramid Healthcare Solutions to Attend HFMA Florida Chapter Mid-Winter Conference 2015

In Executive Leadership, Financial, Healthcare, Human Capital Trends, Operational Excellence, Personal, Published articles or white papers, Revenue Cycle Management on January 14, 2015 at 9:58 pm

(CLEARWATER, FLA.) January 13, 2014 – Pyramid Healthcare Solutions, an Avantha Group company, will attend the HFMA Florida Chapter Mid-Winter Conference 2015 January 26-28 at the Doubletree-Hilton in Orlando, Florida.

According to Brian Hudson, Pyramid’s Vice President of Sales & Solutions, “This year’s mid winter agenda and theme of, What’s New on the Horizon, should be filled with great information for all who attend.” Pyramid Healthcare Solutions is included in the HFMA 2015 Buyers Resource Guide and a regular exhibitor and attendee of HFMA events throughout the year.

About Pyramid Healthcare Solutions
Founded in 1985, Pyramid Healthcare Solutions partners with healthcare providers to assess, validate and resolve gaps in their revenue cycle, leading to improved and sustainable financial results. Pyramid offers a complete best-practice suite of revenue cycle solutions, including coding services (on-site and remote), HIM services, cancer registry, revenue cycle, revenue discovery, charge capture, accounts receivable management, patient financial services, human resources, managed care services, and education and training. Headquartered in Clearwater, Fla., Pyramid employs more than 300 credentialed, knowledgeable healthcare professionals and best practices developed with more than 500 clients. For more information on Pyramid Healthcare Solutions, visit


Tampa Bay Business Journal

In Executive Leadership, Financial, Healthcare, Human Capital Trends, Operational Excellence, Personal, Published articles or white papers on January 14, 2015 at 8:00 pm

December 18, 2014

Brian Hudson

Vice President of Sales & Marketing at Pyramid Healthcare Solutions

Hudson has been named vice president of sales & marketing for Clearwater-based Pyramid Healthcare Solutions, a provider of revenue cycle management services for health care organizations nationwide.

From ICD-10 to “ICDelay Again”: Meaningful Use 2.5

In Executive Leadership, Financial, Healthcare, Operational Excellence, Revenue Cycle Management on April 7, 2014 at 1:37 pm

The recent passing of the “Doc Fix” bill that delays the ICD-10 Compliance date at least a year to 2015 was surprising to many, due to the fact that ICD-10 was included in the bill. It was announced by CMS in February at HIMSS14 that ICD-10 would not be delayed; this in response to a February 12 American Medical Association (AMA) demand letter to repeal ICD-10 and other industry concerns. In a short matter of days, we went from ICD-10… to… ICDelay Again.
As the news and emotions have settled, there are some common themes that are developing:
1. The delay has provided “breathing room” for organizations to “get it right. Based on the previous deadline, CMS was going to provide grace period for those organizations not in compliance. Too many priorities and limited time has been a common theme in the healthcare industry. The added time will eliminate that need and give providers and payers the proper amount of time to set their organizations up for success.
2. There is a need to regroup and modify the plan. The rush to prepare for ICD-10 exposed many organizational weaknesses around, clinical documentation, operational effectiveness, productivity, audits, mapping, doc assessments, etc. that still need to be addressed.
3. There is a “lack of credibility” with CMS and the certainty that the new revised dates will not be achieved going forward. Millions of dollars have been spent in preparation, not to mention the time and resources put forth. The most dangerous concern to organizations that are experiencing “ICD-10 fatigue” – is that apathy and complacency might take hold while in delay mode.
There is something that can be done to ensure a delay doesn’t happen again and provide incentives for organizations to become compliant on time. Remove ICD-10 from the political football of “Doc Fix” bills and create Meaningful Use 2.5. Provide rewards for those organizations that implement ICD-10 sooner rather than later. Meaningful Use 2.5 would allow ICD-10 to be executed between the Stage 2 Information exchange and care coordination and the Stage 3 Improved Outcomes. The original principle for Meaningful Use was to set a “New Model of Care” and address “National Health Priorities” ( ICD-10 accelerates both of these principles. The most recent delay proves that it can happen again. Ensuring that ICD-10 is not tied to future legislation is imperative; making ICD-10 part of Meaningful Use ensures the principles surrounding our National health priorities are met. Linking ICD-10 to Meaningful Use would ensure credibility of the dates being met. This delay, and potential future delays, has negatively affected the industry – AGAIN.

“The Sanity Code” How the New Era in Healthcare Mirrors the NCAA

In Executive Leadership, Financial, Healthcare, Human Capital Trends, Operational Excellence, Published articles or white papers, Revenue Cycle Management on November 12, 2013 at 6:02 pm

As we enter a new era in healthcare, one looks for similar industry’s that have gone through radical transformations.  As we move into a Government run, heavily regulated, Healthcare environment – there are striking similarities between the “new era” in Healthcare and the NCAA.

  1. Regulation and Fear of Sanctions: The American Affordability and Reinvestment Act has created the most complex set of guidelines and regulation ever placed on Healthcare. This has created an incredible amount of uncertainty and confusion. Added with multiple priorities such as Meaningful use, ICD-10 and EHR, there has never been a more tenuous time in Healthcare. Similar to the Post World War II era of the NCAA, where stresses to the systems based on huge student growth from the GI act, television revenue on the rise, and huge financial gains were achieved by the universities. The NCAA created the “Sanity Code” − adopted to establish guidelines for recruiting and financial aid – which ultimately failed to curb abuses.
  2. Violations of the System: The more the regulation, the more there will be gaming of the system. The NCAA was plagued in the 1980’s with unscrupulous agents, greed, and high profile rules violations. Medicare fraud today adds billions of dollars to the total Healthcare spend in the United States. 
  3. Consolidation and Mergers: Just as the NCAA has evolved in the most recent past to SUPER CONFERENCES with no geographical consideration. The sizes of market and revenue opportunity are the key drivers for conference alignment. Similarly, Healthcare is in the process of consolidating in the very same manner creating SUPER SYSTEMS that cross geographical boundaries focused on driving revenue. Small independent and regional entities will struggle to compete in the new era.
  4. Recruitment and the Talent Wars: The key to winning in the NCAA is to recruit the best available talent and win the talent wars. In the same way, the systems and facilities that can attract the best talent are assured of success. In healthcare, the talent pool is dwindling. Nowhere is the ongoing war for talent in the United States more evident than in the critical shortage of Registered Nurses. The looming physician shortage has created aggressive physician recruitment practices, which are similar to star athletes in college football, such as Johnny “Football” Manziel, getting national acclaim for where they choose to attend college.

 The reality is that the NCAA has been a flawed model and has undergone even more expansive regulation that when it was first created. Lawsuits challenging the NCAA continue to press on, many ending up in the Supreme Court. You can be assured that the new era of Healthcare will have many similarities as the The American Affordability and Reinvestment Act is challenged in years to come. The huge expansion of healthcare to an estimated 32 million more users, looming human capital shortages, and the aging baby boomer generation will create stresses never seen before. As the NCAA found out in the Post World War II era – Healthcare in the new era will find there is no such thing as a ‘Sanity Code”.

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Brian Hudson serves as Director of Business Development for Kforce Healthcare specializing in HIT/HIM consulting, ICD-10 solutions, CDI and EMR support solutions. Previous experience in diverse executive leadership roles including; domestic and international healthcare human capital, entrepreneurial start up experience as Co-founder and President of a small boutique, full cycle, nationally recognized healthcare firm; along with SVP, RVP and Director leadership roles for both private growth and public fortune 100 companies. Hudson is a past and present member of numerous Healthcare Associations & organizations, such as, the American College of Healthcare Executives (ACHE – CFL Board Member & West Florida Chapter 2009 – Present), the Healthcare Financial Management Association (HFMA) and also serves as a member of the Talent Supply & Education Caucus for the State of Florida Chamber Foundation’s Six Pillars Caucus.

Moving at the Speed of Change – Healthcare Human Capital 2013

In Executive Leadership, Financial, Healthcare, Human Capital Trends, Operational Excellence, Revenue Cycle Management on February 15, 2013 at 9:14 pm

“If the rate of change on the outside exceeds the rate of change on the inside, the end is near.” ― Jack Welch
The current rate of change in healthcare is more rapid and challenging than it has ever been with little slowdown in sight. This pace of change is similar to what general business faced in the late 1990’s and the defense industry in the 2000’s resulting in many books focused on change and a total paradigm shift in our country’s military strategy. At the recent National Health Policy Conference held in Washington, D.C. Health and Human Secretary Kathleen Sebelius challenged attendees to “get in the game” in regards to change.
Healthcare Executives are faced with a sweeping transformation of their industry; including but not limited to:
• Information Technology issues – Meaningful Use, EHR enhancements or implementation, Information Exchange, ICD-10 Assessment and Implementation, Mobile Health, Outdated systems, Big Data, etc.
• Operational and Quality issues – Readmissions reduction, patient safety and care, pay for performance, lean initiatives to reduce cost, ACO’s and coordination of care execution, etc.
• Financial issues – Reduction in reimbursements, increased spending to support infrastructure, increased costs of Healthcare Human Capital and benefit expense, etc.
The rate of Healthcare change is not going to slow down; competition will only increase at a more rapid pace; and the exponential “X” factor of the enormous demand brought on by the baby boom generation will create the largest healthcare human capital shortage of our lifetime.
This is why with the rapid push to accelerate change leaders must assist their organization by setting new paths and shifting paradigms.
“One of the big challenges for leaders anywhere is that we cannot push change onto organizations faster than they can absorb them. Yes, the organizational capacity for change can be managed, but at some point it has to work with the flow in the organization.” – Daryl Conner Managing at the Speed of Change
Healthcare Executives can help accelerate change in their organization when they recognize the following: People are the most effective and efficient when we they are given clear expectations of the change (even if outcomes are unclear); they are given proper resources, and they are not over burdened to allow them to move at a speed to assist in assimilating the changes. Since the changes facing the Healthcare industry are mainly regulatory and external, giving clear direction can at times be challenging. The other key elements for accelerating change can be accomplished by creating strategic partnerships with organizations that can assist in the ongoing change. Retention and Engagement will be more critical than ever for Healthcare organizations as will the need to develop a Contingent Workforce plan. Retention and engagement can be handled internally with the right focus and tools. Dick Finnegan, CEO of C-Suite Analytics, speaker, and author of Rethinking Retention, says that leaders need to understand that rapid change can create disengagement in employees and increased competition can take away people.
“The challenges that we face today is the global shortage of healthcare professionals as baby boomers and patients begin to out-number qualified professionals.” – Dick Finnegan
Developing a Contingent Workforce is best handled externally by companies who have the resources to assist the many changes brought on by new technologies and regulations. This can be challenging while many organizations move to cost cutting VMS systems that do great for commodity items like surgical supplies or equipment – but fall well short in regards to people. The scarcity of qualified human capital will require organizations to move much faster and rely upon organizations that supply specialized talent and can meet HIPAA and Affordable Care Act compliance. General industry companies have developed strong contingent workforce plans using companies such as Kforce and others to assist in projects, spikes in business, specialized talent needs, and to reduce overall FTE burdens as recruitment and benefit costs have skyrocketed. Healthcare organizations will need to follow the advice of Secretary Sebelius and “get in the game” by changing internal paradigms and by partnering with firms they can trust to meet critical demands.

HIT Professionals Should Party Like Its 1999!

In Executive Leadership, Healthcare, Human Capital Trends, Operational Excellence, Published articles or white papers, Revenue Cycle Management on March 28, 2012 at 2:41 pm

The pop singer Prince said it best with his hit song “1999” – “So tonight I’m gonna party like it’s 1999” – HIT/HIM professionals should use this as an anthem for the current state of Healthcare Reform, EMR, and ICD-10 implementations occurring nationwide. Today’s healthcare environment for HIT professionals is similar to that of Y2K; with the major difference being, there is no set completion date that the new Millennium provided! As the tune goes – there seems to be no “Oops – out of time”! This is even truer today, with the confusion surrounding the recent decision to delay ICD-10.
In fact, uncertainty surrounding ICD-10 deadlines could drive expenditures to far exceed what was spent to prepare for Y2K. A US Dept of Economics & Statistics report titled, The Economics of Y2K and the Impact on the United States, reported that an estimated $100B was spent by firms and public agencies during the Y2K ramp up from 1997-1999. Costs associated with Healthcare reform, EMR, and ICD-10 could easily dwarf these numbers as implementation dates slide.
For HIT/HIM professionals, now is the best of times! HIT/HIM professionals should market themselves and leverage skills accordingly. HIT/HIM professionals have taken on more duties and responsibilities in health organizations as they ramp up for multiple projects that are intricate and time sensitive. These organizations often struggle to give wage increases that reflect these new responsibilities due to outdated Merit Pay Systems or Human Resource programs that do not keep pace with the current demand market. Many HIT professionals have moved into consulting where the financial and career rewards can be much greater and skill sets are developed across multiple settings.
Healthcare Executives as well have moved to leverage the diverse skills sets of these HIT consultants to provide timely and efficient execution, while not adding additional FTE expenditures. Utilizing consultants also allows for flexibility based on uncertainties and the ability to budget accordingly. The challenge for Healthcare Executives today is that they are too focused on short-term cost – rather than the long-term ROI of the projects. One poorly implemented project or system can create havoc in the months and years following, for not only employees using the new systems, but also in lost revenue to the organization as productivity decreases. To complicate matters, many organizations have moved to VMS to control costs in the area of Human capital and dictate rates – many organizations have lost out on skilled talent that can maximize ROI and assist in future employment/provider of choice status.
Understanding that RATE = SELECTION creates a win/win for both the HIT/HIM professional who is seeking to maximize their value in a demand market, as well as the Healthcare organization attempting to navigate the many elements of Healthcare Reform. As the demand increases, the “war for talent” will escalate. Unlike Y2K, the party may continue for a long time with no definite end in sight.

The value of a HIM Specialist – the Key to ICD-10 Success

In Executive Leadership, Financial, Healthcare, Human Capital Trends, Operational Excellence, Revenue Cycle Management on October 18, 2011 at 2:14 pm

Having spent time in many healthcare demand markets, primarily on the clinical side…it is exciting to be involved in the HIM and Revenue Cycle Management side of the Healthcare profession. It is also unique to see how C-Level leaders and Revenue Cycle professionals are attacking the impending coder shortage and technology changes ahead.
Many factors play into the continued coder shortage, including ICD-10, demographics of an aging coder population, and technology and QA requirements that have pushed many coding professionals to the side.
I often discuss the pros and cons of different strategies that face Healthcare executives in managing the impending coder shortage. Since reimbursement risks affect all parties in the healthcare service supply chain, Executives are faced with two choices on how to proceed with their human capital plan to support implementation and execution:
1. Choose to focus on developing in-house capabilities
2. Outsource coding to a trusted partner
As successful risk managers, many executives do not realize the risk or cost of trying to develop in-house capabilities. Not until there are issues and lost revenues with poor coding, backlog of DNFB, or other concerns do executives begin to see the significant investment of time and resources with no guarantee of on-time delivery or success. Recruiting, hiring, managing, training and retaining coders in this time of rapid change has never been so difficult or COSTLY. Healthcare organizations are not structured to support rising salaries or market demands that are occurring in the HIM space. This is especially true with productivity declines that will put added burden on healthcare executives responsible for reimbursement and revenue cycle.
Productivity will be stalled or decline every time there is staff attrition or while employees are learning proper coding in ICD-10. The learning curve will be quite a journey – almost a “learn as you go” scenario. With ICD-10’s expanded code set there is more to know and consider creating significant billing and patient issues. Michael Arrigo, Managing Partner of No World Borders states that “One of the most important risk mitigation strategies for ICD-10 will be choosing and empowering leaders. We need to help leaders make the business case for dealing with ICD-10 as an innovation and quality improvement program as well as a regulatory compliance effort.”
In my work with leading healthcare executives who are facing the coder shortage, they value a specialist like Kforce Healthcare who can provide a solution to managing the impending coder shortage. It is ironic that in an industry like healthcare – that is so specialized, that often outsourcing or specialization is looked down upon as a necessary evil. According to Veronica Hoy, “Outsourcing may seem like a more expensive alternative, but it’s important to consider the value of this type of expertise. When you factor in costs of benefits, training, retention strategies, investment in training resources, productivity loss, attrition and the opportunity costs of lost time, outsourcing emerges as a potentially more economical and value-added alternative.”
Leaders need to have a forward thinking approach to ICD-10 implementation and the reality of the coder shortage and productivity drains that will arise. Many successful leaders are already utilizing the expertise and specialization available to them in the market and investing accordingly. These leaders have adopted a strategy of success for the whole organization – not just a plan to get it done. In the white paper produced by the ACHE – Cost Cutting in Health Systems Without Compromising Quality – it is pointed out that “challenging times require leadership to both create the changes needed in the new environment and to keep the organization steady in its pursuit of its noble mission”. Having a specialist and a partner such as Kforce Healthcare can ensure a successful mission.

Quality Elder Care: the Coming Challenges

In Executive Leadership, Healthcare, Human Capital Trends, Operational Excellence, Published articles or white papers on December 14, 2010 at 5:40 pm

Excerpts and Quotes from a 2010 article in Billians Healthdata that I was quoted in:
Jennifer Dennard, E-Media Marketing Specialist October 2010
Much has been written about the expected “silver tsunami” of senior citizens that will soon reach an age that often necessitates long-term care. The number of people 65 and over already hit the half-billion mark in 2008. That same population will soon outnumber children aged 5 and younger for the first time in history, according to the U.S. Census Bureau. Long-term care facilities are therefore facing a triple challenge of:
preparing for this record number of new patients;
maintaining and improving quality of care while facing staffing and financial challenges; and
adjusting to the impact of IT and other mandates resulting from healthcare reform.
Marc Herrera, Vice President of Skilled Nursing Administration and Risk Management at Southern California Presbyterian Homes (SCPH), which oversees five-star-rated, Glendale, Calif.-based Windsor Manor, sees things a little differently.

“Quite honestly, we are not in a good position to prepare for the influx of people forecasted to need long-term care services in the future because of the lack of capital and what appears to be a reducing number of people able to pay … [our annual] cost,” explains Herrera. “There is also a well-documented shortage of key personnel including administrators, directors of nursing and doctors.”

“Improvement in recruiting and retention are critical to future success,” says Brian Hudson, Senior Vice President at Avant Healthcare Professionals, a healthcare staffing company that provides professionals to long-term care facilities in 25 states. “This includes improving the quality and quantity of basic education and training; increasing financial incentives; improving the work environment; and employing progressive strategies to develop a robust healthcare workforce, which includes transitioning workers from other industries, and employing internationally trained healthcare professionals.”
“Nursing home care is predominantly a Medicaid-reimbursed program that does not adequately compensate for the true costs of care,” Herrera says. “The private pay population has been shifting to assisted living care for years. Healthcare reform will further incentivize payment to long-term care, but we are not seeing it yet.”

Hudson adds that “the challenges that assisted living facilities are faced with is the uncertainty of reforms and how they will impact profitability.”

The Cost of Unfilled Positions

In Executive Leadership, Healthcare, Human Capital Trends, Operational Excellence on March 16, 2010 at 6:09 pm

Written by Brian Hudson 2008

A recent article on points out the cost of unfilled positions. The impact and cost of these open positions raise exponentially in the healthcare industry. Here are some thoughts on the article as it pertains to our industry.
Hiring managers must recognize and be able to communicate that leaving a position unfilled is terrible for the company. Each hour that a position remains unfilled, patient care is at risk, questions go unanswered, and new efficiencies go undiscovered. The numerous intangibles associated with full cost calculation make it impossible to assign an exact cost of your open position. Of course, different positions have different costs per day based on how much revenue or risk that role brings in to the organization. Some positions realistically cost a company more to leave open than others – especially licensed healthcare professional positions. It is not uncommon for licensed healthcare openings, such as, pharmacists, nurse case managers, therapists, and laboratory professionals to cost $1000 or more per day. Meaning it would be in the company’s best interest to spend more on recruiting to make a hire quicker.
These numbers often go unrealized when a position is open, but they can help you to build a case against keeping a position open too long. It is important that you realize the money that can be saved when you incorporate the right solution into your recruiting efforts. The right recruiting solution not only brings in quality candidates when you need then, but it improves your company’s bottom-line in the process.

Have you lost any good people? Part 2

In Executive Leadership, Healthcare, Human Capital Trends, Operational Excellence on March 16, 2010 at 6:05 pm

By Brian Hudson | Originally written January 22, 2008

According to Ann Smith, MPA, MT (ASCP), CHE, Associate Hospital Director, University of Kentucky Hospital, in today’s healthcare environment, hiring the right person for the job and retaining that employee are skills critical to your success. But you can’t do it alone. Smith also points out the cost of 40%-60% of annual salary for each person lost has a draining affect on the company bottom line. In a survey entitled “Job Forecast 2007 – Healthcare”, 21% of healthcare workers plan to leave their current positions in the coming year. Can you afford not to have a retention strategy?
The advantage of using a recruiter  is that they become an integral part of your retention strategy – if you pick the right one! Improving retention can most effectively be addressed internally. Recruiting can most effectively be done externally.