TEDx ReBlog: 9 common-sense rules for getting the most out of meetings

Been in a meeting recently? Sure you have.

When it comes to making the most out of meetings (i.e., productive, clear, professional, and as brief as possible), it’s not uncommon that we drop the ball from time to time. But that doesn’t mean we can’t strive to run meetings as effectively as possible.

Ray Dalio with Bridgewater Associates has some sounds suggestions for making the most of that time you and your coworkers spend locked away in a conference room trying to change the world (or at least, make a decision on the best font for your quarterly report). Clear objectives, firm leadership, and focus top the list, but do yourself a favor and read more here.

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Internal Auditor ReBlog: The value of mentorship

Mentorship is one of the most powerful tools for aspiring internal audit professionals and also provides valuable experiences to mentors. Early in my career, several professionals informally provided me with advice, suggestions, and guidance that helped bring me to where I am today. At the time, I did not realize these individuals were acting as “mentors” but the knowledge, experience, and insights they provided shaped the decisions I made…

At a recent internal audit forum, IIA Executive Vice President and Chief Operations Officer Bill Michalisin co-facilitated a panel on mentoring and career management… As a fellow Emerging Leader, I reached out to Michalisin and some of the panelists and asked them to share their perspectives on mentorship with Internal Auditor’s readers.

Internal auditor Bill Stahl explores the benefits of formal and informal mentoring in the audit community, and makes suggestions on what to look for in a mentor, where they can be found, and makes the case for mentoring others.

Read more here.

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Audit Release: Oregon Health Authority Should Improve Efforts to Detect and Prevent Improper Medicaid Payments

Report Highlights


Our audit found that Oregon Health Authority (OHA) recovery efforts are appropriate and reasonable, but the agency should strengthen efforts to detect and prevent improper payments in Oregon’s $9.3 billion per year Medicaid program. Prevention of improper payments is more cost-effective than attempting to recover improper payments. We also found that delays in processing eligibility for thousands of Oregon’s Medicaid recipients resulted in millions of dollars of avoidable Medicaid expenditures, a critical issue the agency failed to disclose until raised in a May 2017 Auditor Alert. Furthermore, OHA did not timely disclose relevant information, which impeded our audit work. OHA’s new management has been more proactive and transparent in addressing these issues.

Background

An improper payment is defined by the federal government as “any payment that should not have been made or was made in an incorrect amount (including overpayments and underpayments) under statutory, contractual, administrative, or other legally applicable requirements or where documentation is missing or not available.”

Purpose of Audit

The primary purpose of the audit was to determine if the Oregon Health Authority could improve processes to prevent, detect, and recover improper Medicaid payments. The secondary purpose was to follow-up on OHA’s progress to resolve issues we raised in our May 2017 Auditor Alert.

Key Findings

Within the context that Medicaid is a very complex and challenging program to administer, we found:

  1. OHA has gaps in procedures for preventing certain improper payments. Insufficient management of the agency’s processes for identifying and resolving payment and eligibility issues, prioritization of staffing resources, and efforts to address technology issues put taxpayer dollars at risk.
  2. OHA lacks well-defined, consistent, and agency-wide processes to detect certain improper payments, especially related to coordinated care. We identified approximately 31,300 questionable payments based on our review of 15 months of data. OHA needs to continue researching these claims to determine how many were improper; OHA reported that only a small percentage were improper based on preliminary research of 2,700 claims.
  3. OHA recovery efforts appear appropriate and reasonable, but may be underutilized due to OHA’s limited procedures for detecting improper payments.
  4. OHA reported completing the action plan to determine eligibility for the remaining backlog of 115,200 Medicaid recipients. Approximately 47,600 (41%) were deemed ineligible as a result, although this figure may decrease slightly through the end of November. Failure to address this issue in a timely fashion resulted in approximately $88 million in avoidable expenditures.

Recommendations

Drawing from national leading practices, our report includes eight recommendations to OHA focused on strengthening efforts to detect and prevent improper payments. Oregon Health Authority agrees with our recommendations. The agency’s response can be found at the end of the report.

Read full report here

 

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Internal Auditor ReBlog: Courage is easy when there’s nothing on the line

In her book, Extraordinary Circumstances: The Journey of a Corporate Whistleblower, Cooper counsels internal auditors to “find your courage.” Courage means many things to many people, so thinking about it and discussing it with others you trust can help you reinforce your moral foundation.

In Trusted Advisors: Key Attributes of Outstanding Internal Auditors, one of the nine key attributes I examine is ethical resilience, and in speeches about the book, I talk about internal auditors needing to be ethical AND courageous. I have known many ethical internal auditors who kept their heads down rather than confront highly contentious risks, issues, or results. But being courageous often requires being the lone voice. It doesn’t take quite as much courage to stand in line to point a finger. Indeed, courage does not wait for a choir.

But courage doesn’t suddenly blossom within an internal auditor simply because there is an expectation or strong case for it. I go back to Cooper’s admonition to “find your courage,” which requires practitioners to examine what courage is and under what circumstances their own internal fortitude may be tested.

Read more here.

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Governing RePost: Drowning in Data, Cities Turn to ‘Citizen Scientists’

Government has a data problem. Put simply, it collects so much of it that it struggles to analyze most of it.

Of course, states and localities already use data analytics for a lot of things. Departments of revenue, for instance, rely on it to curb tax fraud. Public schools use it to measure student performance and figure out how to boost grades and graduation rates. Cities turn to it to manage traffic congestion and monitor air pollution. But despite all of this, governments are still collecting vast amounts of data and, well, doing nothing with it…

Ted Newcombe discusses a growing trend in local government data analysis, and some of the advantages – and drawbacks – of calling upon nonexperts to help analyze government data. Read more here.

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Internal Auditor ReBlog- Ratings in Audit Reports: Lights or Lightning Rods?

…an audit committee chairman observed that ratings can “shine a light” and help the audit committee quickly focus on the most important findings in a report. However, while ratings may be a “light” for some, they are ultimately a “lightning rod” for others.

Ratings can be a powerful tool, but if management and the audit committee place undue emphasis on them, they tend to have a polarizing effect on line and operating managers whose performance ends up being summarized in a single word: “unsatisfactory.”

Even the most useful tools have their limitations. In this post, IIA CEO Richard Chambers ponders the benefits and drawbacks of the use of ratings systems in internal audits. Read more here.

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DHS – Aging and People with Disabilities: Consumer-Employed Provider Program Needs Immediate Action to Ensure In-Home Care Consumers Receive Required Care and Services

Report Highlights


The Secretary of State’s Audits Division found that the Aging and People with Disabilities (APD) program should take immediate action to address gaps in program design and oversight in order to improve the safety and well-being of participants in the Consumer-Employed Provider (CEP) program.

Read full report here.

Background

Oregon is a leader in providing in-home long- term care options for older adults and people with disabilities. The most used in-home care program is the Consumer-Employed Provider program, which positions consumers as employers of their homecare worker.

Purpose

The purpose of this audit was to assess the policies and processes used by APD to ensure the needs of consumers in the CEP program are met.

Key Findings

The effectiveness of the Consumer-Employed Provider program is dependent on the consumer, the case manager, and the homecare worker. If each is capable, competent, and supported in their role, the current model can be successful. Our audit found:

1. Some consumers are not receiving the support necessary to ensure required employer duties are being performed, which adds to case managers’ and homecare workers’ responsibilities.
2. Case managers are not consistently contacting consumers, or monitoring services consumers receive due to excessive workloads.
3. Agency requirements do not ensure that homecare workers are prepared to provide the care and assistance consumers need.
4. Due to current data collection and utilization practices, it is difficult for APD to determine if consumers are safe and receiving the care and services they need.
5. Current deficiencies in the program may put consumers’ health and well-being at risk and keep the program from operating as intended.

To reach our findings, we conducted interviews and case file reviews, collected and analyzed CEP consumer data, and researched federal and state standards.

Recommendations

The report includes recommendations to improve Consumer-Employed Provider program implementation and support. Recommendations include consistently following existing monitoring policies, addressing case managers’ excessive workload and responsibilities, and providing more support to consumers and homecare workers.
The Department generally agreed with our findings and recommendations. Its response can be found at the end of the report.

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