Readers Write: ICD-10’s Momentum Can Help Physicians Meet New Revenue Cycle Goals

ICD-10’s Momentum can Help Physicians Meet New Revenue Cycle Goals
By Jim Denny

For the past several years, the industry was inundated with warnings about the impending ICD-10 transition that finally occurred October 1, 2015. There were warnings that productivity would be impaired, and that the financial health of physicians could suffer with the anticipated increase in denials and rejections. As the implementation deadline came and went, however, the industry pulled off a relatively smooth and successful transition.

According to Navicure’s ICD-10 post-implementation survey of healthcare leadership, 60 percent of respondents didn’t see any impact on monthly revenue following the transition date. Another 34 percent only saw their revenue decrease by less than 20 percent. In addition, respondents only saw a 13-percent decrease in administrative staff productivity and a 15-percent decrease in clinical staff productivity.

In light of the predictions for a rocky ICD-10 transition, how did physicians achieve success? The right strategy, technology, and preparation plan certainly contributed, but another essential factor was drive: Everyone in healthcare knew ICD-10 would require substantial changes, and everyone knew the consequences for unpreparedness would be severe. Physicians, along with other key players such as payers and technology vendors, worked together and worked hard. In the end, this drive enabled physicians to beat industry predictions about lost productivity and revenue.

Ninety-nine percent of participants in the survey indicated they were ready for the transition on October 1, which was 14 percent higher than the sentiment in August 2015. These metrics show how physicians stayed on task and gained the momentum necessary to achieve their ICD-10 goals, and are consistent from even earlier studies to measure readiness confidence.

As physicians turn their focus toward new priorities, 2016 presents a great opportunity to leverage the same drive that made them successful with ICD-10. Consider these results and corresponding best practices:

• Two-thirds of survey respondents indicated they plan to work on improving overall RCM processes. Claims management was a key part of ICD-10 transition planning, and physicians can continue this momentum by using business intelligence to pinpoint problem areas and set improvement goals. Monitoring key performance indicators such as charge lag, days in A/R and denial and rejection rates can show providers exactly where they need to focus, enabling them to improve processes and staff performance.
• Another top priority included working toward a value-based care model (15 percent). The switch from volume to value is well underway, and physicians can benefit from putting all processes under a microscope to ensure they’re achieving both efficiency and effectiveness. In addition to leveraging BI, physicians should ensure ongoing analysis is a priority — and part of the organizational culture.
• Physicians also identified revamping patient collections strategies (nine percent) as a key goal following ICD-10 implementation. As patients adjust to paying a larger portion of their healthcare costs, two components of a patient collections strategy are particularly important – providing price transparency via pre-service or time-of-service estimates and making arrangements at time of service to collect balances in full, ideally both utilizing automated solutions to streamline efforts.

While none of these initiatives have a hard deadline like that of ICD-10, they’re essential to the financial health of physicians. They’ll require ongoing drive and strategic focus; fortunately, with ICD-10’s success, physicians have already proven they’re up for the challenge.

Jim Denny is president and CEO of Navicure in Atlanta.

Contacts

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

More news: HIStalk, HIStalk Connect.

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

News 2/9/16

Top News

President Obama’s FY 2017 budget allocates $82.8 billion in discretionary funding for HHS. Technology spending highlights include over $700 million for the Cancer Moonshot Task Force; $309 million to help ONC, FDA, and NIH advance the Precision Medicine Initiative; $24 million for AHRQ research; and an unspecified amount that will support “efforts to reform the healthcare delivery system by finding better ways to deliver care, pay providers, and increase access to information so that individuals can receive the right care, at the right time, at the right price.” 

Webinars

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

Acquisitions, Funding, Business, and Stock

McKesson Business Performance Services will lease a 50,000 square-foot call center in Port St. Lucie, FL to support its Patient Access Solutions business. The company, which already employs 300 in the area, has  hired 31 employees to staff the new operation, and anticipates bringing on an additional 80 to 100 over the next six to eight months. The center will open on May 23. A job fair will be held in Port St. Lucie on February 11.

Patient payment technology vendor SwervePay closes $10 million in funding as part of a Series B round. Led by Garland Capital Group, the new funds will enable the Chicago-based company to expand its partner network and hire additional staff. The company has raised $11.6 million since it was founded in 2010.

Announcements and Implementations

San Diego Health Connect selects the Verato patient-matching platform to enhance its patient record location and exchange services across 25 health clinics and hospitals.

In other patient-matching news, Rochester RHIO implements NextGate’s MatchMetrix software as its Enterprise Master Patient Index solution. The RHIO connects 70 healthcare organizations in the 13-county region of Rochester, NY.

MGMA and AMA partner to host the Collaborate in Practice Conference, set to take place March 20-22 in Colorado Springs, CO. The speaker lineup includes Sen. Bill Bradley (D-NJ) and practicing physician and Healthfinch co-founder Lyle Berkowitz, MD. Registration fees start at $1,500; hopefully the “2 for Tuesday” offer will make it easier for already cash-strapped physicians to attend.

The National Billing Center adds evaluation and management tools to its coding automation software.

Everseat joins the Allscripts Developers Program, offering Allscripts end users and their patients access to Everseat’s appointment-booking app.

People

Arcadia Healthcare Solutions appoints Richard Bohmer, MD (Harvard Business School) chair of its new nine-member advisory network.

Telemedicine

First Stop Health, a Chicago-based startup that caters to employers, secures a seed round of $2.1 million, bringing its total funding to $5.6 million.

Other

A family physician in British Columbia fires a patient of 13 years via letter after his office receives documents pertaining to her walk-in clinic visits. “One of the conditions of my taking over your care as your family doctor was that you try if at all possible to avoid using other clinics and keep your medical care at our office,” he wrote. “I would ask that you have my name removed as your family physician as I will not follow up on any further medical correspondence.” The patient, who promptly posted a picture of the letter to social media, says her clinic visits were necessary due to a lack of availability on the part of the physician’s practice.

Finally! App developer Allen Wong develops a hack for the Tesla Model S that enables owners to use the car’s Summon feature from their Apple Watches. The feature enables the car to open the garage door, enter or exit the garage, park itself, shut down, and close the garage door. The company predicts that, “Eventually, your Tesla will be able to drive anywhere across the country to meet you, charging itself along the way. It will sync with your calendar to know exactly when to arrive.”

Contacts

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

More news: HIStalk, HIStalk Connect.

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

News 2/8/16

Top News

CMS releases final open enrollment numbers: 12.7 million consumers signed up for coverage, with over 9.6 million going through HealthCare.gov – 4 million of which were new enrollees – and 3.1 million through state-based exchanges. HHS Secretary Sylvia Burwell deemed it a success, despite the Obama administration’s initial hope that enrollment numbers would ultimately reach nearly 25 million. Last year’s enrollment people saw 10.2 million sign up and pay for coverage.

HIStalk Practice Announcements and Requests

I dug into binge watching season seven of Parks & Recreation last night and literally laughed out loud during Leslie and Ben’s “covert” tour of Gryzzl, an Internet company that has showered Pawnee residents with free devices, WiFi, and gifts personalized via data mining and delivered by drone. As one of the company reps tells Leslie, “Our super-rad algorithm searches all your texts, calls, banking, medical records, blah blah blah, to learn what you really want – from snacks to new books and movies!” If only I could “Vote for Knope” in 2016.

Coincidentally, David Agus, MD highlights the need for balance in addressing privacy concerns and data mining medical records in an opinion piece for the New York Times. (Perhaps he, too, watches P&R a year behind everyone else?) “I get that patients are nervous about releasing their health records,” he writes. “But we cannot let these fears suppress the powerful insights medical data can offer us. When I explain to my own patients what can be done with their information for the greater good in research, nobody has ever said to me, “Don’t use my data.”

Webinars

February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.

Acquisitions, Funding, Business, and Stock

Concierge medicine provider One Medical acquires digital health startup Rise for $20 million. Rise markets an app that provides one-on-one nutrition and diet coaching, and has raised $4 million since its 2013 launch. Lt. Dan takes a deeper dive here.

Telemedicine

ATA seeks nominations for its annual President’s Awards for the Advancement of Telemedicine, to be given out during its annual meeting May 14-17 in Minneapolis. Nominations are due February 29.

Announcements and Implementations

Reminder and patient engagement service vendor Talksoft announces integration with Greenway Intergy.

Physical therapy EHR vendor WebPT develops a patient outcomes tracking and analysis platform, offering performance analysis at the patient, therapist, practice, and company levels.

Family Achievement Center, a pediatric physical and occupational therapy practice based in Woodbury, MN, upgrades to Clinicient’s Total Insight clinical, financial, and RCM solution.

People

E-MDs names Derek Pickell (Convergent Healthcare) as CEO and board director.

Chris Freer (SPH Analytics) joins Leidos Health as vice president of sales.

Big data nonprofit CancerLinq, a subsidiary of the American Society of Clinical Oncologists, names David Dornstreich chief of corporate engagement, Robert Merold chief of strategic initiatives, and Jennifer Wong chief os strategic alliances.

Government and Politics

ONC attempts to clear up confusion around HIPAA with new fact sheets and an accompanying series of blogs.

Other

The local paper looks at the impact last fall’s transition to ICD-10 has had on local providers, pointing to a handful of likely independent physicians who weren’t even aware the transition had taken place. For the most part, however, practices were prepared and seem to have weathered the storm with minimal denied claims. “There has been a need to add staff,” adds Bambi Shertzer-Cioffi, manager of physician billing at WellSpan Medical Group (PA). “We are currently ramped back up to full speed.”

Good news for cybersecurity aficionados: The Malware Museum is now live as part of the Internet Archive’s digital collection. Museum-goers now have the opportunity to relive losing personal files from some of their favorite viruses, including Casino, which forced users to play a game (winners got their files restored); COFFSHOP, which displayed political messages; and Ha, which poked malicious fun at its victims.

Sponsor Updates

• Versus Technology becomes a founding member of the Electronic Hand Hygiene Compliance Organization.
• AdvancedMD makes its patient engagement solution available to users of its AdvancedPM technology

Contacts

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

More news: HIStalk, HIStalk Connect.

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

Population Health Management Weekly Wrap Up 2/7/16

Scientific Technologies develops a perinatal hepatitis B application capable of track and manage infected mothers, and offering preventive care to their babies. The new app, developed via a group of five-state public health case managers and immunization registry specialists, includes infant and mother case management tools, decision support for follow-up care and immunization forecasting, and interoperates with EHRs or immunization registries.

Privia Health integrates Athenahealth Population Health into its AthenaOne services for its network of 1,200 independent physicians across five states and Washington, DC.

United Physicians of San Antonio selects population health management firm Innovista Health Solutions to expand its ACO network and help its 32 independent practices manage value-based care for over 15,000 patients.

Multispecialty physician group Esse Health (MO) selects Lightbeam Health’s population health platform to manage patient populations in certain Medicare Advantage and commercial contracts. The platform includes patient and provider engagement tools, risk stratification, an enterprise data warehouse, and analytics.

Deloitte Consulting awards Premier a subcontract for data registry support for CMS and its Million Hearts campaign, the agency’s first foray into determining if incentivizing physicians for reducing the risk of first heart attacks or strokes among high-risk patients produces better outcomes.

Humana subsidiary Transcend Insights integrates risk analysis and adjustment tools from actuarial firm Millman into its HealthLogix population health and wellness platform.

Evolent Health and Passport Health Plan partner to create The Medicaid Center of Excellence in Louisville, KY. The new center will combine Evolent’s Identifi population health management technology with Passport’s managed care services to serve provider-led Medicaid health plans.

Philips will use Validic’s technology to integrate consumer health data with its HealthSuite connected health products.

A fairly comprehensive survey on the state of population health finds internal systems like IT, tracking, and management to be the leading challenge to pursuing population health management. One of the 300-plus healthcare executives surveyed noted, “We have good data to show what happens within our walls, but we have a hard time accessing data in the post-acute setting. Seventy percent of the utilization is occurring in places we don’t have much data about.” Threat of financial loss and uncertainty of when to transition to a population model round out the top three barriers.

Sponsor Updates

• Premier awards Versus Technology a group purchasing agreement for its RTLS/RFID products.
• Leidos Health will exhibit at McKesson Southeast February 10-11 in Charlotte, NC.

Blog Posts

• Reflections on 2015: Paving the Way to Value-Based Care (Medicity)
• Finding the Perfect Number of Patients (Nordic)

Contacts

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

More news: HIStalk, HIStalk Connect.

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

News 2/4/16

Top News

Practice Fusion confirms that it has laid of 74 people – 25 percent of its workforce – across all divisions in an effort to become cash-flow positive. The last year or so has been a bit of a rollercoaster for the company: New CEO Tom Langan stepped in last August, and rumors swirled a few months later of an anticipated IPO aided by the expertise of JPMorgan Chase. TechCrunch reports the company is looking to push the IPO to 2017, a decision that may have contributed to the layoffs.

Webinars

None scheduled in the next few weeks. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

Hot on the heels of the US Preventive Services Task Force recommendation that adults be screened for depression, WRS Health launches the HS Digital Pen. Patients can use the mental health screening assessment tool and application to fill out assessments, after which results are automatically transmitted via the pen to the physician’s EHR.

Acquisitions, Funding, Business, and Stock

Athenahealth reports a 2015 revenue growth of 23 percent over the previous year, and a 21-percent growth over Q4 2014. CEO Jonathan Bush noted during this morning’s earnings call that the company’s network has grown to serve over 75,000 providers, 38 million patients, and 98,000 information trading partners.

Azcomp Technologies, a Medisoft, Lytec, and McKesson reseller and consulting firm, relocates its Mesa, AZ headquarters to S. Power Road, Suite 117, 85209. 

CVS Health and Target debut co-branded pharmacies at several Target locations in North Carolina. The move is part of a larger plan to convert 1,672 Target pharmacies to CVS Pharmacies across the country over the next six to eight months. CVS Health acquired all of Target’s pharmacies and retail clinics in December. CVS Health Executive Vice President Helena Foulkes expects the co-branding will bring in new customers, who will be exposed to digital tools like its pharmacy app and website to help them manage prescriptions and medication adherence.

Brentwood, TN-based worksite healthcare company Premise Health opens a branch in Alameda, CA to better serve its West Coast clients. The company, which formed a year ago out of the merger of CHS Health Services and Walgreen subsidiary Take Care Employer Solutions, manages over 500 health centers for 200 customers – 40 of which are in California, Oregon, and Washington.

People

Donald Kosiak Jr., MD (Avera Health) joins Leidos as CMO.

Bruce Schreiber (MaxMD) and Renee Smith (Walgreens Boots Alliance) join the DirectTrust Board of Directors.

Telemedicine

Dictum Health adds Geratherm Respiratory’s Spiraflow Sensor to its telemedicine platform for cardiopulmonary diagnostics and remote care of patients with COPD, heart failure, and asthma; and during smoking-cessation treatments.

Government and Politics

The Government Accountability Office is accepting nominations for the HIT Policy Committee through March 2. The committee’s three open positions include a consumer or patient advocate, payer representative, and a representative of purchasers or employers.

Other

Mirror mirror on the wall: Google engineer Max Braun invents a smart mirror that displays news and weather using parts “easily” found online or in stores. He’s contemplating adding traffic updates, daily reminders, and voice search.

Contacts

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

More news: HIStalk, HIStalk Connect.

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