HITECH Act : Economic Stimulus for EMR Adoption

HITECH Act : Economic Stimulus for EMR Adoption

Nitin Chhoda reveals a few ways that the HITECH Act can help a private practice switch to an electronic medical records system using a limited budget.  He also shares the requirements needed so that the practice can qualify with the HITECH Act incentives.

HITECT Act While the HITECH Act may help improve the safety and security of electronic medical records keeping systems, the aspects that clinicians and healthcare providers are excited about is the incentives.

The HITECH Act provides financial encouragement to clinicians, hospitals, and medical practitioners for the “meaningful use” of electronic medical records. A total of $19 billion has been allocated for incentives.

Financial Benefits

There are some great financial benefits to switching to electronic medical records anyway, but the HITECH Act makes things even easier. Physicians could qualify for as much as $44,000 for electronic health record implementation and use over the five years that the Act is funded.

The incentives only apply to the Medicare and Medicaid programs, but they can only get incentives through one program at a time. This means that they can also accrue incentives through one program and then when that runs out, they can accrue the same amount through the other program.

The incentives were also meant to encourage providers to adopt EMR systems for HITECH Act as soon as possible. One deadline was for 2012, and next year the incentives will be lower than they are this year.

And after 2015, medical practices will start to incur penalties if they have not switched to an EMR, starting with a 1% Medicare fee reduction. After 2017, that fee reduction is increased to 3%, an after 2019 the fee reduction will be increased to 5%.

Regional Extension Centers

In addition to financial incentives for adoption of EMR, the HITECH Act also funded 70 regional extension centers that can provide administrative help and guidance for health care providers attempting to make the switch to EMR.

Specifically, these regional extension centers will help “providers select the highest-value option, defined as that which offers the most favorable cost of ownership and operation, including both the initial acquisition of technology, cost and implementation, and ongoing maintenance and predictable needed upgrades over time.”

However, there is no requirement that health care providers use the regional extension centers unless they need help implementing an EMR.

HITECH Act stimulusQualifying for HITECT Act Incentives

The most important requirements for qualifying for HITECH Act incentives for EMR adoption are the proper selection of an EMR system and understanding “meaningful use”.

There are a total of 25 meaningful use criteria, and health care providers must demonstrate 20 out of those 25. Fifteen criteria are pre-determined by the HITECH Act, and out of the final ten, you must choose five. The criteria are measured in three stages over five years.

The first stage of HITECH Act requires that you use a certified EMR system and document set percentages of criteria electronically.

You will also be required to use the reminders and warnings systems that certified EMR systems have, share patient information, and report public health information and quality measures.

The second state of HITECH Act requires that you also send and receive lab results and other information using the EMR.

The third stage of HITECH Act requires that you also enroll patients using public health records, access patient data, improve population health, and report on national high priority conditions. Other criteria may be added in the future.

Medical Management: Defined

Medical Management: Defined

Medical management in today’s world is not as simple as it was decades ago. Many practitioners believe they need to extend their education in order to properly manage their clinic. Nitin Chhoda defines medical management practice in the 21st century.

medical management definitionClinicians and other healthcare practice management professionals spend a lot of time getting a thorough education. Unfortunately, their medical knowledge is not supplemented with quite enough business and medical management study.

Private Practice Trends

Some clinicians opt to get an additional degree in business or medical management so they can comfortably run a private practice. However, that is the exception and not the rule.

There has been a recent trend in private practices where clinicians are finding themselves in financial trouble due to mismanagement of expenses, billing, and health insurance companies refusing to pay for the provided care.

In some ways, the problems of private practice physicians in medical management are not their own fault at all. Insurance companies change their policies frequently, and what was billable one week may not be billable the next.

Additional Education

In response, new degrees and a new career path have been forged so clinicians or their staff can be educated about dealing with the particular challenges of running a medical practice. A medical manager is also often called the healthcare administrator, health services manager, or healthcare executive.

For those interested in medical management careers, you must complete at least a bachelor’s degree in business or a related field, and a master’s degree is highly recommended. The Bureau of Labor Statistics estimates that medical management is growing more rapidly than many other fields due to projections of an increase in demand for medical services over the next decade.

Medical management combines strategy, information management, and leadership for building and managing a successful health care practice.

Components

One of the major components of being able to manage a medical practice is having an understanding of the laws and requirements that health care providers must adhere to, such as HIPAA and the HITECH Act.

medical management definedClinicians are usually concerned with being able to do their job and take care of their patients as best they can.

What a medical management professional can bring to a private practice should include everything else, from understanding how to implement an EMR and EHR system to reporting to government agencies and ensuring that the practice is eligible for tax breaks and HITECH Act incentives.

The health care industry is changing rapidly and clinicians who run a private practice are starting to pay for inattention to administrative and management duties which they do not really have the time to handle.

There are medical management systems that attempt to streamline the way that medical clinics handle administrative tasks, such as billing, scheduling, and health insurance filing.

In fact, most EMR systems are equipped to handle medical management tasks as well as medical records. EMR and EHR systems will include scheduling and billing organization and reminders so that the clinic can be more efficient.

They can also ensure that the proper paperwork is filed for Medicare, Medicaid, and health insurance companies. Claims are often rejected due to illegibility or errors in the paperwork, and EMRs attempt to do away with those kinds of mistakes and rejections.

Health Care Management Overview

Health Care Management Overview

EMR reports can help assist management on deciding whether or not to add more staff. Nitin Chhoda shows managers how EMR can help uncover issues by providing reports based on the needs of the physical therapy practice.

health care management overviewWe don’t tend to think of health care practice management as all that different from any other kind of management.

But it turns out that health care management has to adapt and change policies more quickly than almost any other field.

The business side of running a practice involves a complex billing structure, high regulation, and constant updates.

Health Care Management at its Most Basic 

The most basic definition of health care management can be summed up as the role an office manager plays in a health care practice. An office manager must be aware of the tasks of every staff member; they should be able to re-assign tasks or jobs as necessary.

Often it is the health care management that keeps a practice running smoothly. A health care manager may simply be the person in the office who does not see patients or handle a easy-to-define work load, simply so that when problems arise, there is someone to take care of things.

Today, the health care management role has changed to include monitoring efficiency and making administrative changes. With the introduction of electronic medical records, electronic health records, and technology that can track financial indicators, improving efficiency is not only possible, it has been made much more simple.

Health care management is often in charge of deciding what kind of technology to invest in. Increasingly, this means conducting analysis on current systems and workflows.

The Future of Health Care Management

Health care management is not only changing in the way tasks are delegated, but it is also experiencing the same growth as every other aspect of health care. The health care industry is rapidly approaching a level of demand that has never been seen before, thanks to the baby boomers.

This means demand for skilled employees is going up, too. This is true of certified positions such as x-ray technicians and ultrasound tech, but it is also true for management positions.

As the industry becomes more and more streamlined and efficient due to technology, each added employee turns into a significant benefit to the practice. If demand for services is overwhelming, then the only way to increase capacity is to hire more staff. Health care managers have to analyze the benefit of added staff and then manage the integration of new team members.

health care management outline

Technology is Changing Everything

For health care management programs, technology improvements are both a blessing and a curse.

On the one hand, office managers have to be adaptive, tech savvy, and they have to know how to implement software improvements. On the other hand, the job is changing so fast that it can be hard to know what it means to be hired as the office manager.

With EMRs tracking the number of cancelled appointments that never get rescheduled as well as statistics on referrals and number of visits per patient, health care management is turning into a more technical job. Drawing up reports on efficiency can show health care management how much work needs to be done to reach the goals of the practice.

Health Care Practice Management Present and Future

Health Care Practice Management Present and Future

Nitin Chhoda shares the state of health care practice management from the past and how it will affect the future. He shows how the role of management and its staff are evolving as technology enters the physical therapy business.

health care practice management futureEven though the tasks assigned to health care practice management staff have been around for as long as hospitals have existed, the job of health care administrators is relatively new and is constantly changing.

Handling medical records and medical billing is a big job. For very small practices, these jobs used to be the tasks of the health care practice management, usually in the form of an office manager.

But today, health care practice management involves so much more, and tasks like medical billing and coding are handled by specialists.

The current role of the health care practice management staff involves a lot more analysis and efficiency management than ever before, largely due to changes and improvements in technology.

The role of electronic medical records (EMR) in this change cannot be emphasized enough. Electronic health care practice management technology has allowed health care management to take advantage of data that was previously too time consuming to extract.

Health Care Management Focuses on Patients

Of course, all these technological improvements might lead health care practice management consulting professionals to spend more time with charts and graphs than dealing with patient concerns. But that is not entirely the case. In fact, analyzing performance of the clinic will serve two purposes.

Firstly, identifying problems with efficiency will provide many advantages to the doctors, nurses, clinicians, and entire staff of a hospital or practice. Many health care practice management professionals will be quick to look for ways to save money, which is another advantage of EMRs and using the technology that is available today. But most of the changes that help the practice’s bottom line have other benefits, too.

The second purpose of looking for inefficiencies by using data on outcomes, re-scheduling rates, and visits per patient is to identify where patients can be better served. This is the tangible benefit that technology can bring when used the right way.

Number of Patient Visits

As an example, imagine that some clinicians only see a patient three times before the patient can go back to life as usual but other clinicians spend at least five visits with each patient.

healthcare practice management presentUsually, in a busy office, you would never even notice a pattern of health care practice management like that.

Clinicians tend to know just how often they need to see patients, based on past experiences and what they were taught.

But if you could see that patients with the same complaint were given a more effective treatment or series of treatments, you could find out what it is that efficient clinician is doing.

Health Care Practice Management, a Delicate Balance

It’s easy enough to see how this kind of information could be misused. And it is likely that we’ll see plenty of cases of disgruntled staff members who are frustrated by statistical analysis and being treated as if they aren’t doing a good job.

Health care practice management in the future is going to be more and more a job focused on efficiency. But there are important human elements that must always be kept in mind so a practice is really running the best it can. Unhappy staff are not the way to make things better.

Health Care Management and Medical Billing Relationships

Health Care Management and Medical Billing Relationships

The relationships between the healthcare management and medical billers are important. It involves the whole process of physical therapy billing.

Nitin Chhoda reveals certain areas where healthcare management and medical billers should support each other for the success of the practice.

health care management and billing relationshipsDepending on your first hand experience with medical billing, it may be completely obvious that health care management and medical billing are very closely integrated.

However, many health care practice management professionals who have no experience in medical billing can cause problems for medical billers if they do not educate themselves on the relationship between the two.

Small Practice Medical Billing

In a small practice, it’s very likely that the medical billing will either be hired out to a separate company, or that it will be handled by the health care management staff.

These days it is easier to both hire out as well as accomplish medical billing jobs in-house as part of a position with other responsibilities. But this can cause a lot of problems when that single staff member starts to get overwhelmed.

Medical billing is the most important part of running a medical practice, besides actually treating patients. Health care management involves being able to detect the signs of an overwhelmed medical biller before it causes serious problems. Everyone in the office relies on the medical biller to bring in the payments that keep the practice running.

Health Care Management Indicators

There are a number of indicators which may tell health care management that the medical biller needs more support or more time to do their job correctly. Sometimes changes in workflow can bring efficiency up, but often it is more a problem of being overworked than anything else.

Health care managers who don’t realize how much time it takes to complete the medical billing in the way it should be handled are likely to overwhelm their staff unknowingly.

health care management relationshipsOne way that health care management can identify a problem is by looking at rejections and denials from insurance companies.

This is a tough indicator, because the average rejection and denial rate is about 50% of claims. However, with an advanced EMR you can get more detailed information.

Why has a claim been rejected? How often are rejections and denials due to clerical error, time restriction problems, or incorrect medical coding and health care management? These are the kinds of errors that occur when the medical biller doesn’t have the time to review their work before submitting claims.

Aging Reports

Another indicator are accounts receivable aging reports. Aging reports will tell you how long it takes for claims to be paid. It can also tell you whether or not medical billing and health care management staff is taking the time to review the accounts receivable aging reports regularly enough.

Sometimes payments are delayed or even overlooked because the claim has been sent, but was never received by the insurance company.

Sometimes the rejection or denial is sent incorrectly and the practice will have no way of knowing that this is what happened. Unless someone runs an aging report and checks with the insurance company to determine the status of the claim.

Medical billing involves a lot of duplicate work and communication. Health care management principles can ensure that this work is done correctly by giving medical billers the time to do their job.

Practice Management and Its Fundamentals

Practice Management and Its Fundamentals

Nitin Chhoda shares the basic fundamentals of having an effective practice management that will help increase productivity and efficiency within a practice.

practice management fundamentalsHealthcare practice management is often a delicate balance between the human side of an efficiency equation and the problems or benefits related to technology.

For some practices, the introduction of the latest EMR technology is a difficult and frustrating experience.

For other practices, implementation can go smoothly and an EMR will start to improve efficiency right from the beginning. How can you determine that technology will actually benefit your practice? Good practice management will find out what the goals of the practice are before considering any new technology.

Common Reasons for Technology Improvements

Most practice management professionals know that technology is the way to greater efficiency. Communication via email is considerably more efficient than mailing a letter.

You would never consider going back to paper communication when email is an option, right? That is how most practice management professionals feel about using EMRs and practice management technology once they have implemented and adjusted to the changes.

However, at the start of the process, there will always be pushback. There are high start-up costs, and to answer the questions about whether or not EMRs are worthwhile, you will certainly need to ascertain that there are efficiency problems in the practice that an EMR can solve.

Email Investment

But think about investing in email. Email requires significant start-up investments, including computers, high speed internet, and software. Implementing an EMR may sound expensive, but the benefits almost always outweigh those initial costs.

What are the benefits? Most clinics find that the reduction in paper and the improved speed and quality of communication is the first thing they notice.

Additionally, for medical billing and accurate medical coding, an EMR can represent higher efficiency and better rates of accepted claims. In fact, the number one reason for implementing better technology, from a practice management perspective, is to reduce rejected or denied claims.


Ensuring That Technology Works for Staff

Of course, anyone in practice management will also want to think about how these changes will affect the staff. The idea behind technology improvements is to improve efficiency. But if the staff is not well enough prepared or if they do not find the EMR to be useful or intuitive to use, the outcome will not be improved efficiency.

Similarly, technology improvements can allow for incredible benefits for practice management reporting. Good practice management should include a reporting and review system so that you can focus on changing the things that are not working.

But if the staff doesn’t understand why they are adding more tasks to their day, they may not enter information correctly, leading to useless or even harmful report results.

practice managementAdditionally, there should be an integration of staff needs and goals into the overall goals of the practice management solutions.

Effective practice management will include human resources principles into the overall strategy of improved efficiency.

Rather than assuming staff will figure it out eventually, make sure they are an integral part of the EMR or practice management technology implementation process.

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