Wipfli Rural Health Clinic and Critical Access Hospital Conference

Wipfli Rural Health Clinic and Critical
Access Hospital Conference
January 31 - February 2, 2012
Bloomington, Minnesota
Visit our web site: www.wipfli.com/CAH2012
Join the conversation #WIPCAH
Featuring three tracks!
• Health Care Reform
• Reimbursement
• Technology (Day Two only)

Crowne Plaza Minneapolis International Airport Hotel & Suites
(Formerly Holiday Inn & Suites)
3 Appletree Square | Bloomington, Minnesota 55425
Phone: 800.227.6963 Code: “Wipfli”
Special group rate: $119 room rate, if reserved by January 9, 2012
Mention group name “Wipfli”
January 31 - February 2, 2012
Free shuttle available from the airport and to the Mall of America!
Dress: Business casual. To ensure you personal comfort, we suggest dressing in layers.
Wipfli Rural Health
Clinic and Critical
Access Hospital
Conference
To register, complete the registration form for EACH individual attending from your organization.
Questions? Please e-mail Sylvia Weise at sweise@wipfli.com, or visit www.wipfli.com/CAH2012
for conference information and full speaker bios.
Wipfli Federal ID #39-0758449
Cancellations by January 9, 2012, will receive full refund. Individuals who cancel after January 9, 2012, or who register, but
neither attend nor cancel, are liable for their full registration fee.
Day One: 8 credits, Days Two & Three: 12 credits, Full event: 20 credits. In accordance with the standards of the
National Registry of CPE Sponsors, CPE credits are based on a 50-minute hour.
Wipfli LLP is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors.
State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of
CPE Sponsors through its website: www.learningmarket.org.
Prerequisites: None
Advance Preparation: None
Instructional Delivery: Group - Live
Course Level: Basic
Field of Study: Specialized Knowledge and Applications
For more information regarding administrative policies, such as program cancellation or complaint policies, please contact Sylvia Weise at 715.858.6631 or sweise@wipfli.com.

Agenda
Day One January 31: Rural Health Clinic Forum
7:30 - 8:30 a.m. Registration and breakfast (provided)
8:30 - 10:30 a.m. Medicare Cost Reporting For Rural Health Clinics
10:30 - 10:45 a.m. Break
10:45 a.m. - 12:00 p.m. Billing for Rural Health Clinics
12:00 - 1:00 p.m. Lunch (provided)
1:00 - 2:30 p.m. Billing for Rural Health Clinics (continued)
2:30 - 2:45 p.m. Break
2:45 - 4:30 p.m. Washington Update For Rural Health Clinics
5:00 - 6:30 p.m. Networking social
Day Two February 1: Critical Access Hospital Conference
7:30 - 8:30 a.m. Registration and breakfast (provided)
8:30 -10:00 a.m. General session: Update on Rural Health—The National Rural Health Perspective
10:00 - 10:15 a.m. Break
10:15 a.m. - 12:00 p.m. Breakout sessions (concurrent)
12:00 - 1:00 p.m. Lunch (provided)
Health Care Reform track: Clinical Integration—The Path to True Health Care Delivery Reform
Reimbursement track: The Basics of Medicare Reimbursement and Cost Reporting
Technology track: Leverage EHR Software From a Large IDS Organization—What to Request and What to Expect
1:00 - 3:00 p.m. Breakout sessions (concurrent)
3:00 - 3:15 p.m. Break
Health Care Reform track: Using Valuable Revenue Cycle Information to Make Strategic Pricing and Reimbursement
Decisions and to Understand Key Clinical Quality Indicators
Reimbursement track: Advanced Cost Reporting—“Bottom Line” Impact of Cost-based Reimbursement
Technology track: Meaningful Use Security Risk Analysis—Does Your Security Risk Analysis Measure Up to the
Core Requirement?
3:15 - 5:00 p.m. Breakout sessions (concurrent)
5:30 - 7:00 p.m. Networking social
Health Care Reform track: Community Health Needs Assessment
Reimbursement track: The Medicare Cost Report—A Tool for Decision Making and Strategy Development
Technology track: Meaningful Use–How a Rural CAH Got There and How to Stay There
Day Three February 2: Critical Access Hospital Conference
8:00 - 8:30 a.m. Breakfast (provided)
8:30 - 10:00 a.m. Breakout sessions (concurrent)
10:00 - 10:15 a.m. Break
Health Care Reform track: The 3 Rs of Physician Compensation—Rules, Regulations, and Realities
Reimbursement track: Preparing for Changes in Financial Reporting
Technology track: Day Two Only
10:15 a.m. - 12:00 p.m. General session: Pulling It All Together—A Panel Discussion
12:00 p.m. Close
Wipfli Rural Health Clinic and Critical Access Hospital Conference

January 31, 2012: Day One (RHC) | Session Descriptions
8:30 - 10:30 a.m.
Medicare Cost Reporting for Rural Health Clinics
Learn about the most common cost reporting errors, as well as key
opportunities to improve RHC reimbursement. Specific topics such as visit
statistic reporting, provider productivity standards, commingling, carve-outs,
and Medicare bad debts will be examined.
Presenters: Jeff Bramschreiber, CPA, Partner and Jeff Johnson,
CPA, Partner
10:45 a.m. - 12:00 p.m. and 1:00 - 2:30 p.m.
Billing for Rural Health Clinics
This session is designed for clinic staff involved in charging, billing, and/
or coding for services provided by rural health clinics. It will include an
February 1, 2012: Day Two (CAH) | Session Descriptions
General Session
8:30 -10:00 a.m.
Update on Rural Health: The National Rural Health Perspective
This session will focus on national rural health policy trends impacting
critical access hospitals. Pending legislative and regulatory proposals will be
discussed, as well as current industry trends. The presenter will provide an
overview of the rural health landscape and the actions you can take now to
participate in the rural policy development process.
Presenter: Alan Morgan, CEO, NRHA
Health Care Reform Track
10:15 a.m. - 12:00 p.m.
Clinical Integration—The Path to True Health Care
Delivery Reform
As an acute care provider, (hospitals and physicians), you’re coping with
both the regulatory (health reform legislation/regulations) and market-driven
(consumerism) pressure for collaboration in care delivery. This session will
help you understand the fundamentals behind “reform” that are driving
the need for “service line” delivery across the care continuum, discuss the
definition of clinical integration and the various models that can deliver the
desired outcomes, and outline the relationship between service line delivery
of care and clinical integration. In addition, you will gain an understanding
of how clinical integration can support and drive quality improvements and
operational enhancements across the care continuum.
Presenters: Perry Hanson, MHA, Partner, and James Garvey,
MHA, Director
1:00 - 3:00 p.m.
Using Valuable Revenue Cycle Information to Make Strategic
Pricing and Reimbursement Decisions and to Understand Key
Clinical Quality Indicators
Medical claims data contain a wealth of valuable information on a patientspecific
basis. This session will address how claims data can be used to
develop strategic pricing models for your organization. In addition, we will
provide state and national comparisons, explore how common billing errors
Wipfli Rural Health Clinic and Critical Access Hospital Conference
overview of Medicare billing rules and regulations, issues unique to RHCs,
and common billing problems for rural health clinic providers. Information
pertinent to both independent and provider-based RHCs will be presented.
Presenters: Jeff Bramschreiber, CPA, Partner and Jeff Johnson,
CPA, Partner
2:45 - 4:30 p.m.
Washington Update for Rural Health Clinics
Bill Finerfrock of the National Association of Rural Health Clinics (NARHC)
will discuss recent national developments affecting RHCs. In addition, he will
provide an overview of recent initiatives supported by NARHC.
Presenter: Bill Finerfrock, Executive Director, NARHC
impact hospital revenues, and help you to understand the continuum of care
for your patients, including what happens to patients post-discharge and how
successful your care transition process is at minimizing re-admissions.
Presenters: Jane Jerzak, CPA, Partner and Vicki Mueller, CPA, Manager
3:15 - 5:00 p.m.
Community Health Needs Assessment
As you are aware, recent health care legislation has led to the formation of
the Patient Protection and Affordable Care Act. This act requires all 501(c)
(3) hospitals to submit a Community Health Needs Assessment (CHNA) to the
IRS every three years starting in 2012. As a result, your organization will be
monitored to ensure it’s taking the necessary steps to meet the health needs
of the community. Noncompliance could result in both significant annual
IRS financial penalties and revocation of your not-for-profit status. Therefore,
it’s critical that you carefully document and conduct the appropriate level
of due diligence to plan effectively for any capital, physician-related, and
infrastructural requirements driven by a new or enhanced service offering
as indicated by the CHNA. The objectives of this session are to help you
to better understand the key planning initiatives that should be undertaken,
to assess the feasibility, and to plan appropriately for a new or expanded
service offering.
Presenters: Kelly Arduino, MA, MBA, Director, and Nick Smith, MHA,
Senior Consultant
Reimbursement Track
10:15 a.m. - 12:00 p.m.
The Basics of Medicare Reimbursement and Cost Reporting
If you work in finance, you need to understand the basics of Medicare
reimbursement principles and the flow of the Medicare cost report forms.
Therefore, we will review the basics of Medicare reimbursement principles,
where to find information on the cost report forms, and keys to enhancing
your reimbursement from the Medicare program. This session is intended
for the entry-level financial professional or those who collect the data or
prepare, or review the Medicare cost report.
Presenters: Kathi Krueger, CPA, Manager, and Donna Nelson,
CPA, Manager

February 1, 2012: Day Two (CAH) | Session Descriptions continued
1:00 - 3:00 p.m.
Advanced Cost Reporting—“Bottom Line” Impact of Cost-based
Reimbursement
Completing a Medicare cost report is an annual ritual. Although you spend
a lot of time crunching data, there doesn’t appear to be much reward for all
of your efforts. However, just like a routine physical, an annual “checkup”
of your Medicare cost report is a “healthy” idea. By using a case study
approach, you will learn the importance of completing the cost report
accurately, and we will show you how to identify opportunities to improve
Medicare reimbursement. In addition, we will cover how to respond to the
intermediary (MAC) during a cost report audit and will provide an overview
of changes to the Medicare cost report forms as we transition from version
2552-96 to 2552-10, including changes related to the HITECH Act. This
session is meant for the professional who has a working knowledge of the
Medicare cost report.
Presenters: Steve Thompson, CPA, Partner, and Jeff Johnson, CPA, Partner
Back by popular demand!
3:15 - 5:00 p.m.
The Medicare Cost Report—A Tool for Decision Making and
Strategy Development
Strategic decision making may require extensive resources, including time
and financial commitment. It can involve mounds of reports, hours and hours
of analysis, additional FTEs, or maybe even the expertise of a consultant.
We understand that information technology systems provide unlimited
information for evaluation, but if you are looking for a quick tool for decision
making and strategic development, you may need to look only as far as your
Medicare cost report. While it is important to stress that the Medicare cost
report has its limitations, it may well be one of your best first resources when
evaluating financial questions at a high level. Please bring your cost report
with you to begin your decision making.
Presenters: Kathleen LaBrake, CPA, Partner,
and Holly Pokrandt, CPA, Partner
Wipfli Rural Health Clinic and Critical Access Hospital Conference
Technology Track
10:15 a.m. - 12:00 p.m.
Leverage EHR Software From a Large IDS Organization—What
to Request and What to Expect
Smaller hospitals and rural health clinics struggle to find viable alternatives
to access certified EHR technology on their own. Given Stark relief, some
are turning to larger, integrated delivery systems (IDS) organizations as a
cost-effective alternative. This session will feature two case studies: a small
community hospital and a physician clinic currently leveraging this model.
Learn what they experienced and what you need to know.
Presenter: Janice Ahlstrom, Partner, FHIMSS, CPHIMS, RN, BSN
1:00 - 3:00 p.m.
Meaningful Use Security Risk Analysis—Does Your Security Risk
Analysis Measure Up to the Core Requirement?
If your organization is pursuing meaningful use, you must meet a myriad
of requirements. With Stage 1 Core Objectives, providers must implement
systems to protect privacy and security of patient data in the EHR. This
presentation will review a security framework for conducting yearly risk
analysis to meet this core objective of meaningful use.
Presenter: Paul Johnson, Consulting Manager, CISSP, Certified HITRUST
Practitioner, and CPA
3:15 - 5:00 p.m.
Meaningful Use—How a Rural CAH Got There and How to Stay
There
As a rural CAH organization or rural health clinic, you are working diligently
to implement an EHR, integrate with community care partners, and meet
meaningful use. This session will present a case study of a rural CAH’s
experience in meeting meaningful use. Further, the session will address the
latest reimbursement information and best practices to attain and maintain
meaningful use once you have achieved it.
Presenters: Kim Witkop, Manager, Snoqualmie Valley Hospital, WA,
Konrad Capeller, CPA, Partner, and Janice Ahlstrom, Partner, FHIMSS,
CPHIMS, RN, BSN

February 2, 2012: Day Three (CAH) | Session Descriptions
Health Care Reform Track
8:30 - 10:00 a.m.
The 3 Rs of Physician Compensation—Rules, Regulations,
and Realities
Health care reform initiatives and regulatory requirements impact physician
compensation whether physicians are practicing independently, are
employed by critical access hospitals, or are contracted in rural communities
through professional -services agreements (PSAs). The objectives of this
session are to provide you with an understanding of how trends in physician
compensation are being impacted by health care reform, and how CAHs
can respond to these market forces in light of the various regulatory
requirements concerning hospital-physician arrangements. In addition, we
will discuss how to attract and retain employed/contracted physicians,
create incentives in physician compensation arrangements to achieve
organizational goals, and maintain compliance
with key Internal Revenue Service, Anti-Kickback, and Stark regulations
applicable to hospital-physician arrangements.
Presenters: Davis Fansler, Director, Jeff Bramschreiber, CPA, Partner,
and Art Saunders, Partner
Reimbursement Track
8:30 - 10:00 a.m.
Preparing for Changes in Financial Reporting
2012 will be a year filled with change. Many changes have been proposed
and adopted relating to how health care entities report and record
transactions in their financial statements. Changes to IRS Form 990 are
affecting how community benefits are reported. In addition, the Medicare
cost report will have multiple form changes. This session will offer insights
into these changes, including:
• Discussion related to current health care industry trends and hot topics
• Key understanding of new accounting and auditing guidance issued by the
FASB and the AICPA
• Highlights of the new Medicare cost report Form 2552-10
• Thoughts on where your time should be focused when preparing or
reviewing the Form 990
Presenters: Tim Ritter, CPA, Senior Manager, and
Cori Schoenke, CPA, Senior Manager
Wipfli Rural Health Clinic and Critical Access Hospital Conference
Technology Track
Day Two Only
General Session
10:15 a.m. - 12:00 p.m.
Pulling It All Together—A Panel Discussion
In this session, health care professionals from two health care organizations
will discuss how they are planning for health care reform.
Essentia Health
For more than 15 years, Essentia Health has focused on fully integrating
hospitals and physician practices. Dan McGinty, Critical Access Group
President, will describe Essentia’s approach to the changes posed by health
care reform legislation. He will also share how Essentia Health is proactively
working to reform the care delivery system at the local level, both clinically
and financially, and the opportunities for critical access and other rural
hospital facilities to play important roles in regional care delivery systems.
St. Benedicts Family Medical Center
Jess Hawley, President of St. Benedicts Family Medical Center, will highlight
how St. Benedicts determined that integration was the right move for them.
Jess will share the journey of how St. Benedicts determined the value
proposition of merging with a PPS hospital and the steps involved in the
integration process. In addition, Jess will discuss how key organizational and
operational issues needed to be addressed before the integration process
could be completed. Finally, we will wrap up with a discussion of next steps
by addressing how health care can be most effectively delivered postintegration.

Wipfli Rural Health Clinic and Critical Access Hospital Conference
REGISTRATION FORM
Registration must be received by Friday, January 20, 2012
Complete the registration form below and mail with your check or credit card information to:
Wipfli LLP
Attention: Sylvia Weise
P.O. Box 690 | Eau Claire, Wisconsin 54702-0690
Check box for registration
$195 – Day One only (RHC) $300 – Days Two and Three only (CAH) $375 – Full conference
Registration
Paying by check: Make check payable to Wipfli LLP | Paying by credit card: Accepted by mail, phone (715.858.6631), or fax (715.832.2345).
Method of Payment: MC Visa DISCOVER AMEX | Cardholder: Individual Company
Card Number:
Cardholder Name (please print) Authorization Signature
Select Concurrent Sessions You Would Like to Attend:
Day Two | February 1: Critical Access Hospital Conference
10:15 a.m. - 12:00 p.m. (choose one)
n Health Care Reform track: Clinical Integration—The Path to True Health Care Delivery Reform
n Reimbursement track: The Basics of Medicare Reimbursement and Cost Reporting
Attendee Name Title
Institution
Address City State ZIP
E-mail address
Phone Number
Please check if you have a need or disability with special requirements (You will be contacted by phone)
Exp. Date:
n Technology track: Leverage EHR Software From a Large IDS Organization—What to Request and What to Expect
MONTH YEAR
1:00 - 3:00 p.m. (choose one)
n Health Care Reform track: Using Valuable Revenue Cycle Information to Make Strategic Pricing and Reimbursement Decisions and to Understand Key Clinical Quality Indicators
n Reimbursement track: Advanced Cost Reporting—“Bottom Line” Impact of Cost-based Reimbursement
n Technology track: Meaningful Use Security Risk Analysis—Does Your Security Risk Analysis Measure Up to the Core Requirement?
3:15 - 5:00 p.m. (choose one)
n Health Care Reform track: Community Health Needs Assessment
n Reimbursement track: The Medicare Cost Report—A Tool for Decision Making and Strategy Development
n Technology track: Meaningful Use–How a Rural CAH Got There and How to Stay There
Day Three | February 2: Critical Access Hospital Conference
8:30 - 10:00 a.m. (choose one)
n Health Care Reform track: The 3 Rs of Physician Compensation—Rules, Regulations and Realities
n Reimbursement track: Preparing for Changes in Financial Reporting
No Technology track: Day Two Only
Amount
Enclosed: $
For additional attendees,
please copy this form. For questions,
please contact Sylvia Weise at
715.858.6631 or
sweise@wipfli.com, or visit
www.wipfli.com/CAH2012.