April 12, 2012 - Sentry Data Systems is alerting customers to a revised timeline for the start of the 340B Hospital Recertification process.

The Office of Pharmacy Affairs (OPA) has announced revised dates for contacting hospital senior executives at covered entities about recertification. These hospital representatives will receive an email containing a username, password and instructions for recertifying their institution and their registered outpatient sites in the 340B drug discount program.

This timeline is based on the type of 340B entity.

• Free-standing cancer hospitals, children’s hospitals, rural referral centers (RRCs), and sole community hospitals (SCHs) should receive emails on April 20.
• Disproportionate Share Hospitals (DSH) should receive emails on April 27.
• Critical Access Hospitals (CAH) should receive emails on May 4.

OPA has indicated that these dates are subject to change. Hospitals will have three weeks to complete the recertification process, according to OPA.

Sentry urges its clients to be aware of these dates and prepare to conduct their recertification on schedule, as recertification is a requirement for continued 340B eligibility.

For more information on the 340B recertification process, please refer to our original article.

We are specifically looking for any stories or examples of how 340B enabled your entity to offer care to underserved or low-income patient populations.

A few questions to consider related to 340B success stories:

• Has the 340B program benefited your patient population through health care services that otherwise would have been reduced or removed due to cost?
• Has the 340B program given your entity the ability to continue or improve key service offerings that are of vital importance to less fortunate patients?
• Has the 340B program given your entity the financial stability needed to sustain key care services in your community?

Please contact us or communicate with your Sentry Account Manager to share any 340B success stories you have that clearly illustrate the benefits your 340B program have brought to your institution, and ultimately, your patients.

This recent update is key for your recertification process and includes specific communication dates to be aware of with details on how to be proactive in updating your CE information.

Safety Net Hospitals for Pharmaceutical Access (SNHPA) has asked for our assistance in reaching out to customers and encouraging them to address the recertification process with the utmost urgency.

We will continue to serve as a resource for you as we will issue reminders and online postings of the information we receive.

Look for a recertification e-mail from OPA

The Pharmacy Services Support Center (PSSC) has indicated that 340B hospital authorizing officials will be contacted to recertify their CE’s 340B status with the Office of Pharmacy Affairs (OPA) on either April 9 or April 23 in the form of an email directly to the entity’s authorizing executive.

OPA has said that hospitals which fail to recertify their eligibility will be removed from the program, and that this recertification process is a requirement for hospitals to maintain 340B status.

The email from OPA will contain login information and basic instructions for the authorizing official, as they need to personally recertify that their hospital and all of its registered outpatient sites are eligible for the drug discount program.

Ensure the OPA database has accurate details for your entity

Sentry is strongly encouraging its 340B clients to immediately update their information in OPA’s Covered Entity Database to provide their accurate email addresses and other contact details as a safeguard against missing this critical recertification email.

It is the responsibility of the covered entity to update its information and to accurately identify each of its child sites. Hospitals that know of changes occurring between now and April that need to be reflected in the database may submit change requests now indicating when the changes are scheduled to occur.

Understand the changes to in-house pharmacy eligibility rules

In the past, in-house or owned retail pharmacies were identified as child sites of the parent CE. Going forward, though, OPA has made it clear that stand-alone pharmacies should be dis-enrolled as covered entities and evaluated to determine whether they should be re-enrolled as ship-to sites for the hospital. This is a key distinction that CEs need to be aware of as they recertify with the goal of accuracy and continued eligibility.

Review the OPA seminar and prepare for recertification

A breakdown of the key points from a recent OPA seminar (recap available here) on recertification:

• On either April 9 or April 23, hospital officials responsible for their institution’s 340B enrollment will receive an email from OPA with the username, password, and instructions they will need to actually complete the recertification process.
  • Because these emails will be sent to the authorizing officials only, it is vital that the entity’s contact information in the OPA database is accurate and that the authorizing official or their executive assistant be on the alert to receive these important emails.
  • The email login information will only be good for one attempt, so the authorizing official must have both time and accurate information available to update and verify the hospital’s eligibility and validate the list of child sites and other eligible outpatient facilities for the entity.
• 340B recertification and change request forms must be submitted by an “authorizing official,” which OPA defines as “someone who can bind the organization to a contract, such as the CEO, CFO, COO, Executive Director, President or Vice President of the hospital.”
• OPA has posted a frequently asked questions (FAQs) document about recertification on the PSSC web site. Click here to access it.
• Another webinar on recertification will be held on a date to be determined. Questions about recertification may be sent to340b.recertification@HRSA.gov.

Read the full transcript below.
———————————————————–

The changing role of data in healthcare

Q&A: William D. Kirsh, DO, MPH
Chief Medical Officer, Sentry Data Systems
William Kirsh has more than 20 years of medical and business experience. Kirsh is involved in the development of Sentry’s products where he lends his clinical and healthcare financial expertise. Kirsh recently took time to discuss the changing role of data in the healthcare system.

Q: You say that we need to move from numerator data to denominator data in healthcare. What does that mean?
Kirsh: Numerator data is event data, events that may have happened to an individual. The next evolution is to look at the population being served – the denominator – and the environment the population is in in order to develop a service model for that population. It is population-based medicine. The population could be very small, such as ones by a diseases state or location, but it is still denominator medicine. So, the information that goes into it is a little different than going to collect somebody’s events that have taken place. There is a big distinction between the 1990s and the 2000s in that we are moving aggressively away from numerator medicine toward denominator medicine.

Q: Why is looking at huge volumes of aggregated data important in terms of improving healthcare and moving to denominator data?
Kirsh: Organizations live and die by their data, but think about taking that data to the next level and being able to identify sub-segments of a population where there are adverse risks to the delivery of medication, for instance, and realize that this population is very valuable. This is because you can begin to see populations genetically that medications can be developed for. You need to be able to look at large sets of data in order to pick out those small aberrant populations and it is those aberrant populations that are valuable. But you can’t identify these populations by looking at data in a small way.

Q: Do large IDNs have enough data in-house to effectively manage the new payment and care delivery models?
Kirsh: No. Data is only as good as a reference point. I can get a lot of data and turn it into some kind of a graph, but unless I have reference points, it won’t mean anything. To get reference points you, would need to have other IDNs that are aggregating their data and are sharing it, in order for an IDN to get some premise of where they are as compared with some standard. They could just set their own standard and say they are going to reach that. But, when you look at financial performance and outcomes, you can’t just set your own standard; you have to look at what outcomes are taking place broadly.

©The Changing Role of Data in Healthcare, a work product of the HIMSS Business Insider, is reprinted with permission from HIMSS.

The conference will focus on the increased scrutiny of the 340B program from Congress as well as HRSA and the implications of this oversight amidst the current 340B audit environment. Sentry personnel are ready to speak with conference attendees about preparing their Covered Entities with software solutions that address the critical functions needed to maintain 340B program integrity, operate with ongoing compliance within HRSA guidelines, and develop a documented trail of activity from the provider to the patient to the pill to the purchase.

“The fact that compliance and auditability are now center stage with all 340B stakeholders is the inevitable and natural conclusion of the recent program expansion and Congressional review. I am proud that our software products have always been developed with compliance as their cornerstone. Sentry provides Covered Entities the necessary tools to maintain program integrity and benefits,” said Travis Leonardi, President and Founder of Sentry. “As the Hospital 340B software leader with hundreds of hospital and pharmacy clients across the country, Sentry is uniquely qualified to provide both insight and direction on current 340B discussions.”

Sentry has two key 340B solutions, Sentinel and Sentrex, both of which were developed with the rules based technology that provides audit preparation tools, detailed reports and a documented trail of program compliance. Both Sentinel RCM (hospital program management) and Sentrex (contract pharmacy solution) are guided by the Covered Entity’s federally-mandated Policies and Procedures.

For more information about Sentry Data Systems Healthcare Business Intelligence and 340B Program software solutions visit www.SentryDS.com or call 800.411.4566.

Sentry came in at No. 19 on the list of Fast Tech Award recipients, an honor given to companies that “experienced significant revenue growth from 2009 to 2010,” according to the SFBJ site.

“We are proud to be recognized for our outstanding financial growth and achievements,” said Travis Leonardi, President and Founder of Sentry. “It is an honor to be listed among South Florida’s technology leaders. Our mission is to educate and provide the tools to maintain compliance and stay within the intended use of the 340B drug pricing program.”

Technology leaders were honored at an awards gathering on Thursday, October 13, 2011 at the Westin Fort Lauderdale. The Fast Tech Awards were determined by the SFBJ, who evaluated companies headquartered in South Florida that have been in business at least three years, demonstrate a solid operating history with solutions-based products, display significant revenue growth and make a substantial contribution to South Florida’s economy.

In addition to those award qualifications, Sentry has seen dramatic increase in employee numbers, more than tripling in size in the past three years and opening satellite offices in both Indianapolis and Austin during that time.

To learn more about Sentry’s inclusion in the 2011 Fast Tech Awards, refer to the original SFBJ article.

The purpose of the event, the HIMSS12 Interoperability Showcase Healthcare Business Community DesignSession, was to create use cases and design the Interoperability Showcase for the main 2012 HIMSS event. This collaborative design session involved key healthcare leaders, organizations and members of HIMSS G7, including Sentry.

“We’re excited to be at the table with other significant policy leaders to help focus and guide the next evolution in healthcare contracting and delivery of healthcare services,” Kirsh said.

Kirsh worked with a variety of organizations to develop a use case about Integrating Hospice into End of Life Care for healthcare organizations. The goal of this use case and the other showcase designs is to improve the overall healthcare experience by leveraging technology for better patient care and increased effectiveness for providers and stakeholders.

For more information about HIMSS G7 and Sentry’s work with other healthcare thought leaders, visit http://www.himss.org/asp/topics_medicalbanking_g7roundtable.asp?faid=502&tid=103.

DEERFIELD BEACH, FL —July 28, 2011—Sentry Data Systems, Inc., a healthcare business intelligence technology solutions company headquartered in Deerfield Beach, Florida, announces the opening of a new office in Austin, Texas on August 1, 2011. The satellite office—located at 2028 East Ben White Blvd., Suite 300, Austin, Texas 78741—will support and better address the company’s technology needs. The office is slated to be staffed with a Technical Analyst, Senior Project Manager, Quality Assurance (QA) Manager, Developer, Clinical Director and Office Administrator.

“The opening of Sentry’s new Austin office is an example of our continued growth,” says Travis Leonardi President and Founder of Sentry Data Systems. “Austin is a hotbed for technology advancements and is the perfect place for us to locate as we deliver on our commitment to provide innovative technology-driven products designed to meet our customers’ needs.”

Often referred to as “Silicon Hills,” Austin is known for its professional campuses serving many of the country’s leading technology companies.  As a result, Austin attracts and maintains the highest level of technology talent, often beginning at the University level.  Accordingly, Sentry has partnered with The University of Texas at Austin’s Health IT Program.

“We are thrilled to have Sentry Data Systems as a new supporter for our innovative Health IT program. Their stature as a market leader in the field will bring valuable expertise to our program and our students,” said Dr. Leanne Field, Health IT program director.

The new office will be Sentry’s second satellite office, following the success of their office expansion in Indianapolis, which opened in April 2009.

For more information about Sentry Data Systems Healthcare Business Intelligence Solutions visit www.SentryDS.com or call 800.411.4566.

University of Texas at Austin

The University of Texas at Austin Health IT program was created to address the growing demand for health IT professionals. It offers an intensive nine-week program that leads to a Health Information Management and Exchange Specialist certificate. The program features expert faculty in both theoretical and applied areas of health IT, six weeks of coursework with hands-on experience working with six different electronic health record (EHR) systems, a 12-day practicum that immerses students in real world experiences with health IT companies or organizations, and job placement services. The program takes place in the university’s on campus Health IT Learning Center, which features a mock clinic. For more information regarding The University of Texas at Austin and the Health IT program, contact Lee Clippard, Director for Communications for the College of Natural Sciences at The University of Texas at Austin at 512-232-0675 or lclippard@mail.utexas.edu.

William Kirsh DO, MPH, Chief Medical Officer at Sentry Data Systems, Inc., a healthcare business intelligence technology solutions company, participated as a contributor and editor of the Healthcare Information and Management Systems Society (HIMSS) Revenue Cycle Task Force White Paper on The Future of Revenue Cycle: Preparing for Near-Term Change, published in May 2011. Due to a variety of revenue cycle-related changes occurring in healthcare, the HIMSS Revenue Cycle Improvement Task Force selected five changes that merit immediate attention, discussion, and planning.

Collectively, the document addresses patient access functions, including scheduling, registration and preauthorization, service delivery and charge capture, and business office functions. Each functional section of this piece stands on its own, enabling revenue cycle professionals to focus on their specific area of expertise.

“This document is for any revenue cycle professional, or any healthcare executive whose job function is impacted directly by the revenue cycle, such as the CEO, CFO, or others,” Dr. Kirsh said. “The goal is to raise awareness for all revenue cycle professionals about issues that will confront them in the near and medium-term. These are not hypotheticals or possibilities. These are real-world changes happening now. They are substantial, and they can be very impactful.”

Dr. Kirsh’s participation as a HIMSS committee member came about because of his role as a critical matter subject expert and contributor with deep insights resulting from more than 25 years working as a practicing physician and over seven years as an executive and developer of revenue cycle management and healthcare business intelligence software at Sentry.

Sentry has long been a pioneer in taking disparate hospital data systems and merging them together to gain actionable insights for financial impact within a quarter. Dr. Kirsh leads Sentry’s efforts to deliver healthcare technology solutions that not only lead to greater financial impact for customers but ultimately result in better patient outcomes.

“Dr. Kirsh is an integral part of our team and is intimate with the real world impact of sound revenue cycle management and its significant impact on patient outcomes,” said Travis Leonardi, CEO of Sentry. “We are extremely pleased that HIMSS recognized Sentry for our thought leadership and insights. Anyone involved in hospital revenue cycle management needs to not only read this white paper but also needs to start putting its findings into practice. Sentry can help manage that process for hospitals nationwide.”

The white paper addresses several critical topics for revenue cycle management including The American Recovery and Reimbursement Act that will impact incentive payments made available for utilization of certified electronic health records (EHRs). The publication also addresses the 5010 and its focus on the electronic exchange of administrative and financial information between providers and plans, The Affordable Care Act that includes numerous health-related provisions such as prohibiting denial of coverage/claims and expanding Medicaid, the ICD-10 and its significant changes to increased specificity and coding, and the Quality Measures highlighting an increased focus on quality for proactive healthcare organizations to gain ground and increase revenue.

The full HIMSS article The Future of Revenue Cycle: Preparing for Near-Term Change and access to the white paper are available online at www.SentryDS.com/resources.

About William D. Kirsh, DO, MPH

William D. Kirsh DO, MPH has over 25 years of medical and business experience. Dr. Kirsh is heavily involved in the development of Sentry’s products and lends his clinical and healthcare financial expertise to many areas of their operations. Prior to his role at Sentry, Dr. Kirsh founded eAppeals, LLC, a technology company that simplified the handling of insurance claims appeals for both healthcare providers and consumers. He also served as the Chief Executive Officer and Chief Medical Officer for Foundation Health Plan of Florida and was the Vice-President of Medical Affairs and Quality Assurance at Physician Corporation of America, Inc. Dr. Kirsh is a published author and member of several medical boards, he holds degrees from Florida State University, Nova-Southeastern University of Health Sciences, and The Johns Hopkins University School of Hygiene & Public Health. Dr. Kirsh performed his residency training at The Johns Hopkins University and actively practices hospital-based medicine. He holds appointments as clinical faculty at Nova Southeastern University, College of Osteopathic Medicine and in the School of Public Health. He is also Chairman of the Board of The ARC of South Florida and founding member and Executive Vice President of International Health Initiatives.

In the coming years, an important regulatory change will drastically alter hospital profits and reduce cash flow: ICD 10 coding requirements.

Hospitals, physicians, health systems and any other risk-bearing entities need to be aware of the challenges caused by the impending change. In order to deal with new requirements effectively, these organizations must have a powerful Business Intelligence (BI) software application able to aggregate and analyze a high volume of divergent data. This data will be vital to efforts to turn disparate information feeds into opportunities for effective analysis and action that maintains and improves fiscal results.

The new ICD 10 coding regulations are going push many software applications into obsolescence, and a hospital’s inability to accurately track diagnoses related to purchases and dispensations billed to third party payers will greatly affect cash flow.

Many healthcare organizations are currently focusing their energies and resources on Electronic Medical Records (EMRs), but EMRs by themselves will not provide the only platform to allow the evolution of manipulating data to improve the financial viability of the hospital.

For years, healthcare organizations have relied upon guesswork to control costs, increase revenues, and improve care quality. As providers face changes in reimbursement practices and variations in contracts like Accountable Care Organizations (ACOs), they must begin basing decisions on timely, factual data encompassing an entire care network.

But this kind of holistic data analysis and decision-making is not possible with the fragmented information technology infrastructures many healthcare organizations are currently using. Most institutions are not capable of managing third party contract requirements – like global contracting and payments that are linked to performance – and integrated delivery systems are definitely not prepared to weather the critical financial effects of migrating from ICD 9 to ICD 10 diagnosis standards. This migration directly effects reimbursement and cash flow, and providers will need software applications that focus on small variations of services and their costs in order to achieve desired financial outcomes.

The complex nature of medical management demands solutions that understand third party payer contracts and provide utilization controls to maximize profit. Institutions must be able to understand variations in care by informing their physician network and improve overall efficiency through continuous background analytics and alert engines. All of these chances to grow and improve require the ability to analyze a voluminous amount of aggregated data, the kind of concentrated computing power available only using a healthcare BI solution.

Health delivery organizations shouldn’t see the shift from ICD 9 Coding to ICD 10 Coding requirements as an obstacle, but as an opportunity to gain access to a powerful arsenal of actionable data from a BI application that is prepared to manage new coding requirements and process vast databases of patient, provider and pharmaceutical information. Without any further infrastructure investment, health institutions can benefit from a web-delivered BI solution to receive an integrated view of their business and clinical activities – from supply chain to the revenue cycle to patient care.

Integrating data, converting it to information and making effective business decisions is a powerful step toward overall health reform and increased performance.

William Kirsh, DO, MPH, is the Chief Medical Officer of Sentry Data Systems, Inc., and has decades of experience as a physician in addition to being a recognized and respected speaker at healthcare industry conferences and panels across the country.