Optimizing Career Value

1. Optimizing Career Value Presented by: Harmony Healthcare’s Vice President of Client Solutions September 20th, 2019

2. Goals for the presentation • Provide ideas on how to maximize marketability • Give overview of the talent market today • Provide an overview of the skills, experience, and credentials clients covet • Predict the future (or try) of skills will be valued in the future

3. Our Perspective • 14 years of experience working with hospitals • Approximately 450 consultants working for hospitals across the country (130 CDI professionals) • 75 Percent of our business is directly or indirectly serving hospitals • 20 Percent of our business is directly supporting physician practices • Corporate partner for many of the major consulting and technology firms that support mid revenue cycle functions • 20,000 client and prospect interactions each month

4. Foundational Requirements • Career advancement requires personal investment and sacrifice • You are your best advocate • You will also need help along the way • Being a professional does not stop when you go home • Knowledge is the principal differentiator

5. Education and Credentials • Identify credentials that you have the prerequisites for • Research the advantages of formal education, what is the upside for sacrificing personal time to obtain another degree or credential • Read white papers and industry publications • The importance of dual credentials (what can this mean to your paycheck) • Ask for sponsorship from your employer, is it possible to get what your want without spending time outside of work to get there?

6. The financial value of education Ability Network

7. Volunteering and Self Education • Improve by volunteering to work on cases outside of your area of expertise • Find opportunities to volunteer and work on higher acuity cases within your area(s) of competence • Read white papers, do research, spend 30 minutes each day learning something new or more about what you already know • Take practice leaders to lunch • Ask to participate in leadership meetings

8. Identify a mentor • Birds of a feather, find a “target” and be a sponge • Identifying a mentor requires humility and passion, no one will invest their time if you are going through the motions • Explain your goals, what do you want to accomplish • Be professionally “annoying”, a mentor will often only provide the tools you ask for…..so ask! • Spend time identifying the right mentor, you may have to look outside your current employer

9. The importance of reputation • Arrive early and stay late, how can you be more involved? • Day to day behavior matters, maintain a professional attitude in all situations • Personal presentation plays a tangible role on perception of ability and capability • Get involved, sacrifice time to attend chapter meetings, national conferences, unpaid studies • Get “published”; blogs, linked in post, and/or educational content

10. Social Media, It matters • Create a Linked In profile that accurately reflects your experience while publicly acknowledging your goals • Watch what you post and “like” on social media, more companies than ever are researching your social media accounts before making hiring decisions • https://harmony.solutions/3-concrete-tips-to-leveraging-linkedin-to-get-a-job/ • Use the power of Linked In groups • Keep an eye on job postings and other activity in your local market

11. Market Trends

12. Understanding the national market, key questions • The best way to position career growth is to understand opportunities you have access to • Which hospitals and organizations hire nationally (opposed to locally)? • What does someone in the same position at a similar sized organization expect for pay in a different area? • What credentials or combinations of credentials are demanding the best pay or provide the best opportunity for advancement? • Which organizations covet the skills and experience you possess? https://www.advisory.com/daily-briefing/2019/01/08/hospital-revenue

13. The World is Flat • Meaningful use leveled the playing field for numerous positions within the revenue cycle • The ability to perform key functions remotely changed hiring strategies and realities • Organizations that take advantage of the new reality increase the quality of talent while reducing cost • Entities relying on local salary guides pay more for less talented employees/consultants • What it means for hospitals leaders and staff employees https://harmony.solutions/4-key-takeaways-from-a-new-reality-the-flat-talent-market/

14. Staffing Trends • Clients requested Harmony support because of backlogs, staffing shortages, and special projects for nearly 90% of all engagements through the end of 2018 • Over the past 9 months, that percentage has reduced to 65% “need” with an exponential increase in value added skillsets to assist with proactive strategies • Providers, strategic partners, and payers are demonstrating a willingness to pay for unique experience/skill • A seismic shift in where services are performed and where they are predicted to be performed is changing the strategic planning of hospital executives CMS; Hospitals, beds and occupancy rates, by type of ownership and size of hospital: United States, selected years 1975-2014, CDC, available at https://www.cdc.gov/nchs/dada/hus/2016/089.pdf

15. Future employment competition, Millennials • Millennials have grown up in a technology-powered consumer environment • Norms • Transparency • Rapid delivery • Convenience • Expectations of efficiency and service may be a positive catalyst for a slow-to-change industry

16. Attracting & Retaining Millennial Talent Employer Perception and Image Assure fair treatment and strong sense of corporate social responsibility Salary and Perks Offer flexible hours and schedules with high value on benefits and perks Work environment Embrace dominate focus of work environment is work-life balance Job-specific opportunities Provide ways to gain skills to advance their career Ability Network

17. Shifting to value-based care • Risk based insurance plans continue to expand • Data is determining strategies for the top consulting/advisory firms • Case prioritization is the focus of many established programs • Reporting capabilities have improved, key metrics are being looked at by hospital leaders across the board • Providers and companies that support providers are doubling down for the right talent • Hospitals and health systems struggle to keep pace with payer advancements/changes and denials are skyrocketing • Continued M&A activity/consolidation

18. Technology effects to consider • Vast investment into “AI” and computer assisted programs was made to manage the shortage in talented CDI and coding professionals • Character recognition software is increasing the amount of useful and available documentation • Prioritization of cases reviewed can lead to less reliance or more efficient use of CDI professionals • While the value of interpretation will never diminish, the amount of work CDI professionals will be responsible for will inevitably diminish over time in the inpatient setting

19. Opportunities for growth

20. Physician Education remains paramount • All strategies fail if physicians do not act • Acquired practices require significant education with many currently performing point of care (POC) “coding” • Are continued CDI metric improvements needed? • Clinical validation issues in the inpatient setting require CDIS intervention on the front end • Education for physicians requires a personal relationship that is less susceptible to technology replacement • The talent gap is extreme, not all adequate concurrent reviewers possess the skills needed to change physician behavior positively

21. Overcoming the technology “threat” • Prospective payment experts will forever be coveted by providers, payers, and the many companies that serve those markets • The “unicorns” clinicians and coders that have advanced knowledge of technology • Constantly seek knowledge into higher complexity cases which may never be fully automated • Seek formal technology education and training • Refrain from specific application knowledge rather than higher level understandings https://getreferralmd.com/2019/01/healthcare-technology-trends-for-2019/

22. Population Health and the impact on mid revenue cycle professionals • Claims data is the foundation for quality scores and hospital strategies • Hospital quality scores rely on retrospective data (coded claims) • Health care leaders are using data to determine future strategies and investment • Understanding/Interpreting big data is in high demand • Fundamentals of data analysis rely on individuals that understand the prospective payment system (coders) • Positions within decision support & data analytics are commanding higher salaries than traditional coding positions https://go.beckershospitalreview.com/hubfs/Hospital%20IQ%20WP%202.26.pdf

23. Data Driven Decisions, Data Driven Positions • Data is driving key strategy decisions for hospital leaders • Individuals with the ability to leverage data will be promoted quicker • Decision support positions for a variety of hospital departments is increasing • Understanding individual and group performance in an unbiased manner will appeal to future workforce • Performance improvement will be measured transparently (Do you really want to know where you stand?) https://www.cio.com/article/3209911/big-data-certifications-that-will-pay-off.html

24. DRG and Clinical Validation Denials • The focus of payer and government recovery auditors is changing significantly • 2 midnight rule and medical necessity denials dominated focus for 2017-2018 • Recent shifts to DRG denials require unique clinical and reimbursement knowledge • Clinical Validation (CV) denials are a major revenue threat to the vast majority of hospitals • CDI professionals possess foundational skills needed to combat this threat • Opportunity to advance or add value to current job descriptions will command higher pay

25. The value of understanding the risk adjustment environment • Risk adjustment is about Chronic Disease Management • Medicare Advantage plans continue expansion • Outpatient CDI programs are expanding nationally • Investment is increasing on the physician practice reimbursement side • Global risk & capitation is becoming more prevalent with large physician groups to maximize revenue streams based on their membership panels • CMS administers the risk adjustment program for Medicare Advantage • Many state-based Medicaid plans & ACOs have adopted similar medical risk adjustment methods.

26. Outpatient CDI • Less than 40% of hospitals have a formal outpatient CDI program • Of those, less than 10% have established programs with the vast majority in infancy stages • Higher volume and lower acuity of cases requires a different approach • Understanding risk adjustment on the outpatient side will also benefit inpatient CDIS • Opportunities for leadership and position growth will continue to increase for OP CDI in all settings (physician practice and ED/Ambulatory settings) • New risk adjustment credentials may increase marketability and salary demands https://www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage/

27. Questions and Answers