The push to develop and deploy electronic health records (EHRs) over the past 15 years has brought many changes to the healthcare industry, but the work to fully realize their benefits — and harness their true potential — is not done.
The goal was to decrease costs and improve healthcare quality. While noble in concept and a notion that could revolutionize healthcare, fifteen years later, has it lived up to its promise?
Electronic records have resulted in tremendous benefits to both patients and providers. However, there is still an opportunity to continue to fully embrace the power of technology and data to improve patient outcomes and simplify the patient experience, especially regarding EHRs.
Electronic records have helped ensure that patients are educated about their medical history and that doctors have the information to make crucial — and potentially lifesaving — decisions. EHRs are no different from any new technology; there is always an opportunity to improve.
EHRs improved the patient experience
Over the past decade-and-a-half, the flow of information in our daily lives has hastened, and the desire to see information in real-time has extended to the medical industry.
Before EHRs, the doctor would have to wait for lab results, review them and then contact the patient to discuss the implication. Now, patients and doctors can quickly communicate the impact — such as the treatment plan and potential prescriptions — through the portal.
Previously, if patients had a post-appointment question, they might have a problem. They could call the office and hope it didn’t start a game of phone tag; if it did, they might not confirm an answer to their question until their next in-person appointment.
EHRs power patient portals, allowing patients to go online to assess and review their medical records, and if they have a question, they can post it and retain a digital record of the questions and answers. It also allows patients to see their appointment history and medications, request refills and schedule appointments.
The portal saves time for both patients and providers. Phone calls are now portal messages, and the time formerly expended on back-and-forth phone calls allows both sides to be more productive and informed.
Another benefit of EHRs is the portability of records.
Before, if patients wanted to change doctors, they needed to request printed copies of their records to take to their new provider — and many providers charged. Certified EHRs are required to generate a continuity of care document (CCD) that can be shared electronically.
Verifiable, an API-first innovator to the antiquated provider network management software category, has raised $27 million in Series B funding led by Craft Ventures to accelerate its next stage of growth and product innovation.
Verifiable’s comprehensive suite of network management solutions and real-time verifications empower healthcare organizations to expedite credentialing from multiple weeks to a matter of days. For customers, these efficiency gains can directly translate into millions of dollars of cost savings and added revenue capture, while also helping mitigate compliance risk, meet audit requirements, and improve the overall provider experience.
Verifiable will use this funding to scale go-to-market teams and expand its extensive verifications infrastructure to further differentiate the company’s best-in-category provider credentialing, compliance and network management solutions. The funding will also further accelerate Verifiable’s collaboration with Salesforce. Along with Craft Ventures, Highland Capital Partners, 137 Ventures and Cooley participated in the round, as well as existing investors The Altman Fund and Struck Capital.
“Credentialing isn’t a new challenge—it’s an administrative bottleneck that’s been costing healthcare organizations billions while negatively impacting provider experience and eroding the bottom-line,” says Nick Macario, CEO of Verifiable. “What is new is Verifiable’s integrated approach that truly automates the underlying operations through real-time verifications and workflows to drive speed and efficiency. Some of our largest competitors in the space are also customers of our platform, which speaks to the unique solution and value we bring to market. This is where Verifiable is built different.”
The advent of telehealth has been a groundbreaking step in the global healthcare ecosystem, and even more so in the wake of the COVID-19 pandemic. Treatments targeting autism spectrum disorder (ASD) have been demonstrated to benefit significantly from telemedicine.
ASD is a complicated neurodevelopmental disease that profoundly affects social interaction and behavior. Historically, geographical location, availability of specialists, and limited resources have been substantial barriers to timely diagnosis and treatment. However, telehealth is successfully addressing these challenges, expanding access to autism services, and enabling early intervention.
The Growing Demand for ABA and Telehealth Services
ASD has been identified in approximately one in 36 children in the United States, and early intervention is extremely important for improving long-term outcomes. Applied Behavior Analysis (ABA) is a widely used and recognized therapeutic approach that helps improve social, communication, and learning skills through positive reinforcement.
Unfortunately, the increasing demand for ABA services has strained the limited supply of specialists. As the global pandemic reshapes healthcare delivery, telehealth is emerging as a respected means to bridge these access gaps, providing a lifeline to those who need it most.
How Does Telehealth Work in Autism Treatment?
At its core, telehealth leverages digital technology to deliver healthcare services remotely. For children with autism, this translates into receiving ABA therapy from the comfort of their homes, making the experience less stressful for both the child and their caregivers.
Evidence of Success in Telehealth-Based Autism Treatment
Research has shown that telehealth can be as effective or better as traditional in-person therapy for treating ASD. According to research published in the Journal of Autism and Developmental Disorders, children receiving telehealth-based ABA therapy made comparable improvements in their skills as children receiving in-person therapy.
By Branden Neish, chief product and technology officer, Weave.
Economic challenges are causing small healthcare practices to reduce spending and rework balance sheets. Yet, some healthcare leaders are cutting funds in areas that may end up hurting them in the long run, particularly when it comes to digital solutions.
While digital solutions may sometimes end up near the bottom of a practice’s hierarchy of needs when compared to labor, supplies, rent and utilities, they can have a “make or break” impact on patient experience. And as patients are the lifeblood of any practice, their satisfaction will ultimately determine success or failure.
Amid unprecedented labor shortages plaguing the industry, healthcare staff members don’t have time to be bogged down with time-consuming administrative tasks that take away from patient care. As such, the need for digital solutions becomes doubly important to streamline and automate administrative tasks like scheduling, appointment reminders, payment processing and patient communications.
It is crucial to prioritize patient experience, optimize staff workflows and eliminate unnecessary expenses. Healthcare practices should focus on tools that deliver the highest return on investment in terms of time and cost, ultimately enhancing the experiences of both patients and staff.
In AMGA’s newly released 36th annual 2023 Medical Group Compensation and Productivity Survey, medical groups and healthcare organizations report a 6.1% increase in primary care compensation, compared to 1.5% and 1.6% increases for medical and surgical specialties, respectively.
Primary care also had more significant increases in work relative value units (wRVUs) than other specialties.
“We’re seeing that the compensation levels for primary care have increased this past year, greater than in other specialty types, which in our opinion, is evidence that the E/M coding changes that CMS [Centers for Medicare and Medicaid Services] put into effect in 2021 are now being reflected in organizations’ compensation plans,” said Elizabeth Siemsen, AMGA Consulting director. “Survey results indicate that the gains for primary care are evident as the smoke clears from the slow transition to the utilization of new wRVU weights for compensation calculation and the volume swings of the pandemic.”
With data on more than 190 specialties included, the 2023 survey reveals that compared to the compensation increases in primary care, overall physician specialty types show relatively nominal increases in compensation.
Data in the 2023 report indicate a more stable trend for physicians and other providers than seen over the past few years. The overall increase in median wRVUs increased by 2.9% compared to the prior year. Primary care physician wRVUs account for the bulk of that, with an increase of 4.0%, while medical and surgical specialties were limited to 1.7% and 1.4%, respectively. Additionally, more groups reported wRVU data in the 2023 survey. Finally, 2022 was a full year without the pandemic causing a significant impact on volume.
AGS Health, a leading provider of tech-enabled revenue cycle management (RCM) solutions and strategic growth partner to healthcare providers across the U.S., has been named a Leader in Revenue Cycle Management (RCM) Operations by Everest Group for the third consecutive year.
Everest Group Revenue Cycle Management (RCM) Operations PEAK Matrix Assessment evaluated 25 RCM providers’ market impact and ability to successfully deliver services based on subdimensions, including market adoption, portfolio mix, value delivered, and strategic vision and capability. Results were then used to determine each organization’s overall market leadership position – Aspirant, Major Contender, or Leader.
More information on Everest Group RCM Operations PEAK Matrix Assessment can be found here.
AGS Health is more than a revenue cycle management company – we’re a strategic partner for growth. With expert services complemented by AI-enabled technologies and high-touch support, AGS Health is the premier revenue cycle partner for leading health systems, physician groups, and academic medical centers in the U.S.
With expert insight into modern revenue cycle practices, the company pairs cutting-edge technology with college-educated, trained RCM experts to help clients achieve a high-performance revenue cycle to optimize workflows, maintain compliance, and prevent revenue leakage. AGS Health employs nearly 12,000 team members globally and partners with more than 130 clients across a variety of care settings, specialties, and billing systems.
Annual healthcare spending in the U.S. tops $4 trillion, an unfathomable amount of money, and 25% of that is strictly administrative expenses. Patients and healthcare organizations alike are hard-pressed to keep track of every dollar in the midst of everything else the healthcare industry entails.
Between different forms of insurance, public and private regulations that can vary from state to state, and providers not all being at the same institution, things sometimes simply get lost. Additionally, like any other industry, the more money that’s spent, the more potential there is for pain points during the payment and billing process.
Often in healthcare, providers and patients alike have little to no control over the charges racking up, leading to outstanding balances and more potential for fraud and sketchy credit services.
In the healthcare space, it’s important to remember that when you’re engaging with a customer, you’re likely interacting with someone at a pivotal and vulnerable moment in their lives. Healthcare organizations don’t call the people making payments “customers,” they call them “patients,” and because of the multitude of situations patients find themselves in, the way they engage with payments is also varied.
One person may be a lifelong patient of the same primary care physician, but have only one brief, harried interaction with an urgent care doctor. They may see a specialist once only to be referred to a different specialist that they end up seeing for several years. In all situations, some sort of payment interaction will be required, and they all look a little different.
The Triple Aim framework has emerged as a guiding principle for healthcare organizations seeking to optimize patient care outcomes while simultaneously containing costs.
Developed by the Institute for Healthcare Improvement (IHI), the Triple Aim provides a holistic approach to healthcare delivery by focusing on three interrelated goals: improving population health, enhancing patient experience, and reducing healthcare costs.
This article aims to delve into the rationale behind the Triple Aim, its intended objectives, and its profound impact on health systems and medical providers.
The Need for a Transformation
The United States, like many other nations, faces several healthcare challenges, including escalating costs, inconsistent quality of care, and fragmented systems. The existing fee-for-service model has contributed to excessive healthcare spending without necessarily translating into improved patient outcomes. Consequently, the need for a fundamental transformation in healthcare delivery arose, giving rise to the Triple Aim.
The Triple Aim Explained: Improve Population Health
The first aim of the Triple Aim is to improve the overall health of populations. This involves addressing the determinants of health, promoting preventive care, and implementing evidence-based interventions to manage chronic diseases effectively. By focusing on population health, healthcare providers aim to reduce the incidence of preventable diseases and enhance the overall well-being of communities.
Enhance Patient Experience
The second aim of the Triple Aim is to enhance the patient experience of care. This encompasses various aspects, including improving access to care, fostering effective communication between patients and providers, ensuring care coordination, and respecting patients’ preferences and values. Patient-centered care lies at the heart of this aim, striving to create a healthcare system that meets the unique needs and expectations of each individual.
Reduce Healthcare Costs
The third aim of the Triple Aim seeks to reduce healthcare costs without compromising the quality of care. Healthcare systems are encouraged to adopt innovative approaches to resource management, eliminate waste, and streamline processes to achieve financial sustainability. By addressing inefficiencies and focusing on cost-effective care, the Triple Aim aims to make healthcare more affordable and accessible for all.
In AMGA’s newly released 36th annual 2023 Medical Group Compensation and Productivity Survey, medical groups and healthcare organizations report a 6.1% increase in primary care compensation, compared to 1.5% and 1.6% increases for medical and surgical specialties, respectively.
The Triple Aim framework has emerged as a guiding principle for healthcare organizations seeking to optimize patient care outcomes while simultaneously containing costs.