Part 2: Managing Human Resources Through the Time of Turbulence

Kem Tolliver, CMPE, CPC, CMOMPresident, Medical Revenue Cycle Specialists

Taya Moheiser, MBA, CMPE, CMOMOwner, ITS Healthcare LLC

Presenters report no conflicts of interest at time of presentation.

• Analyze the impact of COVID on HR policies and procedures

• Examine updated processes and procedures to promote diversity and inclusivity

• Outline action plans for recruiting, onboarding, and workforce retention

Learning Objectives

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Remote Workforce Management

Workforce Scheduling Automation & Time-Keeping

Scheduling your staff on your phone or being able to swap and fill shifts

Equitable assignment – helping to prevent staff burnout

Putting in over-qualified people is costing too much

Making sure that staff is working to their commitment levels and their licensure

Using Data for Workforce Planning & Decision-Making

Compare workforce financial metrics Predictive analytics to make scheduling decisions

Workforce Management Dashboards

Plan for cash flow Gain operational insights by

identifying denial trends Monitor accuracy and

decrease human error Improve workforce efficiency Automate processes to

reduce labor output Provide employees with

guidance on best practices

Talent Acquisition Modifications as a Result of the PHE

Healthcare Employment Market Considerations

Prior to recruiting,

research the market for

trends

Talent Acquisition Strategies

Virtual Hiring

• Online Interviews• Accelerate

timelines• Streamline

Recruiting processes

• Virtual Onboarding

Internal Hiring

• Leverage internal skill-sets

• Promote internal mobility programs

• Address internal skill-gaps

Recruiters Role in DE&I

• Diversity, equity & Inclusion are cornerstones of recruiting a diverse workforce

• Create diversity goals

• Build diverse interview panels

“Skills are the new currency”

-David Green, Insight222

https://www.shrm.org/resourcesandtools/hr-topics/talent-acquisition/pages/2021-recruiting-trends-shaped-by-covid-19.aspx

Communicating Organizational Culture to Potential Candidates

Employee Assistance Programs (EAP)Therapy sessions, Mental Health

Resources Unemployment benefits, FMLA

Posting COVID-19 Safety Plans

Staggered shifts, enhanced cleaning Reduced capacity, Social distancing

Job Postings

Organizational COVID-19 Plan Notice of virtual interviews

Workforce Retention & Workforce Wellness

Position Your Organization for Employment Success

What kind of work

environments do your employees need from you?

Stay connected to people

Do good things for others

Be grateful for the positives in your

life

Reduce Negativity

Pray/MeditateGet a good night’s sleep

Exercise regularly

Focus on the future

Talk nicely to yourself

Achieving Happiness: Coping with Chronic Stress By Tom Muha, For The Capital, Published 3/29/09

Strategies To Avoid Burnout

According to a survey report from executive firm Witt /Kieffer, 79% of healthcare executives feel that burnout is negatively impacting their organizat ion. In fact , 79% of healthcare executives believe that their organizat ion is not doing enough to reduce or prevent executive burnout .

Report: Understanding The Impact of Burnout on Healthcare Executives - by Fred Pennic 01/28/2019

Burnout rates are well over 40% in most clinician groups, including providers, nurses, mental health professionals, and social workers. In some groups, the rate is over 80%.

UNIVERSITY OF WISCONSIN–MADISON –Lucy Candib

Corporate Culture Aligning with Quarantine Life Adjustments

Competition for the best workforce is fierce. Not only are employers competing against one another, but we’re also competing against increased unemployment benefits and other Federal and State employee incentive payments.

Our workforce has adjusted to living in quarantine so our corporate culture should align with employees needs.

To be successful in acquiring and retaining an optimal workforce, we need to enhance organizational culture to incorporate real-life work/life balance and social perks into our compensation structures.

Employees are real people how have real lives, families and interests outside of work. Let’s incorporate improving their lives into our workforce retention strategies.

Retention Bonuses

Lunch delivery for virtual work meetings Reimburse for remote workstation expenses

(Wi-Fi, laptop, virus protection) Corporate streaming service memberships Grocery delivery discounts

Corporate gym membership Donate to school fundraisers and

children’s sport’s teams Professional development

opportunities Paid memberships

Performance Bonuses

Employee Perks that Matter

Reengineering Job Descriptions

Employee Querying for Modifications in Responsibilities

Our practice needs have changed since the initial date of your employment. We would like to take inventory of your duties that may have been impacted by our modified organizational needs. Please complete this form by sharing with us your daily duties so that we may better support your daily functions.

Name Response

Position

Start Date

Supervisor

Duties & Responsibilities

Performs pre-work ups (i.e. vital signs, BP checks, etc.) and informs provider

of results

Ensures smooth patient flow by managing waiting room and exam room utilizations

Performs in person and virtual pre-work ups (i.e. vital signs, BP checks, etc.) and informs provider of results

Ensures smooth patient flow by managing in person and virtual waiting rooms and in person

and virtual exam room utilization

Obtain copies of insurance cards, photo ID and necessary intake information. Scan into

EMR/PM software.

Liaison with Patient and/or family member(s) for virtual visit that includes registration link, visit

access link and payment link.

Re-Engineer Job DescriptionsM

edical Assistant JD

Old Job Description New Job Description

Incorporating the Quadruple Aim into Workforce Standards

Quadruple Aim

Patient Experience

Population Health

Reducing Costs

Care Team Well-Being

Incorporate patient satisfaction goals into employee performance expectations

Create opportunities for all employees to contribute to organizational population health campaigns

Institute care standards that allow employee to contribute to healthcare cost reduction activities

Implement strategies to foster work environments that promotes care team well-being through wellness plans, structured work environments and leadership support

Staffing Ratio Analysis

Name Title FT/PT Manager Check Out

CheckIn

Phones Eligibility EMR Inbox

ChargeEntry

Un-categorizedDuties

Sue FD PT Magnolia X X X Who knows

Joe Admin PT Magnolia X X X X Too many to list

John Coord PT Magnolia X X Pre-Auths

Mary FD FT Rose X X Who knows

Faye Admin FT Rose X X X X Billing back-up

Hansel MA FT Rose X X Actual MA’ing

Sam Coord FT Rose X X Pre-Auths

Haw

ke E

ye, M

DRo

ger T

hat,

MD

Policy & Manual Changes

HIPAA Sanctions Policy

Class I Offenses:

(1) Accessing information that you do not need to know to do your job(2) Sharing your computer access codes (user name & password)(3) Leaving your computer unattended while you are logged into a PHI program

(4) Sharing PHI with another employee without authorization(5) Copying PHI without authorization(6) Changing PHI without authorization(7) Discussing confidential information in a public area or in an area where the public could overhear the conversation

(8) Discussing confidential information with an unauthorized person(9) Failure to cooperate with privacy officer

Class I Offense Sanctions include but are not limited to:

(a) Verbal reprimand(b) Written reprimand in employee’s personnel file(c) Retraining on HIPAA Awareness(d) Retraining on our Privacy Policy and how it impacts the employee and their department(e) Retraining on the proper use of internal forms and HIPAA required forms

HIPAA Sanctions PolicyClass II offenses:

(1) Second offense of any class I offense; does not have to be the same offense

(2) Unauthorized use or disclosure of PHI(3) Using another person’s computer access codes (user name & password)

(4) Failure to comply with a resolution team resolution or recommendation

Class II offenses shall include, but are not limited to:

(a) Written reprimand in employee’s personnel file(b) Retraining on HIPAA Awareness(c) Retraining on our Privacy Policy and how it impacts the employee and their department(d) Retraining on the proper use of internal forms and HIPAA required forms(e) Suspension of employee (minimum of one (1) day/ maximum of three (3) days)

Class III offenses:

(1) Third offense of any class I offense; does not have to be the same offense

(2) Second offense of any class II offense; does not have to be the same offense

(3) Obtaining PHI under false pretenses(4) Using and/or disclosing PHI for commercial advantage, personal gain or malicious harm

Class III offenses shall include, but are not limited to:

(a) Termination of employment(b) Civil penalties as provided under HIPAA or other applicable Federal/State/Local law(c) Criminal penalties as provided under HIPAA or other applicable Federal/State/Local law

Human Resources Assessment

HR Document Assessment On File Not on File Requires UpdatesHuman Resources Forecasting/PlanningRecruiting strategyEmployment ApplicationHelp Wanted AdApplicant Tracking SystemCoordination of the interview ProcessApplicant resume reviewsEmployment phone interviewsEmployment personal interviewsEmployment verificationCriminal background checks/E-VerifyOffer LettersEmployment Agreement design/writingConfidentiality AgreementsNon-Compete AgreementsNon-solicitation AgreementsPost-Offer Drug TestingPre-employment TestingOrientation of New EmployeesHandbook review/receipt documentationEmployee Onboarding Process

Remote Workforce Software Agreement

Software User Agreement

This Agreement is effective on ________ and ends on ________ by and between “User” __________ and “Company” ___________, located at ________________.

The Company wishes to provide access to its software for the User. Both parties agree as follows:

Software: User will use the following software on behalf of the Company:

1._______________ 2.________________ 3._________________ 4.______________

Purpose: User will use the above software for the following purposes: Patient care, registration and check out activities.

Access: User will be given the following access to the above software: Schedule, EMR, patient demographics, insurance information

Restrictions: User will have the following software restrictions:

Sharing access with others, access outside of the office without advanced written permission ____________________

Remote Workforce Software Agreement

Software Use Restrictions

Copies and ExportUser may not make copies or export data accessed within the Company’s software without the Company’s written permission.

OwnershipThe original and any copies of the software and data contained within the software including translations, compilations, partial copies modifications and updates are the property of the Company. User understands that the Company regards the software contents as its proprietary information and protected health information as confidential trade secrets of great value. User agrees not to divulge any form or portion of this

information to any person other than employees or approved recipients without prior written consent by the Company. User agrees to treat the data contained within the software with the highest degree of confidentiality, privacy and security.

TerminationSoftware access will terminate at the discretion of the Company and in the event of voluntary or involuntary employment termination or breach of this agreement. Upon termination, User will immediately discontinue use of software.

MaintenanceUser will notify Company immediately in the event that the User believes that an error exists in the software.

SeverabilityIn the event that any provision of this Agreement is determined to be invalid or unenforceable, the remainder of this Agreement shall remain in force as such provision were not a part of the Agreement.

Governing LawThis Agreement shall be governed and interpreted by the laws of the ____________________________.

HIPAA Privacy & Security

HIPAA Still Exists

There were some flexibilities put into place during the Public Health Emergency. Some of those are going to expire. This includes the waiver of HIPAA penalties when good-faith has been evidenced.

1. Perform your annual HIPAA training2. Perform focused training on flexibilities that will expire with the PHE3. Have staff sign-off on training completion and test their knowledge in written form4. Perform and remediate a security risk assessment annually5. Read MGMA's Washington Connection emails and evaluate your impact

1. Example: The 2022 Proposed rule from CMS suggests changes to OIG LEIE requirements which may be finalized in November. IF finalized, all staff and vendors would need to be evaluated against the OIG's List of Excluded Individuals/Entities. If a provider has a relationship with an employee or vendor who is on the LEIE, they could have their licensure with Medicare suspended on terminated.

HIPAA Data Breach Statistics

78.66% External threats

13.75% Inside the

organization

2021 Reported Breaches

40% Email addresses exposed

33% Passwords

Data Breaches that exposed access credentials

24% Global Data

Breach decline

1.5% U.S. Data

Breach increase

Data Breaches first 6 months of 2021

www.hipaajournal.com/healthcare-industry-has-highest-number-of-reported-data-breaches-in-2021/

Consolidate HIPAA & OSHA Training

Many Waste Management vendors offer online support for healthcare organizations that are bundled into monthly waste management fees. Regardless of which resources your organization chooses, bundling services streamlines and consolidates information and portal access for leadership and workforce access.

Training Programs OSHA HIPAA Sharps Safety Use of Personal Protective Equipment (PPE)

Resources Pharmaceutical Waste COVID-19 Bloodborne Pathogens Compliance Documents

OIG LEIE & Compliance Plan

Search for An IndividualSearch for Multiple Individuals | Search for A Single Entity | Search for Multiple Entities

OIG List of Excluded Individuals/Entities (LEIE)

- 33 -©2021 MGMA. All rights reserved.

Last Name (and/or) First Name

Mandatory ExclusionLasts a minimum of 5 years and

are imposed if an individual or entity is convicted of a certain criminal offence

Permissive ExclusionBased on OIG's authority and

discretion based on a wide range of grounds; to exclude an individual or entity

OIG List of Excluded Individuals/Entities (LEIE)

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Wanted For Child Support Obligations

View All Child Support Fugitives

Employer Liability Protect your Patients Include in Onboarding Conduct Routinely

Email: exclusions@oig.hhs.govPhone: (202) 691-2311Fax: (202) 691-2298

HHS, OIG, OIAttn: Exclusions BranchP.O. Box 23871Washington, DC 20026

OIG Compliance Guidance

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OIG Comments – FR 59435The OIG believes that physician practices can realize numerous other benefits by implementing a compliance program. A well-designed compliance program can:• Speed and optimize proper payment of claims• Minimize billing mistakes• Reduce the chances that an audit will be conducted • Avoid conflicts with the self-referral and anti-kickback statutes

OIG Comments – FR 59438To assist physician practices in performing this initial assessment, the OIG has developed a list of four potential risk areas affecting physician practices. These risk areas include:• Coding and billing• Reasonable and necessary services• Documentation• Improper inducements, kickbacks and self-referrals• Specific Risk Areas

59434 Federal Register / Vol. 65, No. 194 / Thursday, October 5, 2000 / NoticesSource: http://oig.hhs.gov/authorities/docs/physician.pdf

Understand regulations

impacting HR Management

Identify credible

resources

Utilize dashboard to manage workforce

Update internal

documents

Incorporate Diversity

and Inclusion

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Conclusion

Kem Tolliver

Kem@MedRevenueCycle.com

@KemTolliver

https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

Taya Moheiser

Taya@ITSHealthcareConsulting.com

@TayaMoheiser

Linkedin.com/in/TayaMoheiser

Thank You!