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Athena Forum Institute
®
2015 Discover Athena Forum Tour!
”Company-Directed Training for Hospital Performance”
The Journey of CM Improvement Begins on Athena Forum.
Dear CM Director,
Our philosophy is that a CM Director can achieve goals at a faster rate
with a better educated staff.
Thanks to all the CM Directors contributing to this presentation.
Welcome!
TOM RASMUSSEN
Thomas A. Rasmussen
CEO & Publisher
Senior Fellow, Jefferson School of Population Health
[email protected]
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Human Capital

“Knowledge workers need knowledge. Knowledge workers are different from factory workers.
Knowledge workers can advance the strategic direction of your business.”
Peter Drucker
The Essential Drucker®

“Staff education is an essential function of leadership.”
Joint Commission
Hospital Accreditation Manual
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Define Management!

“Management is getting work done through others.”
CM Team
CM Director
Social Workers
UM Reviewers
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The Education Multiplier Effect

When ONE CM completes ONE CE course = “advancing one’s practice.”

When the ENTIRE team completes the same course = “improving organizational performance.”
~ “Company-directed training is the tide that lifts all boats.”
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Before and After
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Design
Athena Forum was designed in 2008 by 400 CM Directors as a Management Tool.
Athena Forum has 3 Personalities/Features to Improve Organizational Performance:
1. Management Tool:
CM Directors assign courses to steer the team to hospital priorities.
2. CE Machine for Staff:
Staff love Athena Forum for 700 CE accessed from any computer.
3. Clinical Reference Tool:
7,000 page database is searchable (“21st Century PDR” says CM).
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Pricing
4 Levels of Hospital Educational Site Licenses:
1. ALPHA hospital ( > 500 licensed beds)
$7,500.00 per year
2. BETA hospital (300-499 beds)
$5,500.00 per year
3. CHARTER hospital (100-299 beds)
$3,500.00 per year
4. DELTA hospital, med group, SNF ( <99 beds)
$1,100.00 per year
All benefits available to all hospitals:

Complimentary Management Orientation webinars

Complimentary Staff Orientation webinars

Unlimited enrollments for all employees at site; hospitals can add or delete personnel at any time

24/7 access to all 700 CE certificates (RN, SW, ACM & CCM; certs instantly printable from online

Accessible from all mobile devices (e.g. Nook, Kindle, iPad) at any Wi-Fi location

Tuition pricing for personnel outside the hospital: see “ACO Presentation” or contact [email protected]
Athena Forum Value Proposition: Invest a little – go BIG on staff performance.
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Return-On-Investment Part 1

Many hospitals forecast a conservative ROI of 10 X Athena $3,500.

3 cost-savings examples from 3 CM Directors:
Annual Savings:
1 Athena Forum’s course “Hospital Revenue Cycle” instructs case managers
on reducing avoidable days. Reducing only 10 days a year @ $2,000 saves $20K.
$20,000 per year
2 Athena Forum’s course “Discharge Planning”: instructs case managers on
improving level of care (LOC). Assume one inpatient bed @ $2,000 vs. one SNF bed
@ $375 = $1,625 savings X 10 transition orders = $16,000 savings per year.
$16,000 per year
3 Athena Forum’s course “Improving Heart Failure Management”: instructs
case management teams to reduce HF re-admits by 20%. Assume avoiding 10
Medicare penalties on HF re-admit claims X $1,000 each = $10,000.
$10,000 per year
Total savings:
$46,000 per year
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ROI Discussion Part 2

“We’re seeing declines in hospital readmissions – coordinated with our course assignments to our 9 hospital
CM teams. This is a great value.”
Barbara Ashton RN MSN
Regional Director Case Management
HCA Mountain Division
Salt Lake City, UT

“We’re forecasting improving claims by $100,000 a year. The price of high morale? Priceless!”
Mindy Owen RN MS CCM
Director Case Management
Dartmouth-Hitchcock
Lebanon, NH

“We’re training 380 care coordinators among our 80 medical groups all over Minnesota. 21st Century convenient.”
Sue Robinson RN MS
Manager ACO Education
Allina Health Accountable Care Organization
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Benefits to Member Hospitals

5 Benefits most frequently reported by 850 CM Directors on Athena Forum:
1.
Elevated core competencies of case managers
2.
Improved outcomes
3.
Reduced avoidable days
4.
Improved claims
5.
Reduced readmissions risks
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Maximizing the Power of Staff Development

CM Directors on Athena Forum report 3 essentials to maximize the power of staff development:
1.
CM Director should assign courses to steer the team (popular pacing is 1 module per month).
2.
CM Director should lead monthly discussions (for staff compliance & hospital’s procedures).
3.
CM Director should delegate details of staff completions (to admin, senior CM or an educator).
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Athena Forum Supports Your ACO

The Affordable Care Act requires hospitals in an Accountable Care Organization to:
1.
Demonstrate your preventive care program for our covered Medicare seniors in community,
2.
Demonstrate your chronic care delivery network for covered seniors in community,
3.
Demonstrate your staff coaching process to adhere to Medicare’s 5 Patient Quality Measures.
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Sample Implementation Memo
MEMO TO:
FROM:
DATE:
SUBJECT:
CM Staff
CM Director
January 2, 2015
Staff Performance Program 2015 with Athena Forum
As mentioned, we’re launching a new staff development program with courses on Athena Forum. This is a mandatory program for
all CM staff and will improve our organizational effectiveness as all staff will be taking the same courses as we move forward.
This is also a new and free employee benefit. We’ll be discussing topics at monthly staff meetings. We look forward to improving
all our CM services to patients, families, nursing and payers.
2015
Staff Performance Program
Advancing Practices & Team Performance______________________
JAN
CM Express on Athena Forum
Mod B: Improving Claims
Our CM team has a unique responsibility to get reimbursed for the pt care we deliver.
This impacts the hospital’s revenues! We’ll discuss THU JAN 29 MTG 3pm. Bring CE
FEB
Hospital Revenue Cycle
Mod B: Hospital Cash Flow
Reducing avoidable days is an important task for us. Leadership supports.
Print page 35 for the MTG. We’ll discuss THU FEB 26 MTG 3pm. Bring CE cert.
MAR
Heart Failure Management 1
Mod B: HF Assessment
HF care is complex and expensive. The better we assess our HF Pts, the better care
we provide Print chart “Family History Pertinent to HF.” Bring cert to MTG 3.26.
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Athena Forum Care Management Series® Slide 1 of 2
CM Express [for new hires]
Establishing Your Professional Identity
Mod A: Essentials of Case Management
Mod B: Importance of Claims
Mod C: Resource Management
Mod D: Transitions of Care / Patient Experience
Mod A: Essentials
Mod B: Critical Thinking
Mod C: Emotional Intelligence
Mod D: Conflict Resolution
Mod E: Leadership
Discharge Planning
Mod F: Difficult People
Mod A: Philosophy & Standards
Mod B: Patient Centered Approach to DP
Mod C: External Forces in DP
Hospital Revenue Cycle
Mod A: Industry Cash Flow
Mod B: Hospital Cash Flow: Claims, RAC, Avoidable Days
Ethics in Case Management
Mod A: Ethical Standards of Practice
Mod B: CM Ethics in the Hospital Setting
Mod C: Ethics in the Telecare Era
Mod D: Ethics in Large Corporate Cultures
Mod E: Ethics in the Community Health Setting
Patient Advocacy
Mod A: Advocacy & Care Management
Mod B: Right Care Guidelines for our Patients
Mod C: Key Components to Care Success
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Athena Forum Care Management Series®
Part 2 of 2
Commercial Population Healthcare [SEP2015]
Mod A: Chronic Care Management for a Population
Mod B: Healthcare Analytics & Metrics for Success
Mod C: Tele-health Coaching & Care Transitions
CM Power! [for advanced case managers; SEP2015]
Mod A: Essentials of a High Performing Case Manager
Mod B: Improving Claims as the CFO Would Like Them!
Mod C: Optimizing Resource Management
UM
Mod A: Standards & Regulations in UM
Mod B: Payers, Contracting & UM
Mod C: Quality of Care & UM
Senior Care Series® [Q1 2016]
10 courses for improving care & improving claims on
Medicare’s Top 10 hospital admission clinical conditions.
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Excerpt from Athena Forum’s Population Health
[Mod A: Prior Authorization – Case Study “Leroy J. – “Is Admission Related to ESRD?” partial page 34 of 36 pp]
The Hospital CM contacts the MCO CM to let her know Medicare has not approved the admission. According to the
Hospital CM, Medicare does not feel the respiratory event was related to ESRD, and they also have determined the
patient does not meet criteria for admission. The case has been sent for review.
The hospital CM is requesting an authorization and acknowledgement as primary payer from the MCO. The MCO CM
requests additional information from the hospital CM, specifically regarding the patient’s intensity of service since
admission. Hospital CM provides the following documentation:

With the exception of IV Reglan and IV Zofran in the ER, the patient has received only oral medications, subQ
Heparin prophylactically, and subQ insulin since admission

No hydration has been required

Vital signs: BP ranges from 185/84 to 191/74, HR 86-92, R 16-24, O2 sat 100% on room air. No supplemental
oxygen has been required
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PRN medications have been ordered, but none given since admission

MCO CM advises HCM that intensity of service documented does not meet medical necessity guidelines for
inpatient status. A denial letter is sent specifically for the inpatient stay.
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Athena Forum Clinical Care Series®
Slide 1 of 3
Asthma
CV Risk: Stroke & MI
Mod A: Prevalence & Pathophysiology
Mod B: Assessment
Mod C: Treatment
Mod D: Care Manager’s Role in Asthma
Mod A: Prevalence & Pathophysiology
Mod B: Stroke & The Care Manager’s Role
Mod C: MI & The Care Manager’s Role
Colorectal Cancer
Diabetes
Mod A: Prevalence & Pathophysiology
Mod B: Symptoms & Management
Mod C: Treatments & Interventions
Mod A: Therapies
Mod B: Assessments & Complications
Mod C: Pharmacologic in Diabetes Care
Mod D: CM Role & Pharmacologics Diabetes
COPD
Ebola Virus Care Management
Mod A: Prevalence & Pathophysiology
Mod B: Assessments & Complications
Mod C: Pharmacologics in COPD
Mod D: Care Manger’s Role
Mod A: American Societal Response & Ebola Assessments
Mod B: Infrastructure for Control & Care; Legal Issues/Ebola
Mod C: Patient Education & Reimbursements Ebola Care
Mod E: Pneumonia
EOL & Palliative Care
5 Modules on Patient Goals, Care Mgmt, Regs, CM Role.
COPD rates are rising in women.
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Athena Forum Clinical Care Series® Slide 2 of 3
GI Disorders
Obesity Management
Mod A: Ulcerative Colitis
Mod B: Crohn’s Disease
Mod C: Diverticulitis
Mod A: Prevalence & Pathophysiology
Mod B: Assessments & Complications
Mod C: Treatments & Interventions
Mod D: Care Manager’s Role in Obesity Management
Heart Failure
Pain Management
Mod A: Prevalence & Pathophysiology
Mod B: Assessment & Complications
Mod C: Treatment & Interventions HF care
Mod D: Case Manager’s Role in HF care
Mod A: Pathophysiology of Pain
Mod B: Acute Pain
Mod C: Chronic Pain
Mod D: Types of Chronic Pain
Mod E: Cancer Pain
Multiple Sclerosis
Mod A: Prevalence & Pathophysiology
Mod B: Symptom Management & Rehab
Mod C: Disease & Relapse Management
Mod D: Care Manager’s Role in MS
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Athena Forum Clinical Care Series® Slide 3 of 3
Rheumatoid Arthritis
Women’s Health
Mod A: Prevalence & Pathophysiology
Mod B: Assessments & Complications
Mod C: Treatments & Interventions
Mod D: Care Manger’s Role
Mod A: The Perimenopausal Years
Mod B: Complications in Menopause Care
Mod C: Sexuality in Maturity
Mod D: Care Manager’s Role
Sepsis Care
Wound Care
Mod A: Prevalence & Economics
Mod B: Pathophysiology & Assessment
Mod C: Sources & Predispositions
Mod D: Prevention & Treatment
Mod E: Care Manager’s Role in Sepsis
Mod A: Prevalence & Pathophysiology
Mod B: Assessments & Complications
Mod C: Treatments & Interventions
Mod D: Prevention Strategies
Mod E: Care Manager’s Role in Wound Care
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Athena Forum Behavioral Health Series®
Improving Outcomes in Abuse Management
Mod A: Domestic Violence 1
Mod B: Domestic Violence 2
Mod C: Child Abuse 1
Mod D: Child Abuse 2
Mod E: Elder Abuse
Mod F: CM Role in Abuse Reporting & Management
Improving Outcomes in Depression Care
Mod A: Prevalence & Impact
Mod B: Pathophysiology of Depression
Mod C: Non-pharmacological Treatments
Mod D: Pharmacology in Depression Care
Mod E: CM Role in Depression Care
Harm Risk Behaviors & Suicide Prevention
Mod A: Prevalence & Societal Impact
Mod B: Pathophysiology & Associated Mental Disorders
Mod C: Assessment & Prevention
Mod D: Treatment Management
Mod E: CM Role in Suicide Prevention
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Accreditations: 100% Volume for RN, SW, ACM, CCM

Athena Forum offers 700 CE contact hours for RN, Social Work, ACM and CCM professionals.

RN: Co-Provider with SutterHealth University by American Nurses Credentialing Center [ANCC]
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RN California: Approved Provider with California Board of Nursing
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RN Florida: Approved Provider with the Florida Board of Health in Nursing.
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Social Work: Approved CE Provider by the NASW, Michigan, California.
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ACM: Approved Provider by the ACMA (American Case Management Association)

CCM: Approved Provider of CCM CE by the CCMC (Certified Case Managers Commission)
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Case Study#1 The Strategic Staff Development Program
1. Assess Department Weaknesses
- High LOS at “X” days – commercial payers complaining.
- Heart Failure Re-admits too high – Medicare financial penalties will grow.
- Avoidable days too high – costs $thousands monthly
- Need CM clinical skills – RN managers on units say our CM clinical skills are rusty.
- Denials too high -- Need better percentages, especially with BlueCross.
- Problems with RAC auditors incoming – rumors not good.
2. Develop Positive Strategy
- Lower the LOS to “Y” days
- Reduce HF re-admits by 20%
- Improve denial management to “Y”%
3. Assign Athena Forum Courses to Case Managers for Improved Competencies
- Discharge Planning & UM & Hospital Revenue Cycle
- Heart Failure Assessments, Treatments & Case Manager’s Role in Reducing HF Re-admits
- Principles of Case Management & Standards of Practice
4. Discuss & Integrate Performance Program
- Delegate to senior case manager implement discussions on courses & hosp policy. Consider Gift Certificates to Best Buy, etc)
- Invite guest speakers from hospital, payers, RAC auditors, others. Outside perspectives add value.
- Listen for opportunities to make process improvements.
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Case Study #2 Tackling Hospital Priorities
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Case Study 1:
Reducing HF Re-Admits by 20%
Timeframe:
Athena courses:
Discuss & integrate:
Guest Speaker:
4 weeks: SEP 2015
Heart Failure: Pathophys, Assess, Treatments, CM Role
4 Staff Meetings: SEP 2015
Hospital Cardio Nurse Practitioner
Case Study 2:
Improving our UM Program
Timeframe:
Athena courses:
Discuss & integrate:
Guest Speaker:
8 weeks: JUN 2015
UM: Pre-Admission Reviews, Concurrent Reviews, UR, Transitions
4 Staff Meetings: JUN 2015
UR Manager from BlueCross
Case Study 3:
Improving Sepsis Care & Reducing LOS
Timeframe:
Athena courses:
Discuss & integrate:
Guest Speaker
4 weeks: AUG 2015
Sepsis Care & Resource Mgmt
4 Staff Meetings: AUG 2015
Hospital ICU Director
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Case Study #3: Reducing Avoidable Days
CM Director:
“Our 350 bed hospital has an
unacceptable level of avoidable
days at 50 days a month. At
$1900 a bed night that’s
$95,000 monthly in losses.
That’s $1.1M yearly.
“I assigned your course on
Hospital Revenue Cycle to my 28
case managers.
“My goal was to reduce avoidable
days 30% within 4 months. I have
total support of VP Operations.”
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Case Study #4 The Book of the Month Club



Case Study 1:
Improving our CM in the ED Program
Timeframe:
Athena course:
Discuss & integrate:
Book Club Discussion Leader:
One month.
“Book” - Principles in Case Management: CM in the ED
CM Lunch & Learn meeting end of month.
CM Director: “CM’s are thinking like management – fantastic!”
Case Study 2:
Improving our Utilization Mgmt
Timeframe:
Athena course:
Discuss & integrate:
Book Club Discussion Leader:
One month.
“Book” - UM: Pre-Admission Reviews & Concurrent Reviews
CM Lunch & Learn meeting end of month.
CM Director: “CM’s have the best ideas on process improvement.”
Case Study 3:
Improving Our Claims with Prior-Auth
Timeframe:
Athena courses:
Discuss & integrate:
Book Club Discussion Leader:
One month
“Book” - MCO Prior-Authorization
CM Lunch & Learn meeting end of month.
CM Director: “CM’s have new energy and confidence about prior-auth.”
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Case Study #5 Competency Program for Social Workers
CM Director:
“Our Social Workers can benefit from improving competencies in clinical care and CM business. In 2015 I’m launching
a Social Worker Competency Program -- using 10 courses from Athena Forum. Each of our 5 Social Workers will be
required to complete the following 10 courses on Athena -- at the rate of about one course per month (sooner if they
want to). I’m giving them a vacation break in August and Holiday break in December.
“Each Social Worker will submit the 10 SW certificates from Athena to our Dept Admin -- who will then file the certs in
Personnel Jackets. When I meet for performance reviews in December, I will expect to see 10 certificates as proof of
performance. And of course, they can print each cert a second time for their license. Win-win. Big picture is that we
can now offer our Social Workers a new resource in clinical ed so they can contribute more to our dept performance.”
Social Worker Competency Program with 10 Athena Forum Modules 2015:
1 JAN: Hospital Revenue Cycle: Hospital Cash Flow
2 FEB: Discharge Planning: Patient Centered DP
3 MAR: MCO Continuum: Prior Auth
4 APR: Asthma Pathophysiology
5 MAY: COPD Pathophysiology
6 JUN: CV Risk: Stroke & MI
7 JUL: Heart Failure Care: CM Role
8 SEP Pain Mgmt: Pathophysiology
9 OCT: Wound Care: Case Manager’s Role
10 NOV: Sepsis & LOS
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Case Study #6 Core Competencies & Compensation

Multi-Hospital System (5 hospitals) in Seattle area

CM Director: “Athena Forum education is our core staff competency program for our 100 CMs.”

CM Director: “I assign 10 Athena modules yearly. Certs get filed in each employee’s HR file.”

CM Director: “During annual performance review meetings < 10 certs = no raise.”

CM Director: “With staff changes, a maternity leave and a transfer, we’ve had 100% compliance.”

CM Director: “We don’t measure all metrics, but we see noticeable improvements in 5 teams.”
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21st Century Learning by Case Managers

Starbucks: “About once a month I take my laptop to Starbucks with their Wi-Fi and read a course
on Athena. No one bothers me plus I get to sip on my Grande Latte while learning something new”
Case Manager, San Fran, CA.

Hospital Medical Library: “It’s quiet in the library, so I go down the hall once in awhile to take a
course on Athena Forum with my laptop. I only wish the librarian allowed me to eat a sandwich
there, but you can’t have everything in life.”
Case Manager, Seattle WA

Late Night at Home: “I’m married with 2 kids and am on 2 church committees plus the job, so
time is precious. I have learned that when the boss assigns a course, I am able to take a late
Saturday night at home to read a course on the site. It’s my quiet time for learning.”
Case Manager, Newark NJ

Early Morning Cubicle: “When the boss assigns a new course on Athena Forum I show up super
early the next morning in my cube and take the course ASAP. Good business concepts.”
Case Manager, Atlanta, GA
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What does excellence sound like?

“Thank you for the training this morning, it was exactly what we needed.”
CM Director VA

“Our team is ecstatic to have such an amazing tool at their fingertips.”
CM Director WY

“Athena has exceeded our expectations. Keep up the good work!”
CM Director TX
“The format of Athena Forum is very user friendly.”
CM Director CA

“Conversations are getting more professional. Social Workers love this.”
CM Director IL

“We know it. We trust it. We love it.”
CM Director TN

“Starbucks is the new Learning Café for our younger gen case managers.”
CM Director WA

“Athena is the tide that lifts all boats.”
CM Director NY

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Athena Forum Management Team
Tom Rasmussen
CEO & Publisher
Barbara Leach MS RN
Director Nursing Education
Senior Fellow
Jefferson School Population Health
Mindy Owen RN CRRN CCM
Vice President Education
Past President CMSA
Former Chair CCMC
Janice Graham
Director Web Operations
Ellen Fink-Samnick MSW LCSW CCM CRP
Director Social Work Education
Danae Manus MPA RHIA
Director Course Design
Sarah Hill
Director Hospital Marketing
Kim Billings
Manager, Hospital Sales EAST
Beverly Gulvin
Manager, Hospital Sales WEST
Athena Forum® LLC
EIN # 20-5544409
Rockville, MD 20850
TEL 301-279-2160
Athena was the mythological Greek goddess of wisdom and prudent warfare.
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