Agenda | Kisaco Research

Agenda

Revenue Cycle Management Summit
5-7 February, 2025
Millennium Maxwell House Nashville

Day 1: Wednesday, 5 Feb, 2025
7:30am
Registration
8:30am
Executive Panel
  • Gain insights into the current state of the RCM industry and understand the key challenges healthcare organizations face. 
  • Identify strategic priorities for enhancing financial performance and optimizing the revenue cycle. 
  • Explore the impact of adopting cutting-edge technologies and tools to streamline revenue cycle management processes, reduce costs, and improve overall profitability.
Revenue Cycle Management

Author:

Edward Marx

Chief Executive Officer
Marx Advisory

The youngest child of Holocaust survivors, Ed moved to the United States at age 10. At 16, he served as a medical clinic janitor where he discovered his healthcare calling. Ed took successive positions as combat medic, anesthesia tech, strategic planner and technology manager. He quickly learned how the convergence of clinical, business and digital saved lives. His passion ignited, he jumped feet first into technology and operations in the C-Suite of Cleveland Clinic, NYC Health & Hospitals, Texas Health Resources and University Hospitals.

Intermixed, Ed served the supplier side as well. He was CEO for consulting firm Divurgent, global CDO for Tech Mahindra Health & Life Sciences and CIO of the Advisory Board. Concurrently, he served 15 years as an Army combat engineer officer and combat medic. Today, Ed is focused on his own advisory practice.

Ed does a fair amount of speaking, writing and podcasting. He authored healthcare bestsellers including “Voices of Innovation” and “Healthcare Digital Transformation”. He is currently writing a book for Mayo Clinic on “Patient Experience” and “Voices of Innovation - Payers”. His podcast “DGTL Voices” is “Top 3%” globally. His Blog, CEO Unplugged, surpassed 1M views. Ed recently started a YouTube channel to expand his audience.

Most importantly, Ed is husband to Simran who holds a Doctor of Nursing (DNP). They love to dance and climb mountains. They have 5 grown children and 4 grandchildren. To stay fit, he is captain of TeamUSA Triathlon.

For more career information you can find me:

Twitter https://twitter.com/marxtango

LinkedIn https://www.linkedin.com/in/edwardmarx/

Website https://www.marxadvisory.com/

YouTube https://www.youtube.com/@EdwardMarx

Edward Marx

Chief Executive Officer
Marx Advisory

The youngest child of Holocaust survivors, Ed moved to the United States at age 10. At 16, he served as a medical clinic janitor where he discovered his healthcare calling. Ed took successive positions as combat medic, anesthesia tech, strategic planner and technology manager. He quickly learned how the convergence of clinical, business and digital saved lives. His passion ignited, he jumped feet first into technology and operations in the C-Suite of Cleveland Clinic, NYC Health & Hospitals, Texas Health Resources and University Hospitals.

Intermixed, Ed served the supplier side as well. He was CEO for consulting firm Divurgent, global CDO for Tech Mahindra Health & Life Sciences and CIO of the Advisory Board. Concurrently, he served 15 years as an Army combat engineer officer and combat medic. Today, Ed is focused on his own advisory practice.

Ed does a fair amount of speaking, writing and podcasting. He authored healthcare bestsellers including “Voices of Innovation” and “Healthcare Digital Transformation”. He is currently writing a book for Mayo Clinic on “Patient Experience” and “Voices of Innovation - Payers”. His podcast “DGTL Voices” is “Top 3%” globally. His Blog, CEO Unplugged, surpassed 1M views. Ed recently started a YouTube channel to expand his audience.

Most importantly, Ed is husband to Simran who holds a Doctor of Nursing (DNP). They love to dance and climb mountains. They have 5 grown children and 4 grandchildren. To stay fit, he is captain of TeamUSA Triathlon.

For more career information you can find me:

Twitter https://twitter.com/marxtango

LinkedIn https://www.linkedin.com/in/edwardmarx/

Website https://www.marxadvisory.com/

YouTube https://www.youtube.com/@EdwardMarx

Author:

Lisa Meredith

AVP, Revenue Cycle Management
LifePoint Health

Lisa Meredith

AVP, Revenue Cycle Management
LifePoint Health
9:00am
  • Learn how to identify and overcome clinical and technical denial triggers, potentially saving your organization millions in lost revenue.

  • Walk away with actionable, data-driven techniques to analyze your denial trends, close process gaps and improve first-pass resolution rates. 
Revenue Cycle Management

Author:

Lisa Meredith

AVP, Revenue Cycle Management
LifePoint Health

Lisa Meredith

AVP, Revenue Cycle Management
LifePoint Health

Author:

Howard Kung

Senior Director, Revenue Cycle
Mayo Clinic

Howard Kung

Senior Director, Revenue Cycle
Mayo Clinic
9:30am
  • Learn proven tactics and strategies that the panelists have implemented within their organization to handle denials effectively and efficiently as they arise. 
  • Listen to our expert panel as they provide practical insights on building a robust denials management program.
  • Discover the role technology plays in tracking, analyzing, and optimizing denial management workflows in our panelist's organizations.
Revenue Cycle Management

Author:

Paul LePage

Executive Director, Revenue Cycle Operations
Banner Health

Paul LePage

Executive Director, Revenue Cycle Operations
Banner Health

Author:

Betye Ochoa

Director, Revenue Cycle Redesign
NorthShore University HealthSystem

Betye Ochoa

Director, Revenue Cycle Redesign
NorthShore University HealthSystem

Author:

Ebrahim Barkoudah

System Chief & Regional Chief Medical & Quality Officer
Baystate Health

Ebrahim Barkoudah

System Chief & Regional Chief Medical & Quality Officer
Baystate Health

Author:

Brennan John

Director, Revenue Cycle
Intermountain Health

Brennan John

Director, Revenue Cycle
Intermountain Health
10:15am
10:45am
Networking Break
12:00pm
  • Discover the four key capacity drivers that enhance patient access.
  • Learn strategies to maximize capacity and access across clinics, groups, and organizations.
  • Understand the metrics for measuring capacity and access and explore their interconnections.
Revenue Cycle Management

Author:

Paul Schmitz

Executive Director, Patient Access
AdventHealth

Paul Schmitz

Executive Director, Patient Access
AdventHealth
12:30pm
  • Listen to quick tips on expediting front-end revenue cycle processes such as registration, insurance verification and pre-authorisation.

  • Deep dive into specific metrics on how an integrated financial clearance process can help your revenue cycle.

  • Learn the challenges and benefits of technology adoption in early patient access.
Revenue Cycle Management

Author:

Ismet Sharich

Patient Access Director
Riverside Healthcare

Ismet Sharich

Patient Access Director
Riverside Healthcare
13:00pm
Lunch and Networking
14:30pm
  • Explore the tenets of financial sustainability for healthcare organizations.
  • Gain insight into hospital governance.
  • Engage in a tactical discussion on collaboration between payors and healthcare organizations.
  • Envision the future of a successful healthcare ecosystem - Clinical and Clinician Integration: A Thought Provocation.
Revenue Cycle Management

Author:

Dr Deepak Goyal, MD, MBBS, MBA, CPE, CHCQM, CMRP, CMPC

Executive Medical Director Revenue Cycle and Supply Chain
Monument Health

Dr Deepak Goyal, MD, MBBS, MBA, CPE, CHCQM, CMRP, CMPC

Executive Medical Director Revenue Cycle and Supply Chain
Monument Health
15:00pm
  • Learn to solve one of the most costly RCM Challenges - An open discussion regarding practical tools and insights to minimize costly errors and boost revenue.
  • Discover technology enablers - How to determine if the value is attainable when choosing technology.
  • Learn how to leverage all resources - The solution must include both your team and your technology. 

Author:

Stacy Calvaruso

Vice President of Sales and Client Delivery
ASP-RCM Solutions

Stacy Calvaruso

Vice President of Sales and Client Delivery
ASP-RCM Solutions
15:30pm
Networking Break
16:45pm
  • Expand your perspective by exploring LOVE as a transformative business strategy.
  • Discover how loving leadership fosters a culture of engaged and motivated employees.
  • Reflect on strategies for normalizing love as an integral part of business practices.
Revenue Cycle Management

Author:

Cynthia Johnson

(former) Senior Director, Referral & Claims Administration
Kaiser Permanente

Cynthia Johnson

(former) Senior Director, Referral & Claims Administration
Kaiser Permanente
17:15pm
  • Discover a proven approach to cultivating top performers as a foundation for sustained success. We will focus on the 3 Cs—compassion, consistency, and coachability—key traits for leaders at every level.
  • Learn how setting clear guardrails for leadership while promoting autonomy can drive high-performing, cohesive teams.
  • Explore how adopting a servant-supportive leadership style led to measurable results, including a 22.3% increase in team engagement, a 117% reduction in turnover, and an improved budgeted fill rate from 93.2% to 98.5%.
Revenue Cycle Management

Author:

Willie Brown

VP, Revenue Cycle
Sentara Healthcare

Willie Brown

VP, Revenue Cycle
Sentara Healthcare
17:45pm
  • Explore a detailed case study of Trinity Health’s Lean Daily Management Training Effectiveness Dashboard, showcasing its methodology for measuring Revenue Cycle knowledge transfer and proficiency.
  • Learn vendor-agnostic tools and strategies applied across 17 Health Information Systems (HIS), utilizing the Kirkpatrick Model of Assessment and insights from training over 8,000 professionals.
  • Dive deep into advanced assessment techniques for Revenue Cycle training and gain a practical Journey Map to evaluate and enhance training effectiveness, starting from your organization’s current state.

Author:

Edward B. Thomas MBA/MSW

Director, Enterprise Revenue Cycle Training & Deployment
Trinity Health (HQ Michigan)

Edward B. Thomas MBA/MSW

Director, Enterprise Revenue Cycle Training & Deployment
Trinity Health (HQ Michigan)
18:15pm
Closing Comments and Networking Drinks
Day 2: Thursday, 6 Feb, 2025
7:30am
Registration
8:30am
9:00am
9:30am
  • Gain a concise overview of the 5 OIG healthcare risk areas, including the False Claims Act, Anti-Kickback Statute, Civil and Monetary Penalties, Exclusions, and the Stark Law.
  • Discover the areas commonly denied and at risk of violating the False Claims Act, including medical necessity of admissions and services, unbundling and improper coding and modifier assignment, double billing, billing for services not provided, upcoding, and billing non-covered services as provided.
  • Walk away with resources available to identify what the OIG is targeting and internal resources that facilities can utilize to identify and mitigate hospital-specific risks.
  • Learn about the factors to consider when determining the need to involve legal counsel.
Revenue Cycle Management

Author:

Jill Sell-Kruse

Director, Compliance Risk & Oversight Ethics & Compliance
ScionHealth

Jill Sell-Kruse

Director, Compliance Risk & Oversight Ethics & Compliance
ScionHealth
10:00am
  • Review the latest updates to the OIG's Compliance Guide to ensure your practice aligns with current standards.
  • Identify potential issues impacting your practice and implement proactive measures to address them effectively.
  • Stay informed about recent developments in the compliance landscape to maintain adherence to evolving regulations.

Author:

Sandy Giangreco Brown

VP, Revenue Integrity & Education
Spire Orthopedic Partners

Sandy Giangreco Brown

VP, Revenue Integrity & Education
Spire Orthopedic Partners
10:30am
Networking Break
11:45am

• Identify risk areas in chargemaster (CDM) pricing that are often overlooked.
• Describe ways to rationalize and defend pricing.
• Effectuate processes to stay current with price transparency regulations.

Revenue Cycle Management

Author:

Sandy Giangreco Brown

VP, Revenue Integrity & Education
Spire Orthopedic Partners

Sandy Giangreco Brown

VP, Revenue Integrity & Education
Spire Orthopedic Partners
12:15pm
Revenue Cycle Management

Author:

Frank Shipp

Executive Director
Johns Hopkins Medicine

Frank E. Shipp currently serves as Executive Director of the Johns Hopkins Clinical Alliance, the clinically integrated network of Johns Hopkins Medicine. The network includes over 3,000 providers, consisting of both employed and independent practices.

Frank transitioned to value-based care after 25 years of hospital-based operations experience in both community and academic health systems. During the past nine years, Frank has held executive positions in a Payor-Provider Organization in NYC and has built a highly successful CIN over a five-year period in Northern New Jersey. Frank speaks regular at national healthcare conferences regarding value-based care strategies and tactics.

Frank completed his MBA at Fairleigh Dickinson University, is a certified Fellow of the American College of Healthcare Executives and a trained Black Belt in Lean Six Sigma from Villanova University.

Frank Shipp

Executive Director
Johns Hopkins Medicine

Frank E. Shipp currently serves as Executive Director of the Johns Hopkins Clinical Alliance, the clinically integrated network of Johns Hopkins Medicine. The network includes over 3,000 providers, consisting of both employed and independent practices.

Frank transitioned to value-based care after 25 years of hospital-based operations experience in both community and academic health systems. During the past nine years, Frank has held executive positions in a Payor-Provider Organization in NYC and has built a highly successful CIN over a five-year period in Northern New Jersey. Frank speaks regular at national healthcare conferences regarding value-based care strategies and tactics.

Frank completed his MBA at Fairleigh Dickinson University, is a certified Fellow of the American College of Healthcare Executives and a trained Black Belt in Lean Six Sigma from Villanova University.

12:45pm
  • Explore insights and strategies needed to navigate contract negotiations with confidence and expertise, ensuring you secure the best terms for your organization.

  • Recognize resources for the rules governing various types of health plans and contracting entities.

  • Understand different reimbursement models, discuss techniques for preparing for
    and conducting successful contract negotiations, and highlight common
    challenges and how to overcome them.

Revenue Cycle Management

Author:

Richelle Marting

Director, Managed Care Contracting
North Kansas City Hospital, Meritas Health Corporation

Richelle Marting

Director, Managed Care Contracting
North Kansas City Hospital, Meritas Health Corporation
13:15pm
Networking Break
14:45pm
  • Explore strategies for fostering stronger partnerships and enhancing cooperation between payers and providers to achieve mutual goals.

  • Discover how payers and providers can work together more effectively in key areas such as risk adjustment, utilization management, data sharing, and value-based care.

  • Learn how successful collaboration can lead to better patient outcomes, more accurate reimbursements, and improved financial performance for both payers and providers.

Revenue Cycle Management

Author:

Cynthia Johnson

(former) Senior Director, Referral & Claims Administration
Kaiser Permanente

Cynthia Johnson

(former) Senior Director, Referral & Claims Administration
Kaiser Permanente

Author:

Catherine Pesek Bird

Physician Advisor
Lakeland Regional Health-Florida

Catherine Pesek Bird

Physician Advisor
Lakeland Regional Health-Florida

Author:

Dr Priscilla Alfaro, MD, FAAP, CPC, CPMA, COC, CIC, CFE

VP Payment Integrity
Blue Cross NC

Dr. Priscilla Alfaro is a seasoned healthcare professional with extensive experience in executive medical management, fraud prevention, and healthcare analytics. A certified medical coder, fraud examiner, and auditor, she has a proven track record of improving healthcare efficiency and preventing fraud, waste, and abuse across various roles and affiliations, including the Texas HHS and Anthem.

Dr Priscilla Alfaro, MD, FAAP, CPC, CPMA, COC, CIC, CFE

VP Payment Integrity
Blue Cross NC

Dr. Priscilla Alfaro is a seasoned healthcare professional with extensive experience in executive medical management, fraud prevention, and healthcare analytics. A certified medical coder, fraud examiner, and auditor, she has a proven track record of improving healthcare efficiency and preventing fraud, waste, and abuse across various roles and affiliations, including the Texas HHS and Anthem.

15:15pm
  • Learn practical strategies to help your organization navigate the intricacies of working with numerous payers, each with its own rules, requirements, and reimbursement models.

  • Our expert speaker will share insights on keeping up with compliance, optimizing workflows, leveraging technology for more efficient payer management, and building stronger relationships with payers.

Revenue Cycle Management

Author:

Garland Goins Jr

VP, Revenue Cycle Management
Avance Care

Garland Goins Jr

VP, Revenue Cycle Management
Avance Care

Author:

Monique Pierce

Payment Solutions & Operations
Cohere Health

Monique is a Strategic Executive Healthcare Leader with proven ability to develop solutions and maximize the benefits of Payment Integrity programs.  She is known for having excellent domain knowledge and being driven, high performing, and having a deep dedication to recruiting and developing top talent.

 

Monique started her Payment Integrity career at Oxford HealthPlans in the COB and Subrogation Department after spending time in Payment Policy.  When United Healthcare acquired many health plans in the early 2000s like Oxford, Monique was tagged as part of the Optum team to integrate the processes and people into the COB systems that she had built at Oxford.  She led systems development, quality, reporting, operations, vendor management and was responsible for creating innovative proactive programs that more than doubled savings to $1.4B in three years.

 

Monique developed a successful program that reduced interest expense on late claims for UHC, assisted a communication company to develop COB tools and assisted in strategic system projects before joining SCIO Health Analytics in 2014 to develop new products - specifically prepayment programs.

In 2015 she became the product owner of SCIOMine, the company’s internal audit application and managed the roadmap.  Monique also owned

strategic direction for operational metrics and reporting including executive scorecards. Monique was promoted to VP of Business Opportunities and Client Engagement where she improved Audit Recovery TAT by 39% and reduced client implementations TAT by 11% and the Level of Effort by 18% while increasing the count of implementation projects by 126%.

 

In 2020 Monique joined Devoted Health, a startup company with the goal of building the first ever integrated Payment Integrity Program.  The company has one system, great data, and a great mission; to change health care by treating every member as if they are family.

 

In her spare time, Monique volunteers her time in the community on the Board of Directors of SCARE NH and works in her family business LARP Portal with her husband Rick.

Monique Pierce

Payment Solutions & Operations
Cohere Health

Monique is a Strategic Executive Healthcare Leader with proven ability to develop solutions and maximize the benefits of Payment Integrity programs.  She is known for having excellent domain knowledge and being driven, high performing, and having a deep dedication to recruiting and developing top talent.

 

Monique started her Payment Integrity career at Oxford HealthPlans in the COB and Subrogation Department after spending time in Payment Policy.  When United Healthcare acquired many health plans in the early 2000s like Oxford, Monique was tagged as part of the Optum team to integrate the processes and people into the COB systems that she had built at Oxford.  She led systems development, quality, reporting, operations, vendor management and was responsible for creating innovative proactive programs that more than doubled savings to $1.4B in three years.

 

Monique developed a successful program that reduced interest expense on late claims for UHC, assisted a communication company to develop COB tools and assisted in strategic system projects before joining SCIO Health Analytics in 2014 to develop new products - specifically prepayment programs.

In 2015 she became the product owner of SCIOMine, the company’s internal audit application and managed the roadmap.  Monique also owned

strategic direction for operational metrics and reporting including executive scorecards. Monique was promoted to VP of Business Opportunities and Client Engagement where she improved Audit Recovery TAT by 39% and reduced client implementations TAT by 11% and the Level of Effort by 18% while increasing the count of implementation projects by 126%.

 

In 2020 Monique joined Devoted Health, a startup company with the goal of building the first ever integrated Payment Integrity Program.  The company has one system, great data, and a great mission; to change health care by treating every member as if they are family.

 

In her spare time, Monique volunteers her time in the community on the Board of Directors of SCARE NH and works in her family business LARP Portal with her husband Rick.

15:45pm
  • Discover practical communication strategies to keep patients informed, engaged, and satisfied beyond their visit to the hospital. 

  • Explore the latest cutting-edge technology, such as automated messaging, AI-driven communication platforms, and personalized outreach strategies.
Revenue Cycle Management

Author:

Andrew Zurick

Medical Director Cardiac CT & MRI, Staff Cardiologist
Ascension, St Thomas Heart

Andrew Zurick

Medical Director Cardiac CT & MRI, Staff Cardiologist
Ascension, St Thomas Heart

Author:

Michelle Myers

Director, Patient Financial Services
Boulder Care

Michelle Myers

Director, Patient Financial Services
Boulder Care
16:15pm
  • Understand the critical role of Patient Price Estimates in improving transparency and patient satisfaction.
  • Learn effective methods to measure POS collections and use these insights to drive performance improvements.
  • Equip your team with a clear understanding of the "Why" behind their efforts.
Revenue Cycle Management

Author:

Becky J. Peters

Executive Director of Patient Access Services
Banner Health

Becky J. Peters

Executive Director of Patient Access Services
Banner Health
16:45pm
Closing Remarks
19:00pm
Payer-Provider Party
Day 3: Friday, 7 Feb, 2025
8:00am
Registration
9:35am
  • Discuss assessing and selecting the right technologies (e.g., EHRs, automation tools, AI, and analytics platforms) that align with an organization’s RCM needs and overall goals, considering factors like cost, scalability, and ease of integration.
  • Explore the technical challenges of integrating diverse technologies into existing RCM workflows, including data interoperability and system compatibility.
  • Address the human element of technology adoption, focusing on how to manage change within the organization, train staff effectively, and foster a culture of innovation to ensure successful implementation.
  • Discuss how to measure new technologies and return on investment (ROI), including key metrics like reduced Days in AR, increased collection rates, improved patient satisfaction, and cost savings.
Revenue Cycle Management

Author:

Brennan John

Director, Revenue Cycle
Intermountain Health

Brennan John

Director, Revenue Cycle
Intermountain Health
10:30am
Networking Break
11:00am

Author:

Edward Marx

Chief Executive Officer
Marx Advisory

The youngest child of Holocaust survivors, Ed moved to the United States at age 10. At 16, he served as a medical clinic janitor where he discovered his healthcare calling. Ed took successive positions as combat medic, anesthesia tech, strategic planner and technology manager. He quickly learned how the convergence of clinical, business and digital saved lives. His passion ignited, he jumped feet first into technology and operations in the C-Suite of Cleveland Clinic, NYC Health & Hospitals, Texas Health Resources and University Hospitals.

Intermixed, Ed served the supplier side as well. He was CEO for consulting firm Divurgent, global CDO for Tech Mahindra Health & Life Sciences and CIO of the Advisory Board. Concurrently, he served 15 years as an Army combat engineer officer and combat medic. Today, Ed is focused on his own advisory practice.

Ed does a fair amount of speaking, writing and podcasting. He authored healthcare bestsellers including “Voices of Innovation” and “Healthcare Digital Transformation”. He is currently writing a book for Mayo Clinic on “Patient Experience” and “Voices of Innovation - Payers”. His podcast “DGTL Voices” is “Top 3%” globally. His Blog, CEO Unplugged, surpassed 1M views. Ed recently started a YouTube channel to expand his audience.

Most importantly, Ed is husband to Simran who holds a Doctor of Nursing (DNP). They love to dance and climb mountains. They have 5 grown children and 4 grandchildren. To stay fit, he is captain of TeamUSA Triathlon.

For more career information you can find me:

Twitter https://twitter.com/marxtango

LinkedIn https://www.linkedin.com/in/edwardmarx/

Website https://www.marxadvisory.com/

YouTube https://www.youtube.com/@EdwardMarx

Edward Marx

Chief Executive Officer
Marx Advisory

The youngest child of Holocaust survivors, Ed moved to the United States at age 10. At 16, he served as a medical clinic janitor where he discovered his healthcare calling. Ed took successive positions as combat medic, anesthesia tech, strategic planner and technology manager. He quickly learned how the convergence of clinical, business and digital saved lives. His passion ignited, he jumped feet first into technology and operations in the C-Suite of Cleveland Clinic, NYC Health & Hospitals, Texas Health Resources and University Hospitals.

Intermixed, Ed served the supplier side as well. He was CEO for consulting firm Divurgent, global CDO for Tech Mahindra Health & Life Sciences and CIO of the Advisory Board. Concurrently, he served 15 years as an Army combat engineer officer and combat medic. Today, Ed is focused on his own advisory practice.

Ed does a fair amount of speaking, writing and podcasting. He authored healthcare bestsellers including “Voices of Innovation” and “Healthcare Digital Transformation”. He is currently writing a book for Mayo Clinic on “Patient Experience” and “Voices of Innovation - Payers”. His podcast “DGTL Voices” is “Top 3%” globally. His Blog, CEO Unplugged, surpassed 1M views. Ed recently started a YouTube channel to expand his audience.

Most importantly, Ed is husband to Simran who holds a Doctor of Nursing (DNP). They love to dance and climb mountains. They have 5 grown children and 4 grandchildren. To stay fit, he is captain of TeamUSA Triathlon.

For more career information you can find me:

Twitter https://twitter.com/marxtango

LinkedIn https://www.linkedin.com/in/edwardmarx/

Website https://www.marxadvisory.com/

YouTube https://www.youtube.com/@EdwardMarx

12:00pm
Goodbye Lunch

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