Getting Started with THA

EXECUTIVE OFFICE OVERVIEW

The executive office consists of the president and chief executive officer (CEO), chief operating officer (COO), and a senior executive assistant.

The president and CEO is responsible for creating the vision and overall direction for THA, coordinating with the THA Board of Directors, and establishing the state and national presence for the association. The COO is responsible for managing the internal day-to-day operations, strategic planning, new program development, and assisting in supporting the data and information needs of the membership.

The COO is the primary liaison with the staff at the TennCare bureau, along with the vice president for financial policy, on TennCare issues related to supplemental pools, reimbursement, hospital assessment and the TennCare waiver. The COO also works directly with the vice president for research and reimbursement on issues related to TennCare managed care organizations (MCOs) and commercial payers, including workers’ compensation.

PRIMARY SERVICES PROVIDED TO THA MEMBERS

The executive staff primarily is responsible for establishing the priorities for THA staff, working closely with the THA board and ensuring the Association’s program activities align with those priorities.

They also maintain a very close relationship with the TennCare bureau and coordinates activities related to TennCare supplemental pool funding, TennCare rate variation project, TennCare payment or MCO issues and the hospital assessment.

In addition, the executive staff meets regularly with all payers across the state to address issues and facilitate solutions and communication between the hospitals and the payers.

Other key responsibilities of the department include:

• Overseeing human resources and reviewing all staff evaluations
• Review of selected communications activities
• Overseeing the THA building and grounds
• Overseeing internal accounting

COUNCILS AND COMMITTEES

THA Nominating Committee prepares the proposed slate of officers for approval at the House of Delegates meeting each year.

THA Bylaws Committee prepares proposed changes to THA bylaws to ensure they are appropriate for the current operation of THA and presents them to the House of Delegates annually.

ACCOUNTING OVERVIEW

The THA Accounting Department is responsible for the accurate accounting and safeguarding of company resources. The team prepares financial information that is reported at each Board meeting, which includes: a) the current monthly consolidated financial statements and b) the latest quarterly financial statements for the THA Unemployment Fund.

The department also maintains the hospital assessment program and several grants.

COUNCILS AND COMMITTEES

The Budget and Finance Committee meets via conference call once a year to review the proposed operating budget and capital budget for the upcoming year. Lastly, the committee recommends approval to the THA Board.

The Audit Committee identifies and approves the audit firm that will conduct the current year annual audit. The committee also participates in an engagement meeting with the firm prior to starting the field review to discuss audits and any specific items for review during an audit.   Once complete, the audit is presented to the committee, and again later to the board.

The Investment Committee meets quarterly via conference call with THA staff and the investment manager to discuss the previous fund earnings and any necessary modifications to the investment portfolio. Any modifications determined by the committee are submitted to the THA Board for final approval.

A Dues Task Force is appointed each year to work with THA staff to determine if there is a need to modify the membership dues billing structure and approve the structure for the following year.

The THA Unemployment Fund Operating Committee, comprised of representatives from member hospitals, meets as necessary to approve recommendations to the Board of any fund actions.

MARKETING AND COMMUNICATIONS OVERVIEW

The THA Marketing and Communications Department is responsible for all association communications, marketing and public relations activities.

This department handles all internal and external communication efforts, including member e-newsletters, memos and website content. The team also utilizes other vehicles to keep members informed and tell the hospital story to a broader audience, such as special reports, social media and public relations efforts.

PRIMARY SERVICES PROVIDED TO THA MEMBERS

The Marketing and Communications Department offers direct benefit to members through the following activities:

• Communication with member publications and hospital and health system public relations, communications and marketing staff on comprehensive campaigns
• Seamless coordination on communication initiatives to ensure hospitals are represented and consistent in all public relations efforts
• Management of THA’s online presence, including the website and social media platforms, as well as promoting hospitals’ campaigns and highlighting messaging on THA communication channels

EDUCATION OVERVIEW

The Tennessee Hospital Education and Research Foundation (THERF) is the 501(c) 3 arm of the Tennessee Hospital Association (THA), and is responsible for providing current, cost-effective and relevant information on hospital industry and health-related issues through quality educational programs and the association’s four signature events.

PRIMARY SERVICES PROVIDED TO THA MEMBERS

THERF sponsors nearly 50 face-to-face education programs and webinars on topics that impact:

• Clinical Services
• Emergency Preparedness
• Finance
• Continuous Service Readiness (CSR) Programs with Joint Commission
• Reimbursement
• Compliance
• State/Federal Regulations
• Quality Improvement

SIGNATURE EVENTS

The team is also responsible for the planning process, negotiation of third-party vendor contracts, and on-site execution for THA’s signature events:

• Legislative Day on the Hill
• Small and Rural Hospital Conference
• Summer Conference
• Annual Meeting

EDUCATIONAL OFFERINGS

THERF also supports THA’s Tennessee Center for Patient Safety with its regional workshop series, including speaker recruitment, venue search, logistics, etc., as well as THA’s allied and affiliate groups for meetings, conferences and education sessions.

FINANCIAL POLICY DEPARTMENT OVERVIEW

The Financial Policy Department is the primary membership resource on Medicare and national Medicaid reimbursement regulatory issues, which includes but not limited to provider payment systems, and TennCare supplemental pool payments.

PRIMARY SERVICES PROVIDED TO THA MEMBERS

Each year, the department works to model the hospital assessment to ensure adequate funding for hospital priorities. The department also assists members with issues related to financial reporting requirements, such as changes to the state’s Joint Annual Report of Hospitals or changes in CMS requirements for the Medicare cost report.

In partnership with the Hospital Association of New York State, the department provides financial modeling of proposed changes to Medicare rules to each member facility that could be impacted, such as the inpatient prospective payment system (IPPS), outpatient prospective payment system (OPPS) and other provider-related regulations

COUNCILS AND COMMITTEES

The Supplemental Pool Taskforce convenes to review ongoing adjustments to Medicaid supplemental pool payments to hospitals, provide input on alternative payment structures, and advise the Board on courses of actions.

Members have opportunities to review and provide feedback on comment letters that are drafted in response to state and national proposed rules.

The Financial Policy department hosts webinars pertaining to reimbursement and regulatory issues such as Medicare Cost Report changes and information on the state JAR

GOVERNMENT AFFAIRS OVERVIEW

The THA Government Affairs Department is responsible for all advocacy efforts at the state level. Government Affairs staff represent the interests of the hospital industry before the Tennessee General Assembly, as well as the Governor’s Office and executive branch departments and agencies. The team works with THA departments and the THA Council on Government Affairs, as well as the general membership and Board of Directors to develop recommendations for the Association’s legislative agenda.

PRIMARY SERVICES PROVIDED TO THA MEMBERS

The Government Affairs Department’s work offers direct benefit to members through the following activities:

• Represents hospital positions with state government leaders and lawmakers.
• Introduces and works to pass legislation proposed and supported by THA.
• Works with THA staff and members to review and analyze legislation to identify hospital impact and advocate for THA position.
• Communicate with members about policy and regulatory activities and ensure hospitals are represented in all discussions.
• Manage Friends of THA, the Association’s political action committee (PAC), which supports legislators and candidates for state public office who are supportive of hospital issues.

COUNCILS AND COMMITTEES

The Department also staffs two committees of importance to the association:

Council on Government Affairs reviews healthcare legislative issues and recommends positions to the THA Board of Directors for consideration in shaping THA’s legislative agenda. This council meets twice a year.

Friends of THA PAC Committee supports the work of THA’s political action committee. The committee supports staff in the annual PAC fundraising campaign and in making contributions to legislators and candidates who support and are sensitive to hospital issues.

INFORMATION SERVICES OVERVIEW

The Information Services department is responsible for the collection and analysis of multiple types of hospital data. The department provides technical support to all THA staff and maintains the network security and network operation and infrastructure.

The major functions of THA Information Services include:

• Collection and dissemination of hospital claims and other healthcare data
• Collection and transmission of real-time Admission, Discharge and Transfer (ADT) data
• Analysis of hospital data to create meaningful information for THA staff and members
• Operation and security of the THA internal network
• Development of data collection and data distribution tools to collect data from and provide information to members

THA Information Services (IS) is responsible for all in-house, member and non-member requests for data. These data include hospital patient level claims data found in hospital discharge data, summary of hospital financial and utilization data from the Joint Annual Report (JAR), health manpower data, home health data, hospice data, population data, data from the THA member database and other special purpose datasets. The data analysis unit either completes analyses of the data and provides results to the requestor or provides raw data. In addition, IS staff creates data presentations to support advocacy positions of THA, media messages, and patient safety initiatives.

THA Health Information Network

The THA HIN staff is responsible for managing the collection of patient level claims data from all THA member hospitals and providing a database to the state each quarter to meet the state legislated reporting requirement. In addition, the HIN provides access to the quarterly data through the THA MarketIQ software, a THA-owned product that allows hospitals to access the claims data through the internet and easily produce routine reports needed for marketing and planning. This unit generates significant revenue through the HIN and sale of data products that fund the operation of information services, as well as other functions of THA.

THA ConnecTN

Via a program called ConnecTN, THA collects real-time ADT messages from member hospitals to meet a TennCare requirement to support their PCMH and HealthLink programs. ConnecTN also provides a notification service using this real-time data back to member hospitals, physician practices, and ACO’s on their patients who have encounters with hospitals in the network.

Surveys and Internal IT Support and Security

THA IS collects and disseminates information from several surveys annually, including the member satisfaction CEO survey that provides the basis for THA strategic planning and a THA membership salary survey through a partnership with Salary.com. Additionally, the IS department is responsible for maintaining the association’s membership database and computer network.

THA information services staff serves as the primary THA staff liaison to the:

• THA Data Policy Committee
• THA ADT Technical Subcommittee of the Data Policy Committee
• Tennessee Department of Health (TDH) Health Statistics Division
• Trauma Care Advisory Council

MEMBER SERVICES OVERVIEW

The THA Member Services Department is member driven and member focused.  The staff advocate and address issues that are priorities and of value to hospitals and their teams.

Member engagement is an important part of THA’s programs and services. This includes bringing together councils and workgroups, and representing members with other stakeholders interested in improving the delivery of healthcare in Tennessee.

PRIMARY SERVICES PROVIDED TO THA MEMBERS

The key initiatives for member services include:

Federal Advocacy
There are several opportunities throughout the year to join the THA staff and colleagues from across the state in Washington, D.C., to help educate the Tennessee Congressional Delegation on important hospital and healthcare-based issues. THA also asks members to respond to proposals in Washington that could impact the care hospitals deliver in their communities.

Mental Health and Opioid Abuse
THA has developed a strong working relationship with the Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) on this issue.  THA also represents hospitals on statewide initiatives focused on other issues such as: transportation, emergency department boarding, and opioid treatment and recovery resources.

Continuum of Care
THA has assembled key stakeholders in areas such as inpatient rehabilitation, home health and palliative care to gain perspectives on issues impacting the care continuum. This has included third-party reimbursement and clinical and operational best practices.

Emergency Preparedness and Response
THA works with the Tennessee Department of Health to coordinate the activities funded by the annual federal readiness grant to Tennessee.

COUNCILS AND COMMITTEES

Member Engagement Opportunities
THA Trustee Council is comprised of board members from THA hospital and health systems, and oversees THA’s board certification program, trustee education and other governance-related efforts. The council chair and vice-chair serve as the governance representatives on the THA Board of Directors and help guide the associations’ efforts to support hospital boards.

THA Affiliate Groups representing health professionals from specific areas of hospitals provide continuing education, tools and resources to their colleagues in the state, directly supporting clinical and operational service lines in their organizations. By joining groups such as the Tennessee Organization of Nurse Executives or Tennessee Healthcare Engineering Association, employees have access to best practices from across the state and country and the opportunity for professional development.

Emphasis on the Continuum of Care
THA regularly gathers members from non-acute areas of the health continuum to hear from industry experts and discuss regulatory, policy and reimbursement issues impacting their work.  THA members are invited to participate in the following workgroups:

THA Home Care Alliance invites hospital-based home care directors and administrators to meet in person twice per year.

THA LTAC Group is comprised of administrators and team members from long-term acute care hospitals. This group connects quarterly via phone conference.

THA Psychiatric Section provides a forum for clinical and operational leaders of the state’s psychiatric hospitals and inpatient units to meet quarterly in person. A representative from the section sits on the THA Board of Directors as a liaison between the two groups to help guide THA’s work in the mental health arena.

THA Rehabilitation Therapy Workgroup supports the state’s inpatient rehabilitation hospitals and health systems with acute rehab units and meets twice per year in person. A representative from this group sits on the THA Board of Directors as a liaison between the two groups.

THA RESEARCH AND REIMBURSEMENT DEPARTMENT OVERVIEW

The Research and Reimbursement department serves as the primary THA resource on TennCare MCOs, Blue Cross/Blue Shield, commercial payers and Medicare Advantage.  It addresses issues that hospitals may have with all payers, including the TennCare program and CoverKids.

In addition, Research and Reimbursement works closely with the TennCare MCOs around the implementation of new initiatives and the Tennessee Department of Commerce & Insurance’s TennCare Oversight Division.

PRIMARY SERVICES PROVIDED TO THA MEMBERS

The department also is the primary member resource for payer managed care information or issues assistance, and the THA liaison with hospital managed care, patient financial services, utilization management and compliance staff.  Workgroups meet with the large payers in the state and payer /financial education is provided to all members.

The insurance section also is responsible for monitoring the implementation of payer changes and insurance exchanges required by the Affordable Care Act (ACA) and provides input to the Commissioner of the Department of Commerce and Insurance on that department’s role in monitoring new requirements on insurers in the ACA.

THA research and reimbursement staff helps with compliance issues and provides compliance education through regional groups and webinars.  There is also a state-wide compliance conference each year that includes expert presentations on current compliance issues.

Lastly, staff works with the governmental Fraud Working Group and contractors to provide education and opportunities for members to meet with them.

WORKFORCE STRATEGIES AND RURAL HEALTH  DEPARTMENT OVERVIEW

The Workforce Strategies and Rural Health department includes the Small and Rural Hospital constituency, the Medicare Rural Hospital Flexibility Program (MRHFP), and the Tennessee Center for Health Workforce Development (TCWD), which is an operating subsidiary of THA.

The department is responsible for overall administrative and technical assistance to Tennessee’s acute-care small and rural hospitals, including the certified Critical Access Hospitals (CAH), to improve their clinical, financial, and operational performance.

In addition, TCWD is focused on increasing the healthcare workforce in the state. It is responsible for recruiting and placing primary care physicians in shortage areas, providing incentives to medical residents in exchange for a commitment to work with underserved populations, providing incentive funds to qualified hospitals and other practice sites to attract caregivers, matching medical residents with rural rotations, addressing issues within nursing and allied health education, and introducing Tennessee students to the healthcare professions. TCWD is a 501(c)(3) organization, governed by its own Board of Directors under the auspices of the THA Board of Directors.

PRIMARY SERVICES PROVIDED TO THA MEMBERS

On a broad scale, the Workforce Strategies and Rural Health department works to identify and address healthcare policy issues that affect small and rural hospitals. It seeks to inform hospital leadership about emerging issues and develops position papers, advocacy materials or proposed regulations as needed. It also creates educational, legislative, and regulatory program opportunities for THA members.

Funding and other financial opportunities for small and rural hospitals are another important component of the department’s work. It provides technical assistance to CAH hospitals in developing requests for funding under the MRHFP program and helps determine best strategies for operations and reimbursement. Such funding supports strategic planning, hospital performance improvement, rural network development, rural health clinic development and potential new service lines. Another funding mechanism, the Driving Under the Influence (DUI) Interlock Assistance Fund is also administered by the department.

Recently, the Workforce Strategies and Rural Health department assisted in developing the Tennessee Rural Hospital Transformation Program, in collaboration with the Tennessee Department of Economic Development. The program supports rural hospitals in assessing their sustainability and partners with industry experts to identify potential new delivery models, strategic partnerships, and necessary operational changes.  The goal of the Program is to create a specific transformation plan for each selected hospital and to provide recommendations and actionable steps for preserving healthcare services in the target hospital community.

COUNCILS AND COMMITTEES

THA Small or Rural Hospital Constituency Executive Committee governs the Rural Issues Department and assists the THA Board of Directors in addressing issues impacting the delivery of quality healthcare services by rural and small hospitals and advocating for appropriate solutions to those issues. This committee meets on an “as needed” basis, usually via conference calls.

The Executive Committee is nominated and elected by the Small and Rural Hospital Constituency at its annual membership meeting.

Lastly, the department hosts the Small and Rural Hospital Conference annually and Mid-South Critical Access Hospital (CAH) Conference on a rotating schedule that accommodates the Mid-South states.

TENNESSEE CENTER FOR PATIENT SAFETY OVERVIEW

The mission of the TCPS is to advance Tennessee hospitals’ adoption of proven strategies that enhance the reliability, safety and quality of care patients receive. TCPS provides extensive education, resources and direct support to hospitals to achieve better outcomes.

PRIMARY SERVICES PROVIDED TO THA MEMBERS

Participation in state, national and association-based quality improvement programs and initiatives. For 2021, programs include:

• CMS Hospital Quality Improvement Collaborative (HQIC) with Cynosure Health targeting small and rural hospitals
• TDH funded maternal morbidity and mortality grant
• THA MRSA Reduction Campaign
• THA Sepsis Collaborative
• THA Post-Acute Partnerships to improve outcomes, reduce excess days and costs

Data Reports and Comparisons

TCPS provides CEOs at acute care hospitals with a monthly executive summary report showing their hospital performance compared to their statewide peers based on facility size. Sources for data reporting include the Center for Disease Control (CDC) National Healthcare Safety Network (NHSN); THA claims data, and THA’s Report The THA Board of Directors transparently shares hospital performance on key topics at the board meetings and posts data in advance of meetings.

Tennessee Surgical Quality Collaborative

The statewide collaborative is a partnership with the Tennessee Chapter of the American College of Surgeons where doctors and hospitals measure and improve surgical care in Tennessee using the American College of Surgeons’ National Surgical Improvement Program.

THA Patient Safety Organization

The THA PSO is federally certified as a PSO and has 64 member organizations working collaboratively to reduce harm. It provides a separate, secure environment for member organizations to engage voluntarily in sharing and analyzing patient safety events without the threat of disclosure or increased liability.

Tools for Hospitals

Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety (HSOPS) – survey measures employee perceptions of patient safety

Institute for Healthcare Improvement (IHI) Open School – online courses in the areas of quality improvement, patient safety, and leadership

COUNCILS AND COMMITTEES

• THA Quality Committee
• TCPS Advisory Council
• THA Council on Inclusion and Health Equity

THA INNOVATIVE SOLUTIONS OVERVIEW

THA Innovative Solutions proactively responds to the needs of THA members by identifying the most innovative solutions on the market. Used by hospitals across the state, their solutions enable hospital members to increase efficiency, impact patient care and improve their bottom line.

PRIMARY SERVICES PROVIDED FOR THA MEMBERS

Each solution offered by THA Innovative Solutions must complete a stringent due diligence process, saving hundreds of hospital staff hours spent vetting potential vendors. Innovative Solutions constantly seeks out new and innovative vendors that cater to the needs of our hospital members.

Three approaches are used to provide these services and resources to members:

1. “Owned” programs: Developed internally or in partnership with an outside vendor. THA Innovative Solutions owns the program, and partners with other entities that have the technical expertise needed to deliver value.
2. Strategic partners: Companies that provide a service to hospitals and have agreed to share a portion of revenue with THA.
3. Recommended solutions: Companies that have requested and received an endorsement from THA. These companies pay the Association a flat fee for the endorsement.

Programs are grouped according to common themes:

• Workforce solutions
• Financial solutions
• Operational solutions
• Data and technology solutions

Not only do the partnerships offer significant strategic value for THA members but they create an alternative revenue stream for the Association. The revenue is earned as a result of members’ use of these vendors and programs.

The revenue is divided as follows:

• Covers 100 percent of Innovative Solutions’ expenses
• Helps provide significant grant dollars to the Tennessee Hospital Education and Research Foundation (THERF), which mainly is used for Annual Meeting support and program development
• Donates to THA’s political action committee (PAC), Friends of Tennessee
• Reduces membership dues for those members that use Innovative Solutions’ associated programs
• Absorbs select other THA expenses

COUNCILS AND COMMITTEES

The THA Innovative Solutions Board serves as the governing body for the THA Center for Innovative Solutions, providing strategic direction and leadership in accomplishing the organization’s mission. This board is made up of CEOs, COOs, and CFOs representing all types (large/small, urban/rural, hospital/system) of members across the state and is approved by the THA Board of Directors. The Chairman of the Innovative Solutions Board is selected by the THA Nominating Committee and serves as an “ex officio” member of the THA Board.

Occasionally, members are asked to assist when reviewing and approving vendors or developing programs and/or making recommendations to the Innovative Solutions board. These individuals serve on short-term committees. 

In other instances, Innovative Solutions staff may contact an individual within a member organization for expert advice or counsel.