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Watch CEO’s Presentation on Strategies to Reduce Total Cost of Care
Watch a replay of our CEO, Steve Cyboran, ASA, MAAA, FCA, CEBS, present at the Houston Business Coalition on Health on How to Reduce Total Cost of Care Through Organizational Culture. Joining him as a presenter is Ray Fabius, MD, Co-Founder and President of HealthNEXT.
Available Support
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. Our team includes business and human relations leaders, finance experts, actuaries, clinicians, behavioral health experts, pharmacy experts, and legal resources to guide you through the strategy and compliance process. Please contact us: [email protected].
Career Planning: Effective Pruning Bears Fruit: Manager Development
Join us on Thursday, February 16 from 12:00 to 12:30 CDT for the fourth webinar in Humaculture, Inc.’s “People Development: A Humaculture® Perspective Series.” You will learn how to conduct Career Planning to support manager development, and why “Effective Pruning Bears Fruit” by building manager capabilities.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Christi Green, RN, MS, PHR, strategy and people consultant
Objective
We’ve talked about how to “Effectively Prune” to activate and inspire our workplace AND workforce to further grow and develop employees. Now it’s time to talk about how to use management to grow instead of control, focus on people in addition to results, and be vision driven instead of a problem solver. This leads to growth and new directions as opposed to staying rooted in the current problems.
Career Planning: Manager Development Key Takeaways
During this session, participants will learn that:
- Organizations fall into the “star” employee syndrome
- Organizations may not think from a people development perspective
- Culture of Control creates a toxic environment
- For effective manager development organizations must:
- Promote intentionally to fulfill vision, mission, values
- Effectively identify manager qualities/potential
- Develop and deploy learning and growth opportunities
- Shift to a Culture of Growth with accountability
- Prepare for appropriate transitions
Compliance Toolkit Fourth Quarterly Update Released
The Compliance Toolkit fourth quarterly update was released on October 31, 2022 for changes since it was released on November 11, 2021. The Consolidated Appropriations Act (CAA), No Surprises Act, and Transparency in Coverage Final Rule Compliance toolkit will next be updated on or around January 31, 2023 if there are any updates required.
Compliance Toolkit First Quarterly Update
The Compliance Toolkit first quarterly update addresses:
- The Independent Dispute Resolution section was updated to include a section for the Revenue Procedure 2022-11 which published the percentage adjustment for median contracted rates.
- The Pharmacy Benefit and Drug Cost Reporting section was updated to include a section reflecting the guidance contained in the November 23, 2021 Prescription Drug and Health Care Spending Interim Final Rules, implementing Section 204, Title II, another phase of the transparency provisions of the Consolidated Appropriations Act (CAA) of 2021.
- The Direct and Indirect Compensation section was updated to reflect clarifying language and a section was added to address guidance contained in the Field Assistance Bulletin No. 2021-03 released by the Department of Labor (“DOL”) on December 30, 2021.
- Attachment 1: Compliance Tool – CAA and Transparency Financial Impact Analysis Tool was updated to reflect additional calculations.
- Attachment 9: Compliance Tool – MHPAEA Comparative and Fee Analysis Tool was updated to improve some of the functionality.
Compliance Toolkit Second Quarterly Update
The Compliance Toolkit second quarterly update addresses:
- The Initiation of IDR Process section was updated to indicate that online IDR portal was opened on April 15, 2022.
- The Determination of Payment section was updated to report a court case that invalidated the portion of the interim final rule relating to the presumption that the QPA is the most appropriate amount and a release of a Memorandum, withdrawing the portion of the interim final rule that was invalidated by the court.
- The Petition to Deny or Revoke IDR Certification was updated to report the release of IRS Notice 2022-11, which provides guidance on indexing “the qualifying payment” amount for items and services furnished in 2022 in the case of a group health plan or insurer that does not have enough information as of January 31, 2019, to calculate the median of the in-network contracted rates or in the case there are new items or services being furnished.
- The Fee Disclosure Related to Covered Group Health Plans Section was updated to remove duplicate sections.
- The Public Disclosure of Provider Fees Requirement section was updated to report the release of two new FAQs discussing the machine-readable files used for public disclosure.
Compliance Toolkit Third Quarterly Update
The Compliance Toolkit third quarterly update addresses:
- The “Independent Dispute Resolution (IDR) Procedures for Determining Certain Out-of-Network Rates to Be Paid by Group Health Plans” section has been updated to reflect the following:
- Departments jointly issued FAQ guidance adopting an enforcement safe harbor for health plans and insurers reporting certain types of in-network rates under the transparency in coverage.
- Departments jointly issued revised process guides for independent dispute resolution (IDR) under the No Surprises Act.
- Federal Court stays proceeding in case vacating Portions of No Surprises Act’s IDR Regulations
- Departments Jointly issued Checklist for Surprise Billing IDR Process
- Departments Issued Checklist for Surprises Billing IDR process
- The “Public Disclosure of Provider Fees Requirement” section was updated to clarify that the deadline for posting the Machine Readable Files is July 1, 2022.
Compliance Toolkit Fourth Quarterly Update
The Compliance Toolkit fourth quarterly update addresses:
- Federal Court vacated key portions of the interim final regulation implementing the independent dispute (IDR) provisions of the No Surprises Act relating to air ambulance services.
- The DOL, HHS and IRS finalized options of the No Surprise Act medical billing regulation covering the independent dispute resolution (IDR) process. These regulations first remove the provision that the court invalided and specify that certified IDR entities should select the offer that represents the value of the item or service under dispute after considering the QPA and all permissible information submitted by the parties. The regulation net expanded on the requirement that health plans and insurers disclosure to provided and facilities the QPA for items or services with each initial payment or notice of denial of payment.
- In connection with the release of the final Surprise Billing regulations, the Departments of Labor (“DOL”), Health and Human Services (“HHS”) and Treasury (collectively, the “Agencies”) released an extensive set of FAQs covering surprise billing and price transparency rules. The FAQs are wide-ranging, but provide important clarifications.
- CMS published more detailed reporting guidance along with reporting templates on its RxDC webpage for Prescription Drug reporting due on December 27, 2022. This guidance included the following:
- RxDC reporting instructions
- RxDC templates
- RxDC drug name and therapeutic class crosswalk
- CMS also revised the Model Disclosure Notice Regarding Patient Protections Against Surprise Billing and its instructions and the Standard Notice and Consent Documents Under the No Surprises Act to be used in 2022 and to be used in 2022 and beyond.
- Attachment 2 now reflects the recently released revised “Model Disclosure Notice Regarding Patient Protections Against Surprise Billing.”
- Attachment 3 now reflects the recently released revised “Standard Notice and Consent Documents Under the No Surprises Act.”
Compliance Toolkit Contents
To address the compliance needs of the industry, Humaculture, Inc. partnered with Attorneys Howard Lapin and Larry Grudzien to create a Compliance Toolkit to address all of the requirements in the new law and regulations. It contains over forty documents, including:
- A detailed explanation of the law and regulations;
- A compliance tool that highlights all of the required changes and what steps needed to be taken to comply;
- Sample provisions for plan documents, Summary Plan Descriptions, and administrative services agreements;
- All of the model notices that have to be provided to covered individuals;
- Sample notices that have to be provided to participants; and
- Sample disclosures and reports that have to be made to the governmental agencies.
There are over two hundred and eighty-five (285) pages of documents in this Compliance Toolkit. It has been specially designed for use by employers, insurers, brokers, and third-party administrator to help them effectively to comply with all of the requirements.
Webinar Reviewing the Compliance Toolkit
On December 14, 2021, we conducted a free webinar to review the Compliance Toolkit. We reviewed its contents and explained how it can be used to comply with the requirements. You can view the webinar here.
Hidden Opportunities, A Strategic Compliance Series
Humaculture, Inc. conducted a strategic compliance webinar series over the first five months of 2022 focusing on harnessing the Hidden Opportunities in the No Surprises Act and Transparency in Coverage Final Rule. Our goal was to help organizations create a competitive advantage. Does it make sense to expend limited resources to merely comply with the law and regulations, or is there a way to strategically “design the compliance away” while strategically differentiating the employee value proposition?
Ordering
You can purchase the Compliance Toolkit, which includes quarterly updates through October 31, 2023, for only $450 by contacting us and we will invoice you for the purchase price. Contact us to order your own copy or to ask any questions.
Available Support
We are available to support you in your compliance and financial needs. This Compliance Toolkit, including Financial Analysis Tools will help facilitate self compliance. Our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are also available to guide you through the compliance process, or we can take the lead. We would be happy to have a conversation regarding your needs and can customize a proposal for the level and type of support you may need. Please contact us.
Strategies to Reduce Total Cost of Care, in Search of the Holy Grail
Come see our presentation at the Houston Business Coalition on Health (HBCH) conference on Thursday, December 8 for Strategies to Reduce Total Cost of Care, in Search of the Holy Grail.
See Our CEO Present at HBCH
Presenter: Steve Cyboran, ASA, MAAA, FCA, CEBS, Humaculture, Inc. CEO presents with Ray Fabius, MD, Co-Founder and President of HealthNEXT
Fee: Free for employers not in health services (use link below)
Time: Thu, Dec 8, 2022, 1:00 PM – 1:50 PM CST
Topic: TCoC Reduction Through Organizational Culture
Location: 6100 Main St, 77005 (Rice University Bioscience Research Collaborative)
Webinar Replay: Effective Pruning Bears Fruit: Employee Development
Watch a replay of the third webinar in Humaculture, Inc.’s “People Development: A Humaculture® Perspective Series” to learn how to conduct Career Planning to support employee development, and why “Effective Pruning Bears Fruit” by building employee capabilities.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Christi Green, RN, MS, PHR, strategy and people consultant
Employee Development Objective
We’ve talked about how to “Walk the Garden” to assess employees as well as help them develop capabilities to align with the organization’s vision, mission, and values. Now this webinar focuses on how to activate and inspire our workplace AND workforce to further grow and develop employees. Research is abundantly clear that engaged employees help organizations succeed and bear fruit. There is no silver bullet to increase retention/reduce turnover. However, we do believe that investing in the organizational soil and the culture to nurture and support people will bear the fruits of success!
Career Planning: Employee Development Key Takeaways
During this session, participants will learn that:
- Organizations sometimes fall into the “warm body syndrome” trap
- Unhealthy/misaligned cultures disrupt employee development efforts
- Career planning tends to only occur only for a select few
- For effective employee development organizations must:
- Hire and develop intentionally to fulfill the vision, mission, values
- “Prune” to focus growth as well as direct energy and effort
- “Trellis and irrigate” to support desired growth
- Prepare for appropriate transitions
Available Support
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. Our team includes business and human relations leaders, finance experts, actuaries, clinicians, behavioral health experts, pharmacy experts, and legal resources to guide you through the strategy and compliance process. Please contact us: [email protected].
Watch
Watch the Career Planning: Effective Pruning Bears Fruit: Employee Development Webinar Replay below, or via Rumble.
Career Planning: Effective Pruning Bears Fruit: Employee Development
Join us on Thursday, November 17 from 12:00 to 12:30 CDT for the third webinar in Humaculture, Inc.’s “People Development: A Humaculture® Perspective Series.” You will learn how to conduct Career Planning to support employee development, and why “Effective Pruning Bears Fruit” by building employee capabilities.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Christi Green, RN, MS, PHR, strategy and people consultant
Objective
We’ve talked about how to “Walk the Garden” to assess employees as well as help them develop capabilities to align with the organization’s vision, mission, and values. Now it’s time to talk about how to activate and inspire our workplace AND workforce to further grow and develop employees. Research is abundantly clear that engaged employees help organizations succeed and bear fruit. There is no silver bullet to increase retention/reduce turnover. However, we do believe that investing in the organizational soil and the culture to nurture and support people will bear the fruits of success!
Career Planning: Employee Development Key Takeaways
During this session, participants will learn that:
- Organizations sometimes fall into the “warm body syndrome” trap
- Unhealthy/misaligned cultures disrupt employee development efforts
- Career planning tends to only occur only for a select few
- For effective employee development organizations must:
- Hire and develop intentionally to fulfill the vision, mission, values
- “Prune” to focus growth as well as direct energy and effort
- “Trellis and irrigate” to support desired growth
- Prepare for appropriate transitions
Webinar Replay: Pruning the Vines – Capabilities: Prune to Encourage Growth
Watch a replay of the second webinar in Humaculture, Inc.’s “People Development: A Humaculture® Perspective Series”, to learn how to shape talent for success by “Pruning the Vines,” using capabilities to prune to encourage growth so employees to fulfill their potential and maximize alignment and productivity.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Christi Green, RN, MS, PHR, strategy and people consultant
Prune to Encourage Growth Objective
This webinar explores ways organizations can “Prune to Encourage Growth” to shape talent for the future. Capabilities can be used to help organizations select the best plants, determine how best to organize them in the garden, identify strengths and weaknesses, prune away distractions (weak branches) to encourage growth and fruit production.
Key Takeaways
During this session, participants will learn that:
- Competencies tend to be just a checklist of skills to manage
- People that focus on everything may not be very good at anything
- Highly skilled employees may not thrive in management or leadership
- Effective people development:
- Is rooted in a clear understanding of organizational vision
- Facilitates growth, supports optimal organizational (garden) design
- Assesses skills and needs to support strategic priorities
- Explores the employee’s interests, abilities, and desires
- Identifies potential for transitions, management, or leadership
- Applies principles that work
Available Support
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. Our team includes business and human relations leaders, finance experts, actuaries, clinicians, behavioral health experts, pharmacy experts, and legal resources to guide you through the strategy and compliance process. Please contact us: [email protected].
Watch
Watch the Shaping Talent for Success: Pruning the Vines – Capabilities: Prune to Encourage Growth Webinar Replay below, or via Rumble.
Webinar Replay: Walking the Garden – Shift from Managing to Facilitating Growth
Watch a replay of the first webinar in Humaculture, Inc.’s “People Development: A Humaculture® Perspective Series”, which focuses on how to “Walk the Garden” to build employee relationships, enhance culture, and improve productivity. We discuss transforming your performance management process into one that focuses on facilitating growth and productivity.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Christi Green, RN, MS, PHR, strategy and people consultant
Objective
This webinar explores ways organizations can shift traditional performance management from the dreaded once-a-year process that is focused on past performance into an on-going discussion. “Walking the Garden” builds strong relationships, keeps people aligned with the culture, helps identify issues early that may inhibit productivity, facilitates growth, prepares your next generation of leaders, and identifies opportunities for transition. This requires proper job design to ensure employees are “planted in fertile soil.”
Key Takeaways
During this session, participants will explore:
- The pitfalls of trying to “manage performance”
- Why traditional “performance management” is a dreaded process, often detrimental to employee relationships, culture, and productivity
- How manager job design and span of control may limit effectiveness
- How effective people development will:
- Shift from “managing performance” to facilitating growth
- Help managers and leaders learn to “walk the garden”
- Lead to better alignment between employees’ personal/professional goals and the organization’s strategic priorities
Available Support
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. Our team includes business and human relations leaders, finance experts, actuaries, clinicians, behavioral health experts, pharmacy experts, and legal resources to guide you through the strategy and compliance process. Please contact us: [email protected].
Watch
Watch the Performance Management: Walking the Garden – Shift from Managing to Facilitating Growth Webinar Replay below, or via Rumble.
Performance Management: Walking the Garden – Shift from Managing to Facilitating Growth
Join us on Thursday, June 16 from 12:00 to 12:30 CDT for the first webinar in Humaculture, Inc.’s “People Development: A Humaculture® Perspective Series”, to learn how to “Walk the Garden” to build employee relationships, enhance culture, and improve productivity.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Christi Green, RN, MS, PHR, strategy and people consultant
Objective
This webinar explores ways organizations can shift traditional performance management from the dreaded once-a-year process that is focused on past performance into an on-going discussion. “Walking the Garden” builds strong relationships, keeps people aligned with the culture, helps identify issues early that may inhibit productivity, facilitates growth, prepares your next generation of leaders, and identifies opportunities for transition. This requires proper job design to ensure employees are “planted in fertile soil.”
Key Takeaways
During this session, participants will learn that:
- The problems and misnomer of trying to “manage performance”
- Why traditional performance management is a dreaded process, often detrimental to employee relationships, culture, and productivity
- How manager job design and span of control may limit effective focus
- Effective people development will:
- Shift from “managing performance” to facilitating growth
- Help managers and leaders learn to “walk the garden”
- Encourage growth in a specific direction
- Lead to better alignment between employees’ personal/professional goals and the organization’s strategic priorities
