The backstage and upfront highlights at the HFMA ANI

Events such as the Healthcare Financial Management Association's annual national institute (ANI) are as tightly choreographed as any Balanchine ballet. Journalists need to be assertive in order to obtain any news items that aren't corporately homogenized.

That often means posting myself near where I think a keynote speaker is going to exit--or just make a beeline to where he or she is standing. That made for great fun two years ago, when Peter Orszag all but sneered at me for having the temerity to ask some questions.

To his enormous credit, HFMA President Joseph F. Fifer was incredibly gracious after my mini-ambush--given I had just waltzed backstage and approached him directly, he certainly didn't need to. I wanted to talk to him after he announced the organization had created a hospital price transparency task force.

Fifer told me the changes in healthcare finance have really pressured his membership to be more open on what they charge. "Patients are paying more out of pocket, and it's really creating a marketplace environment," he said, one where price opacity can really no longer fly.

Steven Brill's article in Time about hospitals all but ignoring their own chargemasters was another catalyst for transparency, according to Fifer, as was the billing information recently released by the Centers for Medicare & Medicaid Services.

But even more important, Fifer observed, was media coverage on hospital pricing that sprung from the release of the CMS data.

"That triggered more local exposure than the Time article," and really put pressure on individual hospitals regarding transparency, he said.

On the other hand, hospitals cannot provide price transparency on their own, which is why Fifer said the HFMA launched the initiative.

The initial members of the task force include the Medical Group Management Association, the LeapFrog Group, America's Health Insurance Plans, and Catalyst for Payment Reform. But Fifer indicated that many more groups, including consumer advocates, would come on board.

"This is still in the incubator stage," he said, later adding that "this has been building up for a while, and it is time for us to step up."

A far less sanguine backstager was former acting Centers for Medicare & Medicaid Services Administrator Donald M. Berwick, whom Fifer had introduced as a keynote speaker. But Berwick had good reasons for being tight-lipped: He had announced just the day before he was running for governor of Massachusetts, and managed to forget his new role as political candidate almost instantly.

Berwick's HFMA speech pivoted on the conceit that in order to cut healthcare costs and improve quality, the interested parties can't yell at each other.

That's a noble thought, but an anecdote Berwick used to illustrate the point was not. It revolved around his shouting at his then 6-year-old daughter Becca during a vacation in the Canadian Rockies because she was slow in completing a hike--a 16-mile hike, to be more specific.

The combination of fatigue and anger eventually caused his daughter to cry--and then vomit--Berwick told the audience.

Although Becca Berwick rebounded from that day to graduate from Brown University and is soon to be married, I can't quite imagine this tale resonating with voters. And given Berwick told this story to an audience of about 2,000 finance executives from across the country, there surely were some in the audience.

Berwick appeared to have snapped to his political senses when I intercepted him just before I spoke with Fifer. "I'm here to help the HFMA," he said, quickly adding that the speech was not made in the context of his running for office. Before I could ask more about the incident with his daughter, the 66-year-old Berwick walked away with a swiftness that suggested he still took marathon hikes. Berwick's press office has yet to respond to a request for comment.

The vendor booths at HFMA possessed a come-hither quality Berwick decidedly does not. There was very much a carnival barker-like theme to the exhibits this year, with company representatives practically waving down passersby to partake of their products. There seemed a lot less candy and a lot more shuck-and-jive.

"You look like a race car driver," a model wearing skin-tight attire hired by the PFS Group told me as I walked by its booth. Apparently she had been hired to accentuate PFS's "race to the top" motto.

I asked for more specifics--but the model, apparently not used to in-depth inquiries--said she was just kidding.

Healthcare Payment Specialists offered a "money booth" where $20, $50 and $100 bills could be snapped up by anyone who entered during the show--meant to illustrate that HPS could provide services that would allow its clients to "grab cash out of thin air," as a company representative told me.

Crowe Horwath offered a full-service roulette wheel. I watched Ryan Thompson, a senior director with Dignity Health in Los Angeles, haul in a $25 Amazon gift card after he hit 29 black. I don't know what the symbolism was in that case.

Out of curiosity, I stopped by Accretive Health's booth to see if it was offering the golf course/country club items I had criticized last year. This year, it was offering both manual and electronic smartphone amplifiers.

"That's Ron Shinkman," Accretive Vice President Ronald Hirsch, M.D., remarked to one of his colleagues. "He didn't like our golf balls last year." I said I thought the amplification devices were a better choice. Hirsch told me that there was another booth nearby offering golf balls if I was interested. I quickly moved on, but I never did find that booth. - Ron (@FierceHealth)

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