May is Hepatitis Awareness Month, and SuccessEHS is offering clients a great way to celebrate.
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May is Hepatitis Awareness Month, and May 19 is national Hepatitis Testing Day in the U.S. These initiatives aim to promote awareness about the hidden epidemic of viral hepatitis and encourage at-risk populations to get tested.
According to the Centers for Disease Control and Prevention (CDC), millions of Americans have viral hepatitis and an estimated 72,000 become infected each year. This hidden epidemic particularly impacts a specific demographic of the U.S. population. Today, baby boomers represent approximately 25 percent of the US population, yet they account for roughly 75 percent of all Hepatitis C virus (HCV) infections. Between 50 and 75 percent of these 4 million people are unaware that they are infected, and as a result, they are not being screened or treated. Therefore, despite the availability of new therapies to reduce HCV-related morbidity and mortality, chronic liver disease is the still the leading cause of chronic infection-related death and the fastest rising cause of cancer-related death in the United States.
On Aug. 16, 2012, the CDC issued a new guideline recommending all Americans of the baby boomer generation receive a one-time HCV screening. According to the CDC, as many as one in 30 from this identified generation have been infected with HCV, yet most are unaware. HCV can inflict serious damage on the human liver, causing death by cirrhosis or liver cancer. New therapies are available for HCV treatment, but management of the baby boomer population for screening and treatment can be challenging without the right health IT.
Screening a patient population involves a simple blood test. The challenge lay in identifying patients and applying the evidence-based guideline into practice. EHRs that incorporate clinical decision support tools for population health management can mean the difference between successful treatment of an HCV patient or high morbidity and mortality rates.
For SuccessEHS clients, Hepatitis Awareness Month is the perfect time to take advantage of a complimentary CME opportunity covering the CDC’s recommendations for identification of chronic HCV infection. Physicians can receive one American Medical Association (AMA) Physician’s Recognition Award (PRA) Category 1 Credit™ through this complimentary online opportunity offered to SuccessEHS clients by SuccessEHS and Medscape Education.
It's simple and fast for SuccessEHS clients to participate—click here for a direct link. If you are not yet a member of Medscape, join today (membership is free) to take advantage of this and future opportunities to earn free CMEs.
“Nurses - one of the few blessings of being ill.” - Sara Moss-Wolfe
May 6-12, 2013 marks International Nurses Week. The week is spent honoring the men and women around the world that work tirelessly for the wellness and care of their patients. At SuccessEHS, we know that nurses are the back-bone of patient-centered care delivery.
In honor of nurses' contribution to our country's health, we put together an infographic that highlights their significant impact on health care delivery.
Eligible professionals can earn incentives, avoid penalties and position for success under value-based reimbursement by participating in the Physician Quality Reporting System (PQRS). Learn how to start participating in PQRS reporting in just four steps.
Your "Get out of Jail Free" Card for PQRS Penalties
By now, you’ve probably heard of the Physician Quality Reporting System (PQRS), CMS’ reporting program that collects data on quality measures for certain covered Medicare services. Eligible professionals who successfully report quality measures in 2013 and 2014 are eligible to earn an incentive payment equal to 0.5 percent of their estimated total allowed charges for covered Medicare Part B Physician Fee Schedule (PFS) services provided during the year-long reporting period.
Those who do not participate in PQRS will soon face a 1.5 percent penalty starting in 2015 that will grow to 2 percent in 2016 and subsequent years. The 2015 penalty will be based on the 2013 reporting period. Yes, you read that correctly—those who do not participate or take steps to avoid the PQRS penalty this year will face a 1.5 percent payment adjustment in 2015.
Exacerbating non-participation payment reductions, these penalties are cumulative with penalties for other CMS programs, such as Meaningful Use. For example, providers that fail to participate in PQRS in 2013 and also fail to successfully participate in the Medicare EHR Incentive Program will be subject to both payment adjustments in 2015, for a total Medicare payment adjustment of 2.5 percent. That total percentage would escalate to 4 percent in 2016 and 5 percent in 2017.
PQRS Penalty Avoidance
So, if you haven’t started participating in PQRS this year, are you just out of luck? Before you start scrambling to figure out how much that 1.5 percent penalty is going to hurt, note that there is a way to avoid this penalty for those who choose not to pursue PQRS incentives. PQRS penalty avoidance for 2015 is detailed in 2013 Medicare Physician Fee Schedule Final Rule, which was published in the Federal Register in Nov. 2012. According to CMS, “participation” simply means reporting at least one measure on one patient. Thus, you can avoid the 2015 penalty—though not earn incentives—by reporting one measure on one patient through your claims. Note that while this one measure is not subject to reporting threshold requirements, you still cannot have a zero value for the numerator or denominator.
Need a model of a measure you can report to avoid the 2015 penalty? Follow the example below:
- Report PQRS 130 (documentation of current medications in the record) via a claim on your next Medicare PFS patient.
- Patients 18+ for which EP attests to documenting a list of current meds to the best of his/her knowledge and ability, including ALL prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain medication name, dosage, frequency and route of administration.
- Add CPT G8427 to the next Medicare PFS office visit claim when medications are documented.
- Charge $0.01 and link to any ICD-9 codes, to avoid barriers with the PQRS code being received due to system configuration such as not billing “zero charge” claims.
- Look for remit code N365 line-item rejection, which is your indicator that the provider’s PQRS participation counted.
You are wise to put PQRS penalty avoidance in place as a safety net regardless of your goals to pursue the PQRS incentives. In this way, you can be assured that you will not be penalized if your PQRS reporting is unsuccessful.
PQRS Reporting Still Your Best Bet
Even though you should work to avoid the 2015 penalty by submitting one measure on one patient via claims, reporting PQRS measures is still the best positioning a provider can have for a number of reasons.
Those EPs who are also pursuing Meaningful Use can essentially earn double credit for their data under the PQRS Medicare EHR Incentive Pilot program. By participating in this program, an EP can submit data on the same sample of beneficiaries through their ONC-certified EHR system to meet the Meaningful Use clinical quality measure requirement as well as achieving the requirements for satisfactory reporting under PQRS.
Beyond incentives, participation in PQRS will impact future Medicare reimbursement. Required under the Affordable Care Act (ACA), CMS’ value-based payment modifier (VBPM) program is set to begin in 2015 for groups of 100 or more PQRS EPs based upon a 2013 performance period. By 2017, all physicians, regardless of their group size, will be subject to the VBPM based on a performance period of 2015. The modifier will be a composite of both the cost and quality of care delivered by a provider and will be publicly posted on the CMS Physician Compare website. Reporting of PQRS measures will determine the quality aspect of the VPBM, and thus, will directly impact its application. Private payers are also getting on board with value-based purchasing by tying reimbursement to quality. As such, participation in PQRS offers strong positioning for success under these new reimbursement models.
Taken together, the incentives, penalties, alignment with other CMS’ initiatives and positioning for value-based reimbursement make PQRS participation well worth your time.
Tips for Getting the Most Value from Your EHR
Adopting EHR technology is a significant investment. Most practices spend a great deal of time and resources selecting and implementing an EHR in hopes of gaining returns on that investment in the forms of enhanced care, increased efficiency and improved financial performance. But simply adopting the technology is not enough to generate the most return on investment. If you aren’t taking advantage of the advanced functionalities and opportunities enabled by your EHR, you aren’t getting the highest possible return on your investment. Below are tips for maximizing the ROI of your EHR:
- Leverage interfaces. Interfaces can help you maximize return on your investment in EHR technology. Lab interfaces, for example, can help practices streamline resource-intensive lab processes and improve care delivery, resulting in significant savings.
- Use your patient portal (if offered inherently). If your EHR vendor offers an inherent patient portal, take advantage of this powerful tool. In addition to facilitating patient engagement, patient portals can generate efficiencies for your clinic. You can use portals to provide necessary forms, questionnaires and paperwork to patients before visits, saving time in the waiting room. Through patient portals, patients can request medication refills and appointments and ask medical questions online, without calling your practice, helping clinic staff streamline workflows.
- Using it to earn incentives. Are you using your certified EHR to earn incentives through the Meaningful Use programs? If you have an EHR qualified by CMS for EHR Direct reporting, are you using it to earn incentives and avoid penalties through the Physician Quality Reporting System? Participating in these initiatives will not only help you earn incentives, but will also help you avoid future penalties and position your practice for coming value-based reimbursement.
- Launch population health management initiatives. Using your EHR to monitor and manage the health of patient populations generates significant return on your investment in health IT in terms of quality and outcomes improvements. These improvements will also have an impact on your reimbursement under value-based purchasing programs, such as CMS’ value-based modifier payment program.
- Start participating in health information exchange (HIE). In addition to improving quality of care, HIE holds significant potential to lower health care costs and increase physician efficiency.
- Appointment reminders. Many EHRs include automated appointment reminder tools. Using these can help reduce no-shows, generating a significant return for your practice.
- Make sure you are using the most up-to-date version of the software. EHR vendors typically release several updates each year. These updates include new and improved features, fixes to bugs and more. Failing to update your version means you are missing out on these improved features.
- Take advantage of free resources from your EHR partner. If you have a strong EHR partner, they will likely provide you with free resources, such as white papers, webinars and tips and tricks, to help you optimize EHR use.
The term “patient-centered care” is becoming an industry buzzword. More and more practices and health care organizations claim to deliver patient-centered care. As a blog post on the Health Care Blog put it, “It is as natural for doctors, hospitals, health plans and others to aggressively affirm their ‘patient-centeredness’ as it is for politicians to loudly proclaim their fealty to the hard-working American middle class.”
But what does it really mean to provide patient-centered care? It’s not just a mission statement. It’s not an expression meant to convey that you care about patients. It’s not renovating the waiting room to make it look more like a spa so patients feel relaxed. Much more than an attitude, providing patient-centered care means going beyond traditional patient care to implement fundamental changes designed to empower patients to be active, informed participants in managing their own health care. And more than a marketing ploy to attract more patients, patient-centered care will have real implications for provider reimbursement under value-based purchasing. Patient experience, patient satisfaction and clinical quality data will influence provider reimbursement under CMS’ value-based modifier payment program and Physician Compare website.
Beyond making patient-centered care a mission statement, patient-centered practices implement fundamental changes in care delivery, including:
- Using health IT to track patient compliance with accepted evidence-based guidelines for preventive care and schedule preventive services for patients
- Using patient registries to monitor and manage the health of patients with chronic diseases
- Expanding patient access to care and providers through open access scheduling and expanded hours
- Strengthening communication between patients, providers and staff with the help of electronic tools, such as patient portals and appointment reminder tools
- Closing gaps in care and improving care transitions
- Implementing strategies designed to increase patient engagement and encourage patients to become more active participants in their own health care
- Developing personalized care plans tailored to each patient’s unique needs, and incorporating patient preferences and values into treatment plans and decisions
All of these things require additional time and effort on the part of practices and physicians. Such demands on provider attention can be difficult given how limited and precious this time is today. Because of the additional investment of time and effort, providing patient-centered care may not seem feasible for some providers. However, having the right health IT partner can help address this challenge and make it possible for you to deliver patient-centered care by taking some of the burden off your practice and creating efficiencies.
Want to learn more about patient-centered care? Get tips for providing effective patient-centered care and learn more about how policy supports patient-centered care.
Practical Tips for Mining Your EHR Data
If you have an EHR and practice management system, you have a very valuable asset at your fingertips: patient level health data. Mining your EHR and practice management data will give you insights that can drive improvements in practice performance and clinical quality. Below are a few practical examples of ways your organization can use the data you already have to improve financial and clinical practice performance and position for coming value-based reimbursement.
- What opportunities exist to improve quality? For instance, generate a list of patients with diabetes. How many of those patients who are poorly controlled have had A1c’s in the last three months? How many have had foot exams in the last year? Are there opportunities to improve these rates by sending emails or letters to patients letting them know they are overdue for necessary tests and exams?
- Which treatment protocols are most effective in terms of outcomes? Compare patient lists with pre- and post-treatment data to document successful patterns of care. This type of data analysis will become even more important as the health care industry transitions from fee-for-service to value-based reimbursement.
- How productive are your physicians? The data in your EHR and practice management system can shed light on which of your physicians are most productive and how many visits or procedures are performed per hour.
- How do most patients come to your practice? By analyzing the reasons patients choose your practice, you gain insights that help you more effectively market your practice.
- How can you reduce no-shows? Look at your data to see when no-shows spike and identify common trends in no-shows to uncover underlying problems. If you are not doing so already, create timing codes that specify when the appointment was cancelled, rescheduled or missed so you can use this data to get a better idea of what drives no-shows at your practice and how you can reduce them.
- What opportunities exist to increase revenue? For instance, Medicare patients are eligible for a number of preventive services, including the Initial Preventive Physical exam and the annual Medicare Wellness Visit. By generating a list of your Medicare patients who have not had these visits, you can contact these patients and schedule their annual visit. According to the American Academy of Family Physicians, the average reimbursement for the initial AWV (G0438) is $166 and the average reimbursement for the subsequent AWV (G0439) is approximately $111. Medicare also covers a number of services, screenings, tests and treatments that may be provided during the AWV or another E&M encounter. With these revenue opportunities in mind, using your data to target Medicare patients who need the IPPE or AWV can not only improve quality of care, but also generate a significant recurring revenue stream for your practice.
For SuccessEHS clients, turning data into quality results is fast and simple thanks to SuccessEHS’s powerful, easy-to-use ad-hoc data mining tools and pre-designed digital dashboard. Unlike many other EHR users, SuccessEHS clients don’t need to have in-depth technical skills in order to access their data, key performance metrics and detailed analytics; they can extract their valuable data without any knowledge of database language or structure or use SuccessEHS developed technology that pushes trends to your attention.
If you are in the process of selecting an EHR or replacing an underperforming EHR, be sure to consider the system’s reporting and data mining abilities. Ideally, your EHR and practice management system should enable you to:
- Aggregate operational, clinical and/or financial information in a single report
- Drag-and-drop to build SQL database queries (custom reports) without having to be a programmer
- Perform data mining in real time from your live database
- Save your custom reports for use again and again, as you deem appropriate
- Drill down into a single report or multiple pages of data
- Use push-technology to have the data you need your fingertips through a digital dashboard, complete with drill-through capabilities for the underlying metrics
- Quickly access reporting packages pre-designed to meet key health care reform initiatives such as Meaningful Use, UDS Reporting, Clinical Quality Measures, Ryan White Services Reporting, Patient-Centered Medical Home and other strategic programs.
Sure you've heard the term, but what does patient-centered care really mean? Learn about patient-centered care delivery models, challenges and benefits of providing patient-centered care and how health care policy supports patient-centered care.
We’ve waded through a sea of headlines to bring you the most important health IT headlines. Enjoy a quick review of the top health IT news in our weekly roundup.
EHR Vendors To Face $1M In Government Fees
EHR vendors could have to pay an estimated $1 million in fees to help offset the cost of ONC's certification and standards activities. The proposed fees were released as a part of ONC's budget proposal released Wednesday. The ONC derives its funding from a $2 billion appropriation from the 2009 American Recovery and Reinvestment Act that is set to expire at the end of the 2013 fiscal year. The budget proposal statement claims the vendor fees are necessary to continue the ONC’s EHR certification program and other activities.
Ophthalmologists Take Fight Against Medicare Cuts To Capitol Hill
A group of almost 400 ophthalmologists took to Capitol Hill to express concern over the 2 percent cut to Medicare payments due to the sequester. The physicians backed by the American Academy of Ophthalmologists (AAO) say that cuts to Medicare reimbursements caused by the sequester could cause health risks to their aging patients, who are more prone to have common eye problems. /p>
Study: Free-Text Clinical Notes Analysis Can Predict Adverse Drug Reactions
A new study conducted by Stanford University found that analyzing unstructured clinical data in patients' electronic health records can predict adverse drug reactions. The study published in the Journal Clinical Pharmacology & Therapeutic claims that the use of free-text components of an EHR “opens up new opportunities for leveraging observational data."
Gov. Announces $54M To Help Uninsured Navigate Insurance Marketplace
The Obama administration announced that they will allocate $54 million in grants to help states prepare for the new online health insurance marketplaces. The funds will be given to community groups in 33 states and used to hire and train people to help the uninsured shop the new exchanges, for which enrollment begins Oct. 1.
Study: 37 Percent Of Physicians Believe Clinical Informatics Skills Most Important To Achieving IT Success
According to a report from PricewaterhouseCoopers' Health Research Institute, 37 percent of healthcare professionals believe that clinical informatics skills are the most important factor in helping their organization achieve their IT goals. Another 28 percent listed systems and data integration skills, 10 percent listed technology and architecture support skills and 9 percent thought that data statistics and analytics skills were the most essential in helping their organization achieve their IT goals.
Thanks to Meaningful Use requirements, adoption of patient portals has increased dramatically over the past few years. According to a new survey by AmericanEHR Partners, the number of practices with a patient portal increased from 20 percent in 2010 to 40 percent in 2012.
But while providers are rapidly adopting patient portal technology, many practices lament that their patients are not embracing the technology as quickly as they would like. According to a CMS report from October 2012, 70 percent of physicians who achieved Stage 1 exercised an exclusion clause to the core requirement that they provide an electronic copy of patient records within three days to 50 percent of patients who request them. These doctors were not able to meet the requirement simply because none of their patients asked for their health records. This element of patient engagement becomes even more critical under Meaningful Use in 2014 when this Stage 1 core measure and the menu measure of timely electronic access to health information get replaced with a new measure of having 50 percent of the eligible provider’s (EP’s) patients able to view online, download and transfer their information within 4 days of being available to the EP. Additionally, the replacement measure requires that 5 percent of the EP’s patient actually go online an access their health information.
The CMS report underscores a known problem with patient engagement initiatives: patients aren’t taking the bait. The CMS policymaking emphasizes the expectation that providers must overcome the barriers to patient adoption. While providers are incentivized to adopt health IT tools that enable greater patient engagement, patients have no such financial motivation to use these tools. Despite a new focus on patient engagement strategies, many health care providers are finding it difficult to get patients to become active participants in their own health care.
With the coming shift to value-based purchasing, getting patients engaged could ultimately affect your bottom line. So what can you do to get your patients to use your patient portal? Below are tips for marketing your patient portal to promote patient adoption and use of the portal:
- Provide informational handouts on how to access and use the portal. Place this information at the front desk and in the waiting room so patients can read it while they wait for appointments. Be sure to let them know what’s in it for them—in addition to providing instructions for accessing and using the portal, the handout should highlight ways the portal benefits patients.
- Place a computer kiosk or tablet in the waiting room where patients can register to use the portal and then use it to complete necessary registration forms such as demographic and past medical history information. This way, patients are not only introduced to the portal, but actually have the opportunity to become familiar with it in a setting where staff can provide instruction as needed.
- Send postcards to all active patients to introduce the portal and encourage patients to use it to request their next appointment or medication refill. This will help increase awareness of the portal and encourage patients to use it the next time they need to interact with your practice.
- Add a tag line to common forms of patient communication, such as appointment cards, the bottom of statements, eNewsletters, etc. Use a common message such as, “tired of playing phone tag? Ask about our patient portal.” This is another way to promote your clinic brand, as well.
- Change your practice’s on-hold music to include a message introducing the patient portal. Let patients know that by using the portal, they could likely get what they need—be it an appointment, a medication refill or an answer to a medical question—online without waiting on hold.
- Prominently display a link to the patient portal on your practice’s website and in the office. For example, you could display the link on a window cling at the check-in window in your practice.
- Make the portal your practice’s preferred way of sending information to patients. In order to drive home the message that patients should be accessing the portal, your practice should be communicating that it is the preferred place to send information, forms, etc. For instance, have providers tell patients that lab results can be accessed online when ordering tests. Instruct staff to tell patients that functions are available online when they call for something that could be done through the portal, such as requesting a medication refill.