News 6/14/16

Top News

The telemedicine wars heat up as a federal court in Boston dismisses a patent infringement suit filed by American Well against Teladoc. The legal wrangling began last year when Teladoc petitioned the US Patent and Trademark Office to invalidate several American Well patents. American Well then initiated the infringement suit against Teladoc just before its IPO last summer, asserting that Teladoc’s business model illegally copied one of its cornerstone patents. American Well plans to appeal the decision.

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

Altex Business Solutions makes HealthFusion’s MediTouch EHR and billing software available to its small-business clients.

CureMD adds Izenda’s business intelligence tools to its PM and EHR software.

People

Sturdy McKee, PT (San Francisco Sport and Spine Physical Therapy) joins Clinicient as senior director of client executives.

The AMA names Missouri-based family physician David Barbe, MD president elect.

Telemedicine

Philadelphia-based AllyHealth opens an office in Albany, NY. The employer-focused telemedicine startup, which provides its services through the MDLive platform, hopes to double its Albany staff of four by the end of the year.

Kareo adds telemedicine technology from Chiron Health to its EHR and PM software for independent practices.

Alpine, UT-based Azova launches a white-label telemedicine solution that includes house call, secure messaging, and e-commerce technologies.

Florida lawmakers pass legislation giving public schools the ability to receive Medicaid reimbursements for telemedicine visits.

The Atlantic highlights the Desert Senita Health Center in its profile of rural Ajo, AZ. The article is a thoughtful look at how the FQHC offers many important services to the remote town’s 2,300 residents, yet makes no mention of the vital role telemedicine plays in its services. The center, 100 miles from the nearest hospital, is a member of the Arizona Telemedicine Network.

AMA adopts ethical guidelines relating to telemedicine at its annual meeting in Chicago. Developed over the last three years, the new guidance stresses the potential limitations such technologies might place on care, and the need for ongoing refinement and standards relating to telemedicine technology.

Other

Accountable physician group CAPG publishes a guide to alternative payment models, highlighting CAPG member experiences with APMs ranging from bundled payments to capitated, coordinated care.

Today’s Google Doodle features 1930 Nobel Prize winner Karl Landsteiner, MD the Austrian-born immunologist and pathologist who created the ABO blood group system still used today.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

From the Consultant’s Corner 6/14/16

Snipes and Revenue Cycle Key Performance Indicators – Don’t Take the Bait

[A snipe hunt is a type of practical joke that involves experienced people making fun of credulous newcomers by giving them an impossible or imaginary task.]

With summer now upon us, I think of those lazy summer camp days in Texas as a kid and the ritual of the snipe hunt. In the simplest of terms, a snipe hunt is a hazing tradition where older campers initiate younger campers to “hunt” that illusive small bird, the snipe, shortly after dark on a moonless night with flashlights and burlap bags. The funny thing is that snipes actually exist – just not in central Texas.

What does this have to do with revenue cycle key performance indicators (KPIs)? A lot, these days. We are now in the era of big data, with a virtual endless supply of structured and unstructured data related to the performance of our hospitals and physician practices. Large healthcare organizations have implemented enterprise-wide EHRs and related administrative support systems for patient registration and scheduling, billing, population health, quality reporting, and other specialized functions. These systems come with countless “canned” reports and hundreds of data points. But finding what is important is like finding that illusive snipe. As we all know, data does not always equal actionable information. That’s where business analytics come into play. Healthcare organizations often “bolt-on” companion software applications to their enterprise system so they can find what’s important and actionable in all of that data – in short, making it easier to find a snipe.

(Full disclosure: I’m a data junky. I love business analytics and the focus it can bring to organizations who use it well, but it is really easy to lose sight of the forest for the trees.)

Now, one of the great thing about being a consultant are the great organizations and executives I have the opportunity to work with on a variety of engagements. Over the last couple of months, several colleagues and I have had a chance to work with a great healthcare organization that serves millions of patients across multiple states. The focus of our work was a high-level assessment of professional billing operations for a medical group with a nine-digit annual revenue stream – a big and complex operation. Like most big organizations and medical groups, they have an enterprise-wide EHR with associated administrative support systems, centralized billing with hundreds of employees, a companion business analytics software application, and a passionate and engaged leadership team. Top-level KPIs are good, but they wanted to get better and lower costs – a common 21^st century healthcare goal.

As we started our work, it became obvious to us (as the outsiders) that data governance and discipline were needed. Staff members were working really hard preparing weekly dashboards for operating units, supplying data for monthly financial statements and corporate scorecards, and managing the canned system reports. The problem was that too much information was available. Our feedback on business office operations from the clinical executives was good, but a general theme was, “We don’t have time to deal with all of those reports – it’s not actionable.” The corporate scorecard tracked 18 separate KPIs. The weekly divisional dashboard had 10 KPIs. Their impressive analytics software had 27 KPI “views” with a staggering 103,702 discrete filter view options. To help professional workflows, they had set up nearly 10,000 “to do lists” within their billing system. Big data is alive, well, and flourishing. And, who knows, there might be a snipe somewhere in those millions of data points.

The challenge we faced was getting our arms around all of the data to benchmark the client to national norms for professional billing. We chose the KISS principle (a termed coined by the Navy in the early 1960s) and focused on outcomes.

Besides cash (because making payroll is important to most organizations), the most important professional billing KPI is the Days in Accounts Receivable (AR Days) that remain uncollected for a practice. Jim Denny in his 2013 publication and Mark Coronella in his 2014 publication also agree AR Days should be a major focus of medical practices. In addition, several national organizations, such as MGMA, AMGA, and the Faculty Practice Solution Center benchmark AR Days in their survey data. Collectively, these organizations reported AR Days on more than 250 medical groups representing thousands of healthcare providers. AR Days makes benchmarking to other groups more manageable than other revenue cycle metrics such gross collection rates, which can vary widely because differences in where professional charges are set, payer mix, and confidential managed care contract rates.

In the KPI world, AR Days should be viewed as a lagging indicator for a practice’s professional billing process – in short, an outcome to what is going well or not going very well. Other KPIs, such as denial rates, charge entry lag days, or point of service collections should be viewed as leading indicator for professional billing. Each of these leading indicators -along with others – are important to revenue cycle performance, but they all impact AR Days in a positive or negative way.

We suggested to our data-rich client that they become more disciplined and simplified around data governance and focus on actionable, top-of-mind issues that impact AR Days. As they evaluate business initiatives to improve their revenue cycle performance, they should evaluate each of these programmatic endeavors with the simple question, what will it do for my AR Days?

Randy Jones is senior vice president of Culbert Healthcare Solutions.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

News 6/13/16

Top News

CMS announces that it will dole out $10 million in technical assistance grants over three years to help practices affiliated with Support and Alignment Networks or Practice Transformation Networks transition to new payment models under MACRA and MIPS. Applicants must have received signed commitments to enroll 5,000 or more eligible clinicians and their practices that are in advanced states of readiness (including EHR utilization). Letters of intent are due July 1; applications, July 11. 

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

A Merritt Hawkins report based on recruiting data over the last two years shows that 90 percent of its search assignments were for employment, while just five percent were for solo practice settings, many of which were for concierge or direct pay models. Starting salaries have spiked over the last year, especially for family medicine, psychiatry, obstetrics-gynecology, and dermatology.

Announcements and Implementations

Midwest Orthopaedic Consultants (IL) selects care coordination technology from PinpointCare to assist in care navigation for Medicare patients managed under the Bundled Payments for Care Improvement initiative.

Raintree Systems adds MedBridge educational material to its TherapyRehab Plus and PediatricTherapy Plus EHRs.

The Pennsylvania Dept. of Health, Athletic Trainers’ Society (PATS), and Medical Society develop a consumer-facing online database of physicians who have completed an educational training program focused on concussion evaluation and management.

People

Amar Desai, MD (University of Southern California Medical Group and Ambulatory Services) returns to DaVita Healthcare Partners as president of its HealthCare Partners California Coastal region.

Justin Barnes joins IHealth as partner and chief growth officer. Atlanta-based RCM technology vendor IHealth was formed when IHealth Solutions acquired DNA Healthcare in late May.

Telemedicine

Charleston, SC-based pediatrician Chad Hayes, MD warns parents away from telemedicine services, especially those that offer to treat strep throat, ear infections, UTIs or pneumonia without first performing necessary testing. “As a pediatrician,” he adds, “I’m obviously biased [he is, in fact, opening a new practice next month], but my advice is to find a doctor you trust, hopefully one with some after-hours and weekend availability, and maybe even one who offers some supplementary care by smartphone, text, or email.”

Colorado becomes the 17th state to enact the Interstate Medical Licensure Compact.

Fred’s Pharmacy will install another nine TelehealthOne telemedicine kiosks at stores in Mississippi. The retail pharmacy chain installed its first kiosk last fall.

The Arkansas State Medical Board approves a regulation allowing first-time physician visits to take place through audio-visual technology. The board stipulated, however, that sending a patient’s online medical history to a physician doesn’t count as a valid patient-physician relationship and doesn’t qualify as "store-and-forward" technology.

Research and Innovation

A survey of 1,300 medical groups of five or fewer physicians finds that 67 percent believe MACRA is the root of all evil that will drive them to either close up shop or become employed. Nearly 90 percent of surveyed solo physicians expect to decrease Medicare patient volumes so they won’t have to report on quality and clinical practice improvement activities. Just over 75 percent of small practices identify as “financially struggling” due in part to less-than-adequate billing software. Surprisingly, a combined 63 percent of practices haven’t yet settled on software products that meet their myriad needs. Of those that have, EHRs from SRS Soft, ADP AdvancedMD, and Practice Fusion earned top rankings.

Government and Politics

HHS Secretary Sylvia Burwell and Cuban Minister of Health Roberto Tomás Morales Ojeda, MD sign a healthcare collaboration agreement that will  prompt the two countries to work on health issues including global health security, communicable and non-communicable diseases, research and development, and information technology.

Don’t forget …

Other

The local paper highlights the success nine Albany, GA-based primary care practices are seeing through participation in Blue Cross Blue Shield of Georgia’s Enhanced Personal Health Care program. The program, which incentivizes participating PCPs to improve quality and value, has prompted several practices to tweak their EHRs for improved care coordination.

Steven Stack, MD gives his final address as president of the American Medical Association during the AMA’s annual meeting in Chicago. He kept his remarks light (with just the right amount of gravitas), encouraging his colleagues to persevere in light of the many challenges they face on a day-to-day basis. CMS Acting Administrator Andy Slavitt also made an appearance to talk with AMA delegates about MACRA and physician burnout.

Sponsor Updates

• Black Book names E-MDs the top ambulatory EHR for thoracic and vascular surgery specialties.

Blog Posts

• Do More with Your Versus Badge: Call for Help, Monitor Rounding & More (Versus Technology)

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

News 6/9/16

Top News

Practice Fusion settles with the FTC over charges that it misled consumers by asking for reviews of their physicians without adequately disclosing that those reviews would be posted publicly online. The reviews were published in 2012 as part of the company’s efforts to develop a public-facing healthcare provider directory. “Practice Fusion’s actions led consumers to share incredibly sensitive health information without realizing it would be made public,” says FTC Bureau of Consumer Protection Director Jessica Rich. “Companies that collect personal health information must be clear about how they will use it – especially before posting such information publicly on the Internet.” The settlement, which doesn’t seem to carry a fine, prohibits Practice Fusion from “misrepresenting the extent to which it uses, maintains, and protects the privacy or confidentiality of data it collects.”

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

HealthFusion adds ZocDoc’s appointment-booking technology to its MediTouch YourHealthFile patient portal.

Definitive Healthcare adds data on over 23,000 FQHCs, renal dialysis clinics, and rural health centers to its line of market intelligence solutions.

DJO Global develops claims management and inventory dispensing software for orthopedic clinics.

Medfx and Falcon Physician partner to develop EHR, PM, and RCM software for nephrology practices.

Acquisitions, Funding, Business, and Stock

Austin, TX-based EPatientFinder raises $8.2 million in Series B financing, bringing its total raised to $11 million. The company will use the latest round of financing for further development of its Clinical Trial Exchange software, which helps physicians connect patients with clinical trials and

New York City-based Klara Technologies shift gears, pivoting from a teledermatology software company to instead focus on secure messaging for physician practices.

Telemedicine

FastMed Urgent Care rolls out TouchCare telemedicine services at its 57 clinics in North Carolina. The Durham, NC-based urgent care company plans to waive the telemedicine exam fee if in-person follow-up care is needed. FastMed will expand the new service to its locations in Arizona and Texas by the end of the year.

Atlanta-based MedZed offers a new house call service that combines its EHR-friendly telemedicine capabilities with home visits from medical assistants, nurses, and paramedics.

Missouri lawmakers pass SB621, which authorizes the use of telemedicine yet (if my legalese-reading capabilities are up to par) precludes the prescribing of medication unless a provider-patient relationship already exists.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

News 6/8/16

Top News

Xerox launches Virtual Health Solutions, a new service line that will offer providers telemedicine consulting, interface design and development, and virtual clinic services. The company will no doubt apply lessons learned during its relationship with the now-defunct HealthSpot, which filed for bankruptcy early this year. The company’s move into telemedicine isn’t surprising and makes good on Xerox Chief Innovation Officer of Commercial Healthcare Tamara StClaire’s new-year prediction that the company would remain committed to supplying telemedicine services powered by Xerox infrastructure.

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

Secure messaging startup OhMD releases a free version of its messaging app for physicians. The company, a graduate of the Blueprint Health Accelerator, offers a subscription version with more bells and whistles including EHR integration.

The Consortium of Independent Physician Association, a network of 1,200 physicians managed by Medical Advantage Group, forms CIPA ACO for physicians in Michigan and Ohio. The new ACO will apply to participate in the Medicare Shared Savings Program next year.

Telemedicine

Martha’s Vineyard Community Services (MA) will use a $4,500 donation from the local bank to fund telemedicine services at the agency’s Island Counseling Center. MVCS Executive Director Julie Fay adds that the funding will help expand the center’s psychiatric service capacity to reduce wait times for medication management.

Private-practice pediatricians in Delaware take to the local paper to voice their opposition to local hospitals offering pediatric telemedicine services. An excerpt: “Specifically, our patients’ care is being sacrificed for the sake of convenience, and this phenomenon is being supported and encouraged by insurers, employers, Christiana Care Health System, and, most disappointingly, by Nemours/AI duPont Hospital for Children. This subtle but serious threat to our patients’ health comes mainly in the forms of telemedicine and urgent care centers.” While they make a good case for the value of in-person primary care, I can’t help but wonder if their call to save the “pediatric medical home” has more to do with their bottom lines.

Online healthcare retail marketplace SingleCare rolls out American Well services to its members.

Telemedicine stakeholders in Texas (and their lobbyists) meet behind closed doors to discuss “modernizing [their] telemedicine statutes and reducing the regulatory footprint governing the provision of telemedicine services,” according to an email obtained by The Texas Tribune. The meeting is part of an overall plan on the part of competitors to reach a compromise they can then present to the state legislature by the end of the summer – one that will hopefully ease the state’s fairly restrictive telemedicine policies, which prohibit physicians from treating patients virtually without first establishing an in-person doctor/patient relationship.

Government and Politics

New York pharmacists and legislators applaud the state’s fairly new I-STOP e-prescribing legislation and corresponding InterConnect program, which enables nearly 40 states states to share prescription information. “Our pharmacists do have to have a sometimes difficult conversation with the patient,” says CVS pharmacist Kasey Gaeta. “[But] most of our prescriptions come in electronically now, which is in and of itself a great add. Between the I-STOP program, electronic prescribing and in combination with our prescribers, we find that most of those prescriptions never even get written now and we’re able to keep excess prescriptions from going out there.”

Research and Innovation

A Philips survey of 2,006 patients and 209 providers finds that patients have a higher level of confidence than their providers when it comes to managing their own care. Over 80 percent of patients believe they have the knowledge to do so, while 74 percent are confident they have the necessary tools. Only half as many providers feel patients have the requisite tools, and just 41 percent believe patients have sufficient knowledge. Perhaps more interesting is the revelation that only 24 percent of patients surveyed believe they have complete ownership of their health records, and 31 percent find it difficult to obtain their health information in a timely manner.

Sponsor Updates

• Aprima will exhibit at Sleep 2016 June 13-15 in Denver.
• Healthwise is honored with a 2016 When Work Works Award for its workplace strategies as part of the national When Work Works project.
• The latest KLAS advisory report recognizes Nordic as a top performer.

Blog Posts

• Medical Practice Optimization Simplified, Part 3 of 5 (AdvancedMD)
• All Roads Lead to Dallas for Aprima’s 2016 User Conference (Aprima)

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.