At the Association of Healthcare Internal Auditor’s (AHIA) 37th Annual Conference, Healthcare Auditing: Weathering Change and Keeping Risks at Bay, healthcare internal auditing professionals developed necessary skills to prepare for unprecedented changes in the seas of healthcare reform.
Five PYA professionals presented at the conference. PYA Principal Martie Ross discussed Aligning Incentives: Value-Based Physician Compensation Models. This presentation:
- Defined the disconnect between productivity-based physician compensation models and the demands of value-based payment models.
- Identified and evaluated alternative physician compensation models.
- Addressed the challenges in transitioning from volume-based to value-based compensation.
- Studied how current fraud and abuse laws conflict with strategies related to value-based compensation, and explore potential solutions.
View the presentation below:
In another session, Key Internal Auditing Perspectives for Advanced Practice Providers (APPs), PYA Principal Angie Caldwell and Consulting Senior Manager Sarah Bowman explored the challenges of physician/APP arrangements. In this session, they:
- Explained how employed physicians may leverage APPs, and describe billing and compliance considerations involving physicians utilizing APPs.
- Analyzed the potential impact on employed physician compensation, including fair market value and commercial reasonableness considerations.
- Summarized government and payer perspectives.
- Equipped attendees with an internal audit framework for assessing their organizations’ compliance risks.
View presentation below:
PYA Principal Tynan Kugler and Consulting Manager Susan Thomas offered best practices in physician arrangements in their discussion, Combat Contract Compliance Concerns. The program was structured to:
- Highlight the importance of regulatory requirements and the consequences of non-compliance for healthcare organizations that deal with physician arrangements.
- Address regulatory considerations such as the Stark Law, Anti-Kickback Statute, and False Claims Act.
- Explore additional risk areas such as OIG Fraud Alerts, Medicare Cost Report Certification, and the responsibilities of boards of directors.
View presentation below:
The AHIA conference occurred August 26-29, 2018, in San Diego, CA.
If you would like more information about compliance, physician compensation models, or transitioning from volume-based to value-based compensation, or would like to request a speaker on these topics for your organization or event, contact a PYA executive below at (800) 270-9629.
