Feb 13, 2013 | Uncategorized
Patient Affordable Care Act Changes That Occurred in 2010nIndoor tanning services were assessed a 10% excise tax.nnA re-insurance program offset the costs of health benefits for workers age 55-64 who were forced into early retirement.nnMedicare beneficiaries who fell into the Medicare Part D Prescription Drug “donut hole” received a $250 rebate. They received a 50% discount on brand name drugs in 2011, and the doughnut hole is eliminated in 2020.nnChildren were allowed to stay on their parents’ health insurance until they turn 26.nnNew private plans were required to cover preventive services with no co-payments, and they are exempt from deductibles. Consumers who applied to new plans have access to an external appeals process if coverage is denied.nnInsurance companies were prohibited from dropping coverage if someone got really sick. They couldn’t create lifetime coverage limits. They could no longer deny coverage to children with pre-existing conditions. The same will apply to adults in 2014. Until then, adults with pre-existing conditions who have been denied coverage will get access to temporary health insurance coverage until the exchanges are set up. (To see how to sign up, go to Pre-Existing Conditions.)nnPPACA (Patient Protection Affordable Care Act)Changes in 2011n
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- Medicare-covered preventative services were exempted from deductibles and the co-pay was eliminated.
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- Insurance companies must prove they spent at least 80% of the premium payments on medical services, rather than on things like advertising and executive salaries. Those that didn’t were required to provide rebates to policyholders.
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- States were funded to require health insurance companies to submit justification for all rate hikes.
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- Funds were expanded to increase the number of doctors and nurses, and more community health centers — enough to double the number of patients they can treat in the next five years.
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nChanges in 2013nMedical expenses must be at least 10% of income before they are deductible for those under 65. Manufacturers and importers of medical devices will pay a 2.3% excise tax. Federal funds will increase to allow Medicaid to offer free preventive services, and to extend CHIP for an additional two years. The Federal government will fund states to pay primary care physicians 100% of the Medicare fee. Medicare will start a pilot program to encourage hospitals to bundle services before submitting for payment. (Source: Healthcare.gov)nnAdditional taxes will be paid by the 1 million people who make more than $200,000 and the 4 million couples filing jointly who make more than $250,000. Specifically, they would pay 3.8% Medicare taxes on dividends, capital gains, rent and royalties and 2.35% (up from 1.45%) Medicare taxes on income.nnChanges in 2014nIn 2014, the state-run health exchanges will be set up. Medicaid eligibility will be expanded to include those with incomes up to 133% of the Federal poverty line ($29,000 for a family of four). New subsidies will become available for with incomes up to 400% of the poverty level ($88,000 for a family of four). To find out how this will work, see Affordable Care Act from the About.com Guide to Health Insurance.nnThose who don’t purchase insurance will be assessed penalties:n
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- 2014 – The greater of $95 or 1% of income.
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- 2015 – $325 or 2% of income.
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- 2016 – $695 or 2.5% of income
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nBusinesses with 50+ workers must pay $2,000 per worker (except for the first 20) if they don’t offer health insurance. Those that do receive a tax credit of 50% of the premium cost.nnSource: HealthReform.gov; Ryan Donmoyer; March 22, 2010, Article Updated July 13, 2012.
Feb 13, 2013 | Uncategorized
Worst V-Day diagnosis code:nI51.81 – “Broken heart syndrome”nnStruck by Cupid’s arrow:nS26.99xA – Other injury of heart, initial encounternW21.89xA – Struck by arrow, initial encounternnThe only kind of chocolate you DON’T want on V-Day:nN80.1 – Chocolate cystnnMost common ICD-10 diagnosis code reported at Mardi Gras in New Orleans:nW52.XXXA – Crushed by crowdnnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Feb 8, 2013 | Uncategorized
Seminar Title: ICD-10: A Coder’s PerspectivenSeminar Cost: FREE – Don’t miss out on this excellent opportunity!nnSeminar Description: An informative seminar to give a coder’s viewpoint of the ICD-10 transition and to alleviate fears of what the new code set will mean to coders and billers. We will review guideline changes, new concepts and problematic code sets, along with in-depth discussions of the impact to outpatient coders, tips on how to begin the education and training process, and tips on how to avoid potential pitfalls during the implementation process.nnThis program has the prior approval for 2.0 CEU’s from the American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA).nnSeminar Dates and Locations:nEnglewood, CO: Swedish Medical CenternSpruce C Conference Roomn501 E Hampden AvenuenEnglewood, CO 80113nnDate: Wednesday April 10, 2013nTime: 2-4pmnnThis class is full and can no longer accept new registrants. Please register for our Thornton, CO class if you wish to attend.nnnWeb-based ICD-10 training is coming soon! To receive updates on upcoming seminars, webinars and training, join our email registration!
Feb 4, 2013 | Uncategorized
T14.8 – Multiple contusionsnnW04.XXA – Fall while being carried by other personsnnY90.1 – Evidence of alcohol involvement determined by blood alcohol level, 20-39 mg/100 mlnnZ72.820 – Sleep deprivationnnZ72.6 – Problems relating to gambling and bettingnn nnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Feb 4, 2013 | Uncategorized
Was it: T71.141Ann Asphyxiation due to smothering under another person’s body (in bed), initial encounter, accidentalnnOr was it: T71.143AnAsphyxiation due to smothering under another person’s body (in bed), initial encounter, assaultnn nnIn preparation for the upcoming deadline for ICD-10 implementation, Welter Healthcare Partners presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed from your providers to comply with ICD-10 coding, and more importantly, for accurate and clean claims submission to keep your revenue stream flowing! We are to help YOU prepare for the October 1, 2014 implementation date. Please don’t hesitate to contact us for all of your training and education needs!
Jan 30, 2013 | Uncategorized
CERTIFIED PROFESSIONAL CODER (CPC) PREPARATION COURSE & CERTIFICATIONnn
Certified coders are in high demand! Advance your career in the medical field and get certified now! With limited time left to register, make sure you sign up today!
nThis course will be offered as a combination live and web-based class to offer maximum flexibility for any student. It is designed to offer the most comprehensive and complete coding information to prepare students for the CPC examination and a career in the medical field. This course will include a brief overview of medical terminology, anatomy, CPT, ICD-9 CM and HCPCS manuals, and coding scenarios for practical application in the work environment.nnUpon completion of this course, participants will be prepared to sit for the nationally accredited American Academy of Professional Coders (AAPC)/Certified Professional Coder (CPC) coding certification examination.nnThis examination will be offered to class participants at the completion of the course.nnCourse Schedule: CPC Classes begin Tuesday, February 26, 2013. Classes will be held every Tuesday from 5:30 PM–8:30 PM, and every other Saturday from 9:00 AM–12:30 PM. The final exam is on June 15, 2013.nnCourse Format: Live and web–based to offer maximum flexibility for any student.nn nnClass size is limited, so register today to guarantee your spot!nnRegistration Deadline: Friday, February 15, 2013.nnClick here for more information.nnClick Here for Course Schedule and Registration Form.nnYou may also find the Course Schedule below.
Jan 23, 2013 | Uncategorized
nnIn response to the government’s continued focus on improving quality of care through payment policy, several changes to new and existing regulatory requirements recently came about through the 2013 Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System (OPPS), and the Medicare Physician Fee Schedule (MPFS) Final Rules (“Final Rules”). As a result, hospitals will be faced with new challenges in 2013 and beyond.nnWhat Hospitals Should DonnIn 2013, hospitals should pay particular attention to these requirements in the Final Rules:n
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- Closely monitor the IQR and OQR reporting requirements;
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- Understand the development of the Value Based Purchasing program and the new measures that will apply in future years;
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- Immediately focus on strategies to reduce readmission rates to avoid future penalties;
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- Know the process for appealing CMS decisions related to quality–based payment programs;
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- Immediately implement mechanisms to respond to changes in the 3-day payment window and its impact on hospital-owned physician practices; and,
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- Be aware of other payment policies that could change in the future.
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nSource: www.polsinelli.com; January 1, 2013.
Jan 16, 2013 | Uncategorized
January 14, 2013 — FOR IMMEDIATE RELEASE:nnDenver, Jan 14, 2013 — Welter Healthcare Partners, Inc. (WHP) is very proud to announce the addition of Rebekah S. Gatti (CCS-P, CPC, CPC-I, CEDC, CPMA) to our healthcare management and consulting organization. WHP is an industry leader in providing healthcare facilities with consulting and medical coding services.nnRebekah S. Gatti has 30 years experience in the healthcare industry, both inpatient and outpatient (hospitals and physicians), with specialty in Emergency Medicine, General Surgery, OB/GYN, Cardiology, Orthopedics, Oral Surgery, Pain Medicine, Mental Health and Occupational Medicine. She holds multiple certifications from both the AAPC and AHIMA.nnMs. Gatti has extensive experience with medical practice management, including revenue enhancement, reimbursement analysis, collection issues, compliance plans, chart auditing, and personnel management issues. She provides educational seminars for physician groups and hospitals on coding, auditing, modifiers, evaluation and management, documentation issues and ICD-10 preparation and financial neutrality. She also provides instruction in medical coding, having successfully completed the PMCC instructor certification course. Ms. Gatti is an AHIMA-approved ICD-10-CM/PCS Trainer. She is the author of “Introduction to Inpatient Procedural Coding Using ICD-10-PCS.”nnPrior to employment at Welter Healthcare Partners, Ms. Gatti was the ICD-10 Manager for a healthcare software company supervising the Content Team, and Coding Supervisor at a large multi-practice company in Virginia where she provided documentation training for over 300 physicians and physician extenders.
Jan 15, 2013 | Uncategorized
Medicaid Primary Care Payment IncreasennThe Affordable Care Act (ACA) enacted changes to Medicaid primary care reimbursement. Eligible physicians will receive supplemental payments for services rendered between January 1, 2013 and December 31, 2014. These supplemental payments will raise the Medicaid reimbursement to Medicare rates. To be eligible for the supplemental payments, physicians must self-attest as having a specialty in family medicine, general internal medicine, and/or pediatric medicine. Only physicians can complete the attestation! Staff or other representatives are not allowed to complete the attestation on the provider’s behalf. Click here to complete provider attestation.nnBeginning in 2013, providers applying for initial credentialing or re-credentialing must submit a Certificate of CME Credit, which is received after completion of the opioid educational webinar. The webinar can be viewed by going to Pinnacol’s website.nnMedicare Electronic Prescribing (eRx) Incentive ProgramnnThose practices that did not meet the reporting criteria established for avoiding the 2013 eRx payment adjustment, or request a hardship exemption by July 2012, are subject to a 1.5% reduction in reimbursement in 2013.nnGood news for practices that did not meet the reporting criteria: CMS has re-opened the Quality Communication Support Page, as of November 1, 2012, to allow individual professionals an additional exemption for the 2013 eRx payment adjustment!nn What you need to do by January 31, 2013 to avoid the payment adjustment:nnSubmit a hardship Exemption Request via the Community Support Page –n
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- Hardship exemptions include: Demonstrate the intent to participate in the EHR Incentive Program and adoption of Certified EHR Technology by registering for the EHR Incentive Program. Participants in the EHR Incentive Program must provide their entire EHR Certification Number to receive this hardship exemption.n
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- Physicians who are unable to prescribe due to state, federal or local law;
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- Physicians with fewer than 100 prescriptions between 1/1/12 and 6/30/12;
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- Physicians in rural areas without sufficient high-speed internet access; or
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- Physicians in areas without enough pharmacies available for e-prescribing.
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- Meet the reporting criteria:n
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- Report the eRx measure for at least 25 denominator-eligible visits from January 1, 2011 through December 31, 2011
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- Report the eRx measure’s numerator (G8553) on claims for at least 10 billable Part B Physician Fee Schedule services from January 1, 2012 through June 30, 2012.
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Medicare Provider Revalidations
nMedicare is continuing their efforts to re-validate ALL Medicare providers! There is 2 years left in their intended time frame.nnYou will be receiving a notification letter (letters being mailed between late 2011 & March 2015). You (the provider) only have 60 days to complete and submit the proper forms that must be completed. The process is/was to be suspended until after completion of the new MAC transition. However, if you do/ did receive a revalidation notice, don’t ignore it! PTANs will be deactivated if forms are not received and processed.n
Provider credentialing has become increasingly complex! Welter Healthcare Partners offers credentialing and reimbursement management services to support every practice’s needs! Call or email us today for more information!
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Jan 10, 2013 | Uncategorized
Per AMA guidelines, the new code set should be used for claims filed as of January 1, 2013. Practices are advised to check with their local payers to verify payer implementation date of the new codes, to avoid any unnecessary claims denials and delays in payments!nnClick here for CPT changes for ALL SPECIALTIESn
nContact Welter Healthcare Partners for all of your coding education and training needs! Welter Healthcare Partners is now offering customized ICD-10 training for providers, practices and hospitals. Contact us today for more details!
Jan 8, 2013 | Uncategorized
CERTIFIED PROFESSIONAL CODER (CPC) PREPARATION COURSE & CERTIFICATIONnnCertified coders are in high demand! Advance your career in the medical field and get certified now!nnThis course will be offered as a combination live and web-based class to offer maximum flexibility for any student. It is designed to offer the most comprehensive and complete coding information to prepare students for the CPC examination and a career in the medical field. This course will include a brief overview of medical terminology, anatomy, CPT, ICD-9 CM and HCPCS manuals, and coding scenarios for practical application in the work environment.nnUpon completion of this course, participants will be prepared to sit for the nationally accredited American Academy of Professional Coders (AAPC)/Certified Professional Coder (CPC) coding certification examination.nnThis examination will be offered to class participants at the completion of the course.nClick here for more information.nnClick Here for Course Schedule and Registration Form.
Jan 2, 2013 | Uncategorized
Congress passed The American Taxpayer Relief Act of 2012, to avert the “fiscal cliff.” President Obama is expected to sign the legislation shortly.nnIn addition to various tax and spending measures, the legislation includes provisions of direct importance to medical group practices. The legislation:n
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- Prevents the Medicare physician payment SGR cut for one year. It eliminates the 27 percent Medicare physician payment cut, which took effect today and replaces it with a “zero percent update” to the Medicare physician fee schedule conversion factor for 2013. As has occurred with prior temporary extensions of this kind, this is not a fee schedule rate freeze. It means any conversion factor adjustments and RVU changes contained in the final fee schedule rule for 2013 may result in payment rate changes, but the massive SGR cut is nullified for a year.
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- Turns off the January 2, 2013 sequester for two months. This prevents various defense and other automatic cuts from occurring, including an across the board, two percent cut for all Medicare providers. It’s expected Congress will revisit issues related to the sequester in the near future.
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- Extends the Medicare 1.0 work RVU GPCI floor through December 31, 2013
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- Increases the Medicare Part B equipment utilization assumption for advanced imaging services to 90 percent effective for fee schedules established for 2014 and subsequent years, thus reducing future payments
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- Extends the Medicare therapy cap exception process through December 31, 2013
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- Increases the Medicare therapy service multiple procedure payment reduction from 25 to 50 percent effective April 1, 2013
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Dec 27, 2012 | Uncategorized
A new report from the Agency for Healthcare Research and Quality (AHRQ) highlights the cumulative experiences of more than 100 grantees that implemented major health IT projects between 2004 and 2007.nnThe report, Effective Teamwork and Sustainability in Health IT Implementation, reviews grantee experiences related to planning, long-term use, partnerships, vendor relationships, and end-user perceptions a few years after the end of the project period. According to the grantees, the most important factors affecting the sustainability of health IT were the ability to demonstrate benefits from health IT to grantees’ organizations, clinician support, and cost–related issues. Grantees said that most health IT products that were implemented and upgraded during the study continue to be used. However, they reported that in order for health IT projects to be successful, clinician buy-in and support must be established early in the planning period and be sustained during implementation and maintenance phases. Effective planning, including completing a detailed workflow analysis, implementation plan and process re-design assessment prior to implementation, were strong markers of long-term viability.nnThe report is available here.
Dec 19, 2012 | Uncategorized
Physicians are scheduled to receive a 26.5 percent reduction in payments starting Jan. 1 unless Congress intervenes. Action to avert the cut is being considered as part of broader fiscal cliff negotiations on tax and spending policies. However, these discussions remain up in the air, creating uncertainty over the timing of a solution.nnThe latest estimates from the Congressional Budget Office (CBO) indicate that a one-year patch to prevent the SGR cut would cost $25 billion. While most members of Congress agree that the current Medicare payment system must be repealed, the cost is daunting. Details should emerge in the coming week.
Dec 12, 2012 | Uncategorized
Here a few highlights from Becker’s Hospital Review 10 Major Takeaways From CMS’ FY 2012 Financial Report–Click here to view the article in full.nnOne of the most important organizations within the healthcare sector is CMS, and for obvious reasons. It is one of the largest healthcare payors in the world, and the federal agency dictates many of the rules that will directly and indirectly impact the finances of hospitals and health systems.nnOn Nov. 15, CMS posted its FY 2012 financial report. CMS CFO Deborah Taylor, a certified public accountant, prepared the 202-page document, which is required by law every year. Here are 10 of the biggest takeaways from the report.nnWhat the nation’s healthcare dollar looked like in 2012. Government health programs consume the largest parts of the U.S. healthcare system, and CMS’ report broke down the different healthcare payors and how much money they represented in FY 2012. Here’s how much each sector represented for every dollar spent on the U.S. healthcare last year:nn• Private insurance: 31.6 centsn• Medicare: 21 centsn• Medicaid: 16.3 centsn• Other government programs: 13.3 centsn• Out-of-pocket: 11.1 centsn• Other private programs: 6.7 centsnnFurthermore, Medicare and Medicaid, including state funding, represented 54 cents of every dollar spent on nursing homes, 49 cents of every dollar received by hospitals and 33 cents of every dollar spent on physician services.nnMedicare Part A Benefit Payments. Inpatient hospital spending accounted for 54 percent of Medicare Hospital Insurance, or Part A, benefit outlays in FY 2012. Managed care represented the next-highest total at 25 percent, while skilled nursing facilities received 12 percent of Part A payments.nnMedicare Part B Benefit Payments. Medicare Part B, or Supplementary Medical Insurance, covers all physician, hospital outpatient, home health, lab test and other services not covered by Part A. Physicians services accounted for the largest slice of Part B at 24 percent. Prescription drugs accounted for 21 percent, while hospital outpatient services represented 11 percent.nnMedicaid Enrollees. Children represented the largest portion of Medicaid beneficiaries in FY 2012 at 50 percent. The remaining enrollees were adults (23 percent), disabled (18 percent) and elderly (9 percent).nnFederal Medicaid costs. State and federal medical assistance payments and administrative costs totaled $452.5 billion last year. CMS’ share of Medicaid outlays totaled $260.1 billion of that total.nnMedicare and Medicaid Recovery Auditors. Medicare RACs recovered $2.3 billion in over–payments in FY 2012, as reported earlier. However, that figure does not include dollar amounts related to claims in the appeals process or claims that had been successfully appealed by providers.nnMedicaid RACs were supposed to go live Jan. 1, 2012, although not all states have finalized their programs. According to the report, “states that have been unable to implement Medicaid RAC programs by Jan. 1, 2012, have been submitting [state plan amendments] to CMS requesting implementation delay exceptions.” CMS released a Medicaid RAC final rule in September 2011, projecting savings of $2.1 billion over the next five years. Roughly $910 million of that total would be returned to states.nnSource: www.beckershospitalreview.com Bob Herman; December 7, 2012.
Dec 5, 2012 | Uncategorized
Almost 10 percent of U.S. patients receive their healthcare from an accountable care organization (ACO), and almost half live in areas served by at least one ACO, according to a new study from Oliver Wyman. This means that ACOs, little known in the United States as recently as two years ago, now have a substantial presence and are poised to offer a competitive threat to traditional fee-for-service medicine.nn“There’s a common impression that ACOs play a minuscule role in American healthcare,” says Niyum Gandhi, one of the authors of the study. “But when you go out and actually count what’s on the ground, you realize that they’re already achieving critical mass.”nnThere is no single, universal definition for ACOs. In its census, Oliver Wyman counted not just participants in Medicare’s various ACO programs, but also commercial ACOs and healthcare delivery organizations that apply some other name to themselves but follow the basic elements of the accountable care organization: They are healthcare providers that take responsibility for the full healthcare needs of a defined population, receiving savings payments based on cost savings and quality.nnThe ACA directed Medicare to create ACO programs – today there are 150 Medicare ACOs, and the number is expected to more than double in January, when Medicare announces the next class of participants in its Shared Savings Program. Because it is difficult to operate a single organization under a fee-for-service and an ACO model at the same time, most participants in Medicare ACO programs eventually shift their non-Medicare patients to ACO models as well.nnA total of 25 to 31 million U.S. patients currently receive their care through ACOs. They include:n
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- 2.4 million patients in Medicare ACO programs
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- 15 million non-Medicare patients in Medicare-oriented ACOs
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- 8 to 14 million patients in non-Medicare ACOs
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nBecause Medicare’s ACO programs were designed to create a care delivery model that could compete with fee-for-service, the Oliver Wyman study analyzed how many people lived in a locale served by at least one ACO. The astonishing answer: 45 percent of Americans. And there are 19 states in which more than half of the population live in an area served by at least one ACO.nnCritics have argued that few of today’s ACOs live up to the potential of the model, and the Oliver Wyman team are quick to agree. “Many of the organizations we have looked at are really ACOs in name only,” says coauthor Rick Weil. “But this is a case where averages don’t count. Instead, you look at the spread of the new model and the performance of the best-in-class. And best-in-class ACOs are delivering exceptional results. For example, one California ACO had a zero percent premium increase its first year—something many people in healthcare would have said was impossible. As more and more ACOs learn to make the model work, they have the potential to change the whole dynamic of U.S. healthcare for the better.”nnSource: www.thestreet.com; November 29, 2012.
Nov 28, 2012 | Uncategorized
At the 98th meeting of the Radiological Society of North America in Chicago on Nov. 26, 2012, Keith J. Dreyer, DO, PhD, vice chairman of radiology at Massachusetts General Hospital in Boston and associate professor of radiology at Harvard Medical School, discussed the future of imaging informatics in the face of meaningful use.nnCMS’ meaningful use program is one of the ways the federal government is focusing on quality, safety and access with healthcare, said Dr. Dreyer. By urging providers to use certified electronic health record technology, the federal government is hoping that safety and quality of healthcare will increase while the cost of healthcare will decrease. According to Dr. Dreyer, physicians and radiologists need incentives to have a patient-centric focus in their healthcare decisions and that is what meaningful use is — an incentive.nnDr. Dreyer pointed out that more than 50 percent of physicians and 80 percent of hospitals have enrolled in the meaningful use program, with payments passing $7 billion, from when meaningful use legislation as part of the HITECH Act was first passed in February 2009 to when the most recent regulations — stage 2 of meaningful use — were released.nn”What does this mean for radiologists? Well, nearly all radiologists are eligible for the program. In 2011, 32 percent of radiologists said they planned to participate, and in 2012, that percentage has doubled,” said Dr. Dreyer. “While meaningful use can be a challenge for radiologists, there are various exclusions and temporary exemptions available. The thing to remember is that the stages of meaningful use are important.”nnThe stage 2 regulations for meaningful use have two specific objectives for imaging:n
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- Image ordering measure: Physicians have to use certified electronic health record technology to order more than 30 percent of imaging exams.
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- Image results measure: Physicians have to use CEHRT to receive more than 10 percent of imaging results.
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nDr. Dreyer concluded his presentation by commenting on the futures state of radiology and healthcare in general. “There are four metrics that I see as being important: productivity, profitability, performance and presence. The future of healthcare technology will hinge mostly on performance and presence. [Going forward], quality and relevance can drastically increase,” said Dr. Dreyer. “Productivity may take a hit for a while, and if you hinge your profits to productivity, you may see decreases. However, if profits are tied to quality and performance metrics, there will be better outcomes in the long run.”nnSource: www.beckershospitalreview.com; Kathleen Roney; November 28, 2012.nn
Nov 21, 2012 | Uncategorized
Below is an article from EHR Intelligence, outlining how author Robert Green believes EHR – enabled staff members can and do influence the reputations of clinics.nnA conversation I shared with the physicians and manager of a small pediatric clinic several years agonnis still a timely example of how fundamental people and health IT are to determining a clinic’s reputation and conversations about improving it. The physicians had decided years earlier that the value of making a commitment to EHR was important to the consistency not only of the daily patient experience but also between physicians who substitute for one annnother. What they recognized was that the contents of the EHR were as important for the sake of replacing bad handwriting in notes and idiosyncratic approaches to documentation as they were for enabling one physician to step in for another and pick up the conversation with a patient where it left it off.nnBeing able to differentiate one’s own clinic from the next comes from the recognition that onlynnnna coordinated team can deliver a consistent experience, regardless of where this patient experience begins and ends. A clinic can either take the opportunity to define its own reputation through its approach to patient engagement or have its reputanntion determined by its patients, who will talk to each other about what should have happened and why and why.nnAccessibility of electronic health information is already changing the nature of the patient-clinic interaction. We all know of the reputations of the clinics in our neighborhoods that have evolved over time. And these reputations I’m referring to have had little to do with their online or “digital” reputation. The experiences that patients and clinic staff have shared over the years (perhaps even generations) that have established these reputations are those that have occurred between people in the face-to-face interactions in the clinic. However, as the patient experience continues to grow in terms of population health outcomes and the individual’s day-to-day experience, it is an important time for physicians and their staff to recognize how to participate in the culture of care that is defined by the brand that is the physician as well as the clinic as a whole.nnJust as the accessibility of health information continues to expand from the patient’s personal history to general educational material in digital form, so too is the nature of the interaction between patient and clinic expanding. Now we are seeing the convergence of those longstanding reputations built upon one-on-one encounters and digital reputation established by connecting with patients in convenient formats and online.nnThis evolution demands a new level of reception in the clinic, one requiring a sustained and fully engaged dialogue among the entire clinic staff. The conversation about traditional and digital patient experiences is one that represents a great opportunity to accept the gratitude of each patient. Whether it’s an unconditional “thank you” or even one that is qualified with a comment or concern for future encounters, this is the reputation of the clinic as a whole and each individual physician. What’s more, because this patient experience is happening in so many ways well beyond the walls of the exam room, a fully engaged staff members will find themselves contributing to this reputation more every day.nnWhereas in the past the patient experience was defined by the coveted clinic appointment, what happens before and subsequent to that encounter has now become equally important in terms of the reputation of the clinic and physician. The challenge is to keep in mind within conversations about and interactions related to EHR and health IT that this converged clinic reputation is driven by a well-defined patient experience supported by a fully engaged clinic staff.nnSource: www.ehrintelligence.com; Robert Green, November 20, 2012.
Nov 14, 2012 | Uncategorized
Health and Human Services (HHS) Secretary Kathleen Sebelius today announced the final rule implementing the part of the health care law that delivers higher payments to primary care physicians serving Medicaid beneficiaries. The new rule raises rates to ensure doctors are paid the same for treating Medicare and Medicaid patients and does not raise costs for states.n
The Centers for Medicare & Medicaid Services (CMS) issued a final rule with comment period on November 1, 2012 for Medicare’s payments for physician fees for 2013. It includes a new policy to pay a patient’s physician or practitioner to coordinate the patient’s care in the 30 days following a hospital or skilled nursing facility stay. Recognizing the work of community physicians and practitioners in treating a patient following discharge from a hospital or nursing facility will ensure better continuity of care for these patients and help reduce patient readmissions. The changes in care coordination payment and other changes in the rule are expected to increase payment to family practitioners by seven percent—and other primary care practitioners between three and five percent—if Congress averts the statutorily required reduction in Medicare’s physician fee schedule.n(Click here to see the full release by CMS.)
n“The health care law will help physicians serve millions of Americans across the country,” Secretary Sebelius said. “By improving payments for primary care services, we are helping Medicaid patients get the care they need to stay healthy and treat small health problems before they become big ones.”nnThe final rule implements the Affordable Care Act’s requirement that Medicaid pay physicians practicing in family medicine, general internal medicine, pediatric medicine, and related subspecialists at Medicare levels in Calendar Years 2013 and 2014.nnThis payment increase goes into effect in January of 2013.nnIn addition to payment improvements, the health care law includes numerous initiatives designed to bolster primary care and strengthen the primary care workforce, including an expansion of medical residency positions for primary care physicians, new investments in physician assistant and nurse practitioner training, and an unprecedented expansion of the National Health Service Corps, which provides scholarships and loan repayments to primary care providers who practice in underserved areas.nnFor more information about today’s final rule visit:nhttp://www.cms.gov/apps/media/fact_sheets.aspnnTo view a copy of today’s final rule visit:nwww.ofr.gov/inspection.aspxnnSource: www.cms.gov; November 1, 2012.nwww.hhs.gov; November 1, 2012.
Nov 7, 2012 | Uncategorized
The Centers for Medicare and Medicaid Services (CMS) has released updated reference grids for Stage 1 and
Stage 2 meaningful use requirements, detailing how meaningful use objectives align with EHR certification criteria.nnEach quick reference grid includes the meaningful use objectives and which group of physicians those objectives apply to, the core set and menu set of measures, and the EHR certification criteria that correlate with those measures. These updated
Stage 1 and
Stage 2 grids can be accessed in PDF form from
HealthIT.gov.
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nnSource: www.ehrintelligence.com; Jennifer Bresnick; November 7, 2012.nn