Healthcare Reform & Technology:
Download
1 / 30

Healthcare Reform & Technology: Positioning Your Practice for the Future - PowerPoint PPT Presentation


  • 143 Views
  • Uploaded on

Healthcare Reform & Technology: Positioning Your Practice for the Future. Presented By:. Maureen West McCarthy, CPA Snyder Cohn, PC. Jonathan Krasner BEI (Business Engineering, Inc.). February 28, 2012. The Reform Landscape. Improved Outcomes Reduced Cost (ACOs, Shared Savings)

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Healthcare Reform & Technology: Positioning Your Practice for the Future' - phong


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Healthcare Reform & Technology:

Positioning Your Practice

for the Future

Presented By:

Maureen West McCarthy, CPA

Snyder Cohn, PC

Jonathan Krasner

BEI (Business Engineering, Inc.)

February 28, 2012


The reform landscape
The Reform Landscape

  • Improved Outcomes

  • Reduced Cost (ACOs, Shared Savings)

  • Readily available (and usable) information

    • Health Information Exchange (HIE)

      • Provider to Provider

      • Patient to Provider


The reform landscape1
The Reform Landscape

  • Engage patients in their treatment

  • Patients responsible for their own health

  • More direct costs borne by patients

  • Emphasis on preventative medicine and wellness

  • Patient Centered Medical Home (PCMH)


Ultimately change in the way providers are reimbursed
Ultimately…. Change in the Way Providers are Reimbursed

  • Fee for Service Quality Based Payments?

  • Capitation for a full range of services?

  • Hybrid? (i.e., fee for service with quality based incentive)



What is an aco
What is an ACO? will not continue indefinitely.

  • Accountable Care Organization

  • Payments based on outcomes

  • For larger organizations, but small practices can participate.

  • Outcomes adjusted for patient panel

  • Every major carrier has an ACO model


* The American Recovery and Reinvestment Act (ARRA), and specifically the Health Information Technology for Economic and Clinical Health Act (HITECH) provisions have resulted in an intense focus on the use of technology in the healthcare setting.* EHRs are the “foundation” for outcomes measurements.



The stick medicare penalties starting in 2015 for non adoption and meaningful use of ehr
The ‘stick’ = Medicare penalties starting in 2015 for NON-adoption and Meaningful Use of EHR


Medicare meaningful use
Medicare Meaningful Use NON-adoption and Meaningful Use of EHR

  • Physician payments are 75% of Medicare allowed charges

  • Penalties – reduction in physician fee schedule

  • 10% increase in incentives if physician practices in a designated health professional shortage area

  • At the Secretary’s discretion, Medicare payments can go down as much as 5% in 2019 and beyond


CMS has reported that over 176,000 eligible professionals and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.‘the train has left the station’


We believe …… and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.THE PRIVATE CARRIERS WILL FOLLOW SUIT. Outcomes-based payments can’t realistically be measured and determined using paper records.


What can physicians ideally expect with ehr use
What Can Physicians (Ideally) Expect with EHR Use? and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Improved Efficiencies (i.e., ‘real time’ info sharing and updating of patient charts)

  • Fewer Medical and Rx Errors

  • Improved care coordination and ability to make quick, informed decisions (emergencies)


What can physicians ideally expect with ehr use1
What Can Physicians (Ideally) Expect with EHR Use? and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

A more automated, streamlined practice.


Ehr and billing system integration
EHR and Billing System Integration: and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Complete charge capture (services and tests performed)

  • Coding documentation

  • Reduction in staff time for data entry

  • Increase in speed of payments


Cost benefits of ehr
Cost Benefits of EHR: and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Less storage costs (medical records)

  • Reduction in number of staff (after full implementation and training – might take a few years)

  • Reduction/elimination of transcription costs


Using an ehr data vs information
Using an EHR: Data vs. Information and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Data is information in raw form.

  • Information is processed data that is usable in decision making.

  • With EHRs, we often have too much data BUT want and need information.


Using an EHR: Data vs. Information and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.Make sure your EHR is providing you with information and not just data.


Evidence based care
Evidence-Based Care: and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Ability to report system data for specific population/illnesses/conditions

  • Use of shared data to determine optimal treatment (i.e., what has worked and what has not for patient populations)

  • Disease Management & Care Coordination


Evidence based care1
Evidence-Based Care: and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Reporting of quality metrics (generated by EHR) to CMS and carriers

  • Higher utilization of ‘best practices’ (i.e., a patient with a given condition receives the same treatment, regardless of the setting)


Engaging patients
Engaging Patients: and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

Assisting patients in becoming more knowledgeable and informed about their care.

  • Patient portals

  • Automated phone and text reminders

  • Customized patient education

  • Personal Health Records (PHRs)


Transitioning to ehr
Transitioning to EHR: and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Design processes around new technology and continually build on them (not a ‘one-time’ event)

  • Staff training and implementation plan

  • Define and put ‘rules’ in place

  • Need ‘buy-in’ from all users (especially physicians) in order to be successful


Why else purchase an ehr
Why Else Purchase an EHR? and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Attract new physicians

  • Makes a practice more marketable

  • Makes a practice more valuable

  • Attract patients


Beware
Beware…… and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Choose the right system for your practice and specialty

  • Fully understand the system

    • Software capabilities

    • Maintenance and support agreements (additional training included?)


Beware1
Beware…… and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Compliance with privacy requirements

  • Use templates carefully (do not over-rely on them)

  • Increase in payor audits


Other technologies to be adopted in 3 5 years
Other Technologies to be Adopted in 3 – 5 Years: and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Remote monitoring (with integrated data feeds to EHR)

  • Tele-medicine

    • iPAD, Skype

    • Already in use in direct pay relationships

    • Especially used in Primary Care/PCMH


In conclusion
In Conclusion: and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • The cost of healthcare is driving change. Medicare Trust Fund going bankrupt.

  • Payment methodology is moving away from standard fee for service.

  • Technology (EHR) is the only realistic way to measure outcomes.


In conclusion1
In Conclusion: and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.

  • Many benefits come with the use of technology in a medical practice.

  • There is a push for more patient involvement in care.

  • Position your practice to benefit from these changes.


Any questions
Any Questions? and hospitals have registered to receive stimulus money. $2.5 billion was awarded in 2011.


ad