Guest post by Lea Chatham, editor-in-chief, Getting Paid, a Kareo Resource.
Lea Chatham
Patient engagement has been the hot topic of this past year or two. Everyone agrees that engaging patients more in their healthcare can help reduce costs and improve overall health. A study conducted by HIMSS in 2015 showed that the majority of physicians believe patient engagement is beneficial and should be a part of their job. However, the study also concluded that over 40 percent of physicians worry that there is little reimbursement for engagement activities.
Patient are looking for more ways to connect with providers from online scheduling to text reminder to email follow ups and social media. And while many see these as conveniences, the reality is that they do also improve health and have the potential to reduce costs. Studies have shown that simple follow up communications via text and email can help ensure patients show up for appointments and can reduce hospital re-admissions, which has a big impact on healthcare costs.
Unfortunately, physicians are already stretched thin trying to care for patients, run their practices, adhere to complex programs like meaningful use and PQRS, and navigate changes like ICD-10. Who has the time to do more? And many providers worry that “engagement” means more work with less reimbursement. But it doesn’t have to be that way.
In fact there are many opportunities to automate engagement and provide the tools patients want without adding any time or effort to a provider’s plate. Today, there are solutions that once set up enable easy online scheduling, text and email reminders, follow up patient surveys, and even re-care programs.
This infographic highlights some of the feelings of both patients and providers feel about patient engagement and shows how practices can utilize engagement strategies that benefits both and do have a financial return.
For many practices, the focus this year has been on ICD-10 and preparing for an effective transition. As a result, a growing problem has been slipping under the radar—patient collections.
Today, patient due amounts make up 30 percent or more of practice accounts receivable. And the longer it takes the practice to collect from a patient, the less they get paid. According to Mary Pat Whaley, after 60 days the percentage collected drops to below 60 percent.
ICD-10 will likely remain a key focus for practices through the end of 2015 at least. But don’t let that stop you from taking some time to look at the state of your patient collections. This infographic shows how the landscape is changing and what practices can do to ensure they get paid.
Let’s face it, return on investment (ROI) for an electronic health record (EHR) has been has been a rainbow unicorn kitty for practices over the years. Some studies have indicated that many practices don’t see positive returns for years if ever while others show very positive results of increased revenue per full time provider and ROI in as short as two and half years.
Why the big variation? It’s hard to say for sure but some of the factors may be practice size, type of EHR, and looking for the ROI in the right places. According to the Physicians Practice 2014 Technology Survey, sponsored by Kareo, over 40 percent of practices have seen a return on their investment from their EHR.
Some of the places they are seeing financial rewards may be old news but others could be a surprise.
CMS Incentives
It will come as no great shock that practices that got on board with PQRS and meaningful use at the beginning have reaped some financial benefits. The full incentives for MU early adopters was $44,000, and they avoid any penalties. For the past several years one of the top three reasons physicians cited for changing or adopting and EHR was qualifying for incentives.
The incentives are gone but the penalties are still in play. If you haven’t started yet, you will have reductions in your Medicare payments starting this year, but that doesn’t mean you shouldn’t get on board. If you serve a large portion of Medicare patients it may make sense to attest for MU to avoid further penalties.
Reducing Expenses
The ability to cut costs has always been a bugle call for EHR, and nothing has changed. You can cut costs and streamline with an EHR. The key is to ensure it is implemented correctly with the right workflow, that everyone is onboard and using it the way they are supposed to, and you let go of paper as much as you can.
When you do that, you can save anywhere from $5 to $8 per new paper chart along with ongoing savings on paper, toner, and printer and fax equipment. They are seeing so many benefits from the EHR, they’d never go back now. Eric Pokky, practice manager at Total Healthcare for Women, says about 20 percent of their patients are new and those charts run $5 at their practice. With 15 new patients a week, that is a savings of around $300 a month.
When physicians maximize the EHRs documentation tools, you can also cut transcription significantly or all together. Transcription has been estimated at as much as 11 percent of total collections so that is a substantial savings. For a primary care provider who brings in $300,000 a year, that is a savings of more than $30,000 alone.
I remember when the Health Insurance Portability and Accountability Act (HIPAA) passed. I was working for a leading practice management software vendor. Everyone was overwhelmed by what was involved. We developed a huge amount of education and information for our customers. Some people wondered if the healthcare industry could make such a major change.
Today, HIPAA is ubiquitous. Many practices take it for granted. They are not concerned about a breach because they believe they have done everything they need to do. In a recent study by MedData Group of physicians top practice management priorities for 2015, HIPAA didn’t even make the list.
“We instigated HIPPA when it came out, and it is in place and second nature to us,” said Joann Lister, a provider at a family medicine practice in Texas. “We have all worked at the hospital so we had plenty of training on the rules. Our physical space and computers are confidential. Our practice management and EHR software, Kareo, always goes back to login when we are done in a room so the next patient does not see anything. We have limited personnel so it is easier to know that everyone honors the HIPAA rules.”
The question is: Have practices gotten too complacent with HIPAA? With the latest changes to HIPAA in 2014, have they followed through on making changes and updates? The data and experience of industry experts and consultants suggests that there may be a problem with HIPAA compliance.
“The last analysis we did for a practice had 41 pages of regulations that required implementation,” recalled practice management consultant Rochelle Glassman, CEO of United Physician Services. “Most practices do not know what the complete requirements are. They believe that if they have the patients sign the privacy form that is all they need to do. This year there were updates that included the new HITECH Act and the HIPAA Omnibus rule. I can guarantee that many practices have not updated their HIPAA program to include the changes because they do not even know they exist.”
Guest post by Lea Chatham, content marketing manager, Kareo.
In the recent Physicians Practice Technology Survey, sponsored by Kareo, there are two trends that bode well. First, the majority of practices surveyed were independent, and second, there were more positives about EHRs than negatives. It looks like things are finally heading in the right direction.
Ongoing EHR Concerns Linger
That isn’t to say that practices don’t continue to have concerns, however. Nearly 20 percent of those surveyed still don’t have an EHR. The barriers? Implementation, interoperability and cost. And implementation of EHRs is cited as the top technology challenge for practices.
“The transition to an EHR can be hard, especially when practices choose the wrong system the first time and have to go through the process twice,” explains Laurie Morgan, senior partner at Capko and Morgan, a practice management consulting firm. “So it is really important to make the right choice. What we have seen is that the practices that have been on a good system for while do see the value and the workflow benefits. It just takes some time.”
On the flip side though, 57 percent are happy with their choice of vendor, which may mean that we will start to see a slowdown in EHR switching, giving providers a chance to focus on patient care and building their practices. In addition, more than 40 percent say they have seen a return on investment, and even more cite an improvement in efficiency.
For those who are unhappy with their EHR, this is a clear sign that better technology is out there. It is a matter of making sure to choose the right one and implement it correctly. “There are several steps practices can take to make sure they get the right EHR at the right price,” says Tom Giannulli, MD, MS, chief medical information officer at Kareo. “These days most of the affordable cloud-based EHRs will have the basic features so it often comes down to a few special needs and the implementation and training. To help improve satisfaction with the EHR it is really important to take advantage of all training and support and invest the time to get familiar with the system.”
