HIStalk Practice Interviews George Lazenby, CEO, Emdeon

Geoge Lazenby is CEO of Emdeon of Nashville, TN.

Tell me about yourself and the company.

I am CEO of Emdeon, which is  a leading provider of revenue and payment cycle management and clinical information exchange solutions, connecting payers, providers, and patients in the US healthcare system.

How has business changed after the Blackstone acquisition?

The biggest change has been the transition to being a private company. Under Blackstone’s ownership, we’ve been able to shift our focus away from analyst calls and quarterly performance and place it more squarely on our customers and long term growth strategies.

Describe the incidence of paper-based claims and how the Emdeon Payment Network can help increase electronic payments.

Electronic claims are now at 95 percent. Conversely, electronic payments are only about 10 to 15 percent of total payments in healthcare.The Emdeon Payment Network is a comprehensive suite of services that combines electronic and print payment infrastructures with an intelligent analytical engine to leverage the payer’s chosen distribution channels for healthcare payment transactions.

Emdeon Payment Network has been designed to give payers a strategic, cost-effective solution by providing more opportunities to shift transactions from costly paper checks to electronic payments, while providing considerable postage and operational savings for any remaining paper check payments. The Emdeon Payment Network can help payers significantly reduce provider payment distribution expenses and potentially eliminate provider payment distribution printing costs completely over time.

Further, by switching most paper check-based provider payments to electronic methods consisting of virtual card payments, Automated Clearing House (ACH) direct deposit payments, and Image Cash Letter (ICL) payments, provider enrollment challenges can be significantly reduced. Emdeon Payment Network examines inbound payment files and routes each payment using the payer’s chosen payment distribution methods to minimize payment distribution expenses.The Emdeon Payment Network has been designed to virtually eliminate the burdens typically associated with payment management by offering payers a comprehensive approach to electronic and print payment distribution.

What opportunities will the Affordable Care Act create for the company?

The Affordable Care Act decreases the number of uninsured patients and results in more covered lives.This expanded population increases utilization on the healthcare system as a whole and utilization of care engages the revenue cycle system, which is good for Emdeon. Further, as more people seek coverage and additional payment models evolve, providers will have a need to understand additional funding sources, such as patient payments. Emdeon offers technology to assist with estimating the patient’s financial responsibility up front which can help with providers collect funds at the point of service.

What does Emdeon Clinical Exchange EHR Lite do and what products does it compete with?

Emdeon Clinical Exchange encompasses products and services that are designed to unite healthcare communities. Today, hospitals, physicians, labs, payers, and pharmacies use Emdeon’s leading healthcare information network to securely exchange health information nearly seven billion times annually.These healthcare stakeholders are demanding greater connectivity to each other and the ability to facilitate comprehensive, end-to-end clinical information exchange.

Emdeon Clinical Exchange integrates Emdeon’s electronic prescription routing, lab orders and results exchange, care alerts, medication history, clinical messaging, and ONC-certified EHR capabilities into a comprehensive SaaS-based platform.This robust collection of clinical components is designed to work with our customers’ existing systems and workflows, and therefore can help minimize financial risk by providing a relatively inexpensive alternative compared to higher cost capital-intensive solutions.

Furthermore, by connecting to our customers’ existing infrastructure, our SaaS-based exchange can have virtually-instant clinical connectivity to the EHR systems we empower. Most of these EHR systems are already Emdeon customers so integration is seamless.

Everybody’s talking about analytics tools. What are practices look for in that area?

Providers are looking for analytics that help them run their offices more efficiently that increase reimbursement and help them properly document care to comply with increasing quality standards. Examples are comparisons of practice patterns to evidence based medicine protocols to identify gaps in care. These analytics both improve care quality and help providers document how they practice against these standards for compliance/reimbursement thresholds.

How is the company addressing healthcare fraud, waste, and abuse?

Emdeon has built a leading payment integrity and cost containment solution by acquiring three market leaders – The Sentinel Group, EquiClaim and TC³ Health – and integrating them with Emdeon’s vast healthcare network. By combining the best of these companies’ recognized leadership in fraud, waste and abuse technology, investigation expertise, cost management services and comprehensive audit and recovery services, Emdeon is able to offer healthcare payers one complete solution to help en,sure accurate claim payments throughout the adjudication lifecycle.

By leveraging Emdeon’s vast claims data and network, these services enable superior detection of fraud, waste and abuse, and the reduction of costly errors and time-consuming manual processes. As a result, payers can increase efficiencies, maximize returns, and have confidence that their healthcare payments will be correct.

How do you see the small physician practice changing in the next few years, both in general and from a technology standpoint?

Expect 2013 to be a turning point for participation in emerging Medicare payment initiatives that are driving the formation of accountable care organizations, shared savings programs, bundled payment pilot projects, and value-based payment modifiers. And, if Meaningful Use is not enough of an incentive for practices to ramp up EHR deployment efforts, these new initiatives surely demand they look closely at enabling solutions to access and utilize the data needed to improve care and reduce costs.

Additionally, January 1, 2014, is the deadline by which all payments under Medicare must be conducted via electronic funds transfer. And, while providers will not be required to accept electronic payments from commercial health plans, all payers will be required to have the ability to facilitate these transactions.

From a technology perspective, technology and service solutions providers continue to roll out innovative tools that assist providers in responding to the many industry challenges, ensuring they will have material impact on the cost-quality curve while receiving accurate and timely reimbursements for the services they provide.

News 6/6/13

Thirty-five percent of physician groups plan to purchase, replace, or upgrade their ambulatory EHR according to a HIMSS Analytics/CapSite report on ambulatory EHRs and PMs. Other key findings from the survey of over 800 practices:

• eClinicalWorks, Allscripts, and NextGen are the dominant EHR providers for free-standing practices; Epic, Allscripts, and Cerner are the market leaders for hospital-owned practices.
• The most important driver for EHR purchases is increased practice efficiency, followed by increased quality delivered and easier data sharing between facilities.
• Allscripts, NextGen, and eClinicalworks have the largest market penetration for PM systems in free-standing clinics; Epic, GE, and Meditech lead in hospital-owned practices.
• Forty-six percent of physicians groups plan to join an HIE.

Henry Schein will add dashboardMD’s healthcare dashboards and BI tools into its MicroMD PM and EMR systems.

HIT sales and services firm Sterling Computer Corporation acquires Wide River Technology Extension Center, the HIT consulting division of CIMRO of Nebraska. CIMRO is the REC for Nebraska and will continue to serve in that capacity. According to the press release, the REC’s grant money is scheduled to end in February, 2014. Sterling’s acquisition of Wide River allows the HIT consulting business to continue, even after the grant money runs out.

At least 122 EHR vendors claim they will offer a fully functional mobile access and/or iPad native version of their EHRs by the end of this year, and another 135 vendors report having mobile apps on their near-term strategic horizons. Hospitalists, primary care providers, and internal medicine physicians have the strongest preference for EHRs on mobile devices; surgeons express the lowest interest. According to a Black Book survey of over 1,400 practices, drChrono offers the iPad EHR application with the highest customer satisfaction scores.

Greenway Medical announces the grand opening of its new corporate headquarters.

US News & World Report and Doximity will offer a free online directory of over 700,000 practicing US physicians. The information will be available to consumers but physicians can control whether certain information is shared publically by maintaining an online profile on doximity.com. That’s a clever way for Doximity to increase its number of physician “users.”

The 182-physician Covenant Medical Group (TX) adopts the PerfectServe clinical communications platform to provide secure and streamlined communications between clinicians.

Athenahealth announces it will guarantee the ICD-10 transition for new clients who are live before June 30, 2014 and will waive its fees on services if it is not ICD-10 compliant by the government’s Oct. 1, 2014 deadline.  In addition, athenahealth will backstop the revenue cycle for independent practices by providing a cash advance against submitted claims, if those claims are delayed by payers in the ICD-10 transition period.

Drchrono will offer its paid EHR subscribers access to online patient education resources developed by Mayo Clinic.

E-mail Inga.

News 6/4/13

CMS releases data on 30 types of outpatient procedures from across the county for such services as clinic visits, echocardiograms, and endoscopies. Average submitted charges for a Level 4 hospital clinic visit ranged from $111 (Charleston, SC) to $2,000 (St. Petersburg, FL); payments ranged from $48 (Sidney, OH) to $178 (San Jose, CA).

CMS also posted a de-identified list of over 146,000 EPs working with RECs that includes a breakdown by EHR vendor, implementation status, and specialty. Since RECs cater to smaller primary care practices and rural healthcare providers, I intend to take some time soon to crunch the numbers to better understand which vendors are dominating this segment.

Robert Tennant, MGMA’s government affairs senior policy advisor, discusses the need to protect patients and practices from HIPAA risk, including suggestions to mitigate problems should a provider lose his/her mobile device. Other risks addressed: the use of computer screens that might be visible to patients and visitors and  complications from a down server.

The local paper profiles Marietta, GA-based Nuesoft Technologies and its president and CEO Massoud Alibakhsh, who founded the company in 1993. Alibakhsh reports the company has historically grown 18 to 20 percent per year, but believes it may need to double its staff of 140 over the next two years as a result of its recent designation as a Practice Fusion billing partner.

Hayes Management Consulting expands its clinical and revenue cycle optimization service lines to include increased focus on measuring outcomes and outcome-driven operational improvement services.

I noticed on Hayes’ Website a blog post that offered some great recommendations for successful EMR physician training, including offering providers CME credits and engaging physicians as super-users.

Twitter is a popular and generally reliable source for health information, according to a University of Texas at Austin study of 9,510 vaccine-related tweets. Researchers conclude that healthcare providers and other stake holders should consider social media channels to address patient education in accessible and understandable ways.

iPads and iPhones are the top choices for physicians interacting with EHRs and staff, with 59 percent of office-based physicians saying they already integrate or are integrating tablets into their operations. Sixty-eight percent prefer iPhones over Androids or other platforms.

A study in Annals of Family Medicine looks at some of the ways innovative clinics are redesigning workflow to improve physician satisfaction. Included in the fixes: using MAs as scribes to create electronic documentation and delegating team members to filter normal lab results and prescription refills.

Vitera Healthcare completes the first of three waves of Stage 2 MU certification for its Intergy EHR solution.

The medical director of the New York-Presbyterian Hospital immunization registry says that children were nine percent more likely to be fully vaccinated for influenza when a pop-up alert was added to the children’s EMRs and synchronized with the New York City vaccine registry.

The Massachusetts Medical Society says it is working with several state agencies to develop recommendations on how to interpret and implement a state law that requires physicians to comply with EHR MU requirements in order to obtain licensure as of 2015. Depending on the interpretation, a nasty storm could be brewing, given the significant percentage of physicians either ineligible to participate in the MU program or simply opting out.

EMR record-keeping and duty hour limits have reduced the amount of time that doctors-in-training spend with patients to an average of eight minutes per patient, or about 12 percent of an intern’s day. Because of electronic documentation requirements, interns now spend almost half their days in front of a computer screen.

E-mail Inga.

News 5/30/13

From Weird News Andy: “Re: Dr. gives up all insurance. Lots of great quotes here.” A physician in Maine stops accepting insurance but anticipates his practice will continue to perform well financially, despite losing several hundred patients. Thanks to WNA for pointing out several of the doctor’s more interesting comments, including, “I’m freed up to do what I think is right for the patients.” That testimony alone should help business, since few patients prefer doctors who do what’s wrong for the patient.

Sibley Heart Center Cardiology (GA) selects MediRevv to provide A/R management services for its 40 physician practice.

ADP AdvancedMD launches MyICD-10, a Website to help practices prepare for the ICD-10 that includes Webinars, articles and news on the new code set, and a recommended preparation timeline.

Fifty-four percent of physicians say they are “satisfied” or “very satisfied” with their EHR vendor, compared to 63 percent a year ago, according to a Zirmed-sponsored of 1,291 physicians. Only 57 percent of EHR adopters report that their systems have made them more efficient and just 43 percent report a return on their technology investment.

Advocate Physician Partners (IL), a care management collaboration with Advocate Health Care, implements its 500th independent physician on SynAPPs, Advocate’s cloud-based version of eCW’s EHR.

PDR Networks, a provider of patient drug safety and support services for EHR and e-prescribing platforms, will market OPTIMIZERx Corp.’s eCoupon financial support technology, which integrates with e-prescribing workflows.

Clyo Internal Medicine (OH) selects simplifyMD as its EHR provider.

Practice Fusion announces preferred billing partnerships with ADP AdvancedMD, CollaborateMD, and NueMD. Absent from the list is Kareo, which was a long-time Practice Fusion partner that launched a competing free EHR a couple months ago.

The Texas Medical Association, Dallas County Medical Society, and Harris County Medical Society establish Physician Services Organizations for Patient Care, which will bring together providers, health plans, and technology vendors to test and develop new care models for physician practices.

Medical practice software and billing service provider Encoda is awarded a patent for automated direct-to-payer RCM technology.

Almost one-third of physicians buying EHRs today are replacing EHRs, compared to 21 percent three years ago according to a study by Software Advice. The top reason for replacing a legacy system: dissatisfaction with current EHR.

E-mail Inga.

News 5/23/13

More than half of all doctors and other EPs (291,000) have received MU incentive payments through the end of April, according to HHS Secretary Kathleen Sebelius. HHS has met or exceeded its goal for 50 percent of doctor offices and 80 percent of eligible hospitals to have EHRs by the end of 2013, leading Sebelius to conclude that, “we have reached a tipping point” for EHR adoption.

Net Health, a provider of clinical solutions for outpatient specialty care, acquires Integris, a provider of an EMR/PM solutions for the urgent care, occupational health, and hospital employee health markets.

The New Jersey chapter of Entrepreneurs’ Organization and the Star-Ledger/NJ.com name SRS CEO Evan Steele the winner of the Garden State Entrepreneur Excellence Award in the $10M+ category.

Greenway Medical adds ClientTell’s ReminderManager patient communications solution to its Online Marketplace as a certified API solution for the PrimeSUITE platform.

Athenahealth names Midland Orthopaedics (SC) the winner of its athenaVision award for helping “make healthcare work as it should.”

DocuTrac, a provider of EMR technology for behavioral health, will add DrFirst’s e-prescribing technology into its QuicDoc EMR Professional and Enterprise edition software.

Cerner’s PowerChart Touch mobile solution receives a bronze award for Best Clinical Health Care Experience at the 2013 International User Experience Awards.

Greenway Medical announces the availability of its PrimeMOBILE mobile access solution for the Windows 8 platform.

PracticeMax, a provider of PM and technology services for physician offices, acquires the Phoenix-based ABC Medical Management, a provider of billing and PM services for anesthesia and pain management specialists.

More than one third of physicians participating in a CareCloud/QuantiaMD survey predict their practices will be less profitable in the next year, compared to 22 percent foreseeing increased profits. The biggest perceived threats to profitability were declining reimbursements, rising costs, ACA-related requirements, and coding and documentation changes. Other key findings from the survey of 5,102 physicians include:

• Almost half believe that increased operational and billing pressures will leave their practice unable to accept any of the expected influx of insured patients from the implementation of the ACA.
• A mere nine percent were “very confident” in the current process for getting paid.
• The majority of physicians spend more than 20 percent of their time coding, documenting, and performing administrative tasks, rather providing than patient care.
• Almost sixty percent of independent physicians were not looking to sell their practices.

E-mail Inga.