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News 12/20/17

December 21, 2017 News No Comments

Top News

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The FCC identifies nearly 1 million homes and small businesses across largely rural areas of the continental US that are eligible for up to $2 billion for broadband deployment over the next 10 years as part of its Connect America Fund. That money will be awarded to those companies who bid to install the services at lowest cost. “Closing the digital divide is my number one priority,” says FCC Chairman Ajit Pai (who is still suffering fall out from pushing through repeal of net neutrality), “and through this innovative Connect America Fund auction, we are poised to take the next big step in reaching that goal. In rural America, broadband opens the doors of opportunity by connecting remote communities to global markets, jobs, education, healthcare and information.”


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information.


Announcements and Implementations

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OpenEMR announces availability of its open source Cloud Express EHR on the AWS Marketplace.

B Golden Care Services (TX) selects chronic care management technology from Reliq Health Technologies.


Acquisitions, Funding, Business, and Stock

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Veriheal (fka OnePath Medical) will offer online appointment scheduling for its three new medical marijuana offices in Montana. The company, which also has locations in Maryland, New York, and Pennsylvania, also offers a white-label telemedicine solution for providers in telemedicine-friendly states looking to connect patients with appropriate medical marijuana treatment virtually.

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PM and EHR vendor ICoreConnect acquires coding and documentation improvement company ICDLogic for an undisclosed sum. This marks the second acquisition for ICoreConnect; it bought IPenMD Solution in 2013 – the same year ICDLogic opened for business.


Government and Politics

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As expected, Congress passes the tax reform bill along party lines, including a repeal of the ACA individual mandate. Commonwealth Fund President and former National Coordinator David Blumenthal, MD has penned a summary of the bill’s healthcare implications in the Harvard Business Review. I assume it’s a far easier read than attempting to digest the House and Senate versions of the final bill.


Telemedicine

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Just in time for reading over the holiday break, the Center for Connected Health publishes its annual review of state-based telemedicine legislation. Thirty-five states (seven more than 2016), some with multiple entries, are featured.


Research and Innovation

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The American Academy of Pediatrics selects Physician’s Computer Company to assist with its research on childhood obesity. PCC has already recruited 18 pediatric practices for the two-year study, and will also manage data extraction and sharing of health data between the practices and the AAP. “So much of what we have to deliver to pediatricians is about a government or insurance requirement,” says PCC Director of Pediatric Solutions Chip Hart, “so we’re delighted to be able to focus on the patients for once. We were also really impressed with our clients’ reaction to this opportunity – they have to do a lot of free work, but they do it because they are pediatricians."


Other

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Local public radio looks at the way the delivery of mental healthcare is being reimagined in Austin, TX. Travis County’s mental health agency, for example, has redesigned its bipolar disorder clinic to be more patient-centric. After checking in at the front desk, patients forego the traditional waiting room and are instead escorted to a private, almost apartment-like room equipped with chairs, a couch, and television. Staff come to them instead of patients being shuffled around to different exam rooms. The Austin-Travis County Integral Care clinic has partnered with Dell Medical School on the redesign experiment, which the two groups hope will ultimately lead to more mental health services being provided outside of hospitals.

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In her letter to Santa, American Council of Science and Health Director of Medicine Jamie Wells, MD laments the lack of truth in medical advertising, pointing to Theranos, the over-utilization (and sometimes disingenuous) use of the word “provider,” the hype around value-based care, the debacle of EHRs, and the “fix” of interoperability: “Now, interoperability is the latest buzzword,” she explains. “Don’t get it twisted, this is not new, nor is it some breakthrough. It is an attempted fix to the nightmare of EMRs without being honest enough to acknowledge that EMRs were supposed to possess it in the first place. While we are at it, proclaim in their current form that they are little more than glorified billing platforms.”


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News 12/20/17

December 20, 2017 News No Comments

Top News

The FCC identifies  nearly 1 million homes and small businesses across largely rural areas of the continental US that are eligible for up to $2 billion for broadband deployment over the next 10 years as part of its Connect America Fund. That money will be awarded to those companies who bid to install the services at lowest cost. “Closing the digital divide is my number one priority,” says FCC Chairman Ajit Pai (who is still suffering fall out from pushing through repeal of net neutrality), “and through this innovative Connect America Fund auction, we are poised to take the next big step in reaching that goal. In rural America, broadband opens the doors of opportunity by connecting remote communities to global markets, jobs, education, healthcare and information.”


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information.


Announcements and Implementations

OpenEMR announces availability of its open source Cloud Express EHR on the AWS Marketplace.

B Golden Care Services (TX) selects chronic care management technology from Reliq Health Technologies.


Acquisitions, Funding, Business, and Stock

Veriheal (fka OnePath Medical) will offer online appointment scheduling for its three new medical marijuana offices in Montana. The company, which also has locations in Maryland, New York, and Pennsylvania, also offers a white-label telemedicine solution for providers in telemedicine-friendly states looking to connect patients with appropriate medical marijuana treatment virtually.

PM and EHR vendor ICoreConnect acquires coding and documentation improvement company ICDLogic for an undisclosed sum. This marks the second acquisition for ICoreConnect; it bought IPenMD Solution in 2013 – the same year ICDLogic opened for business.


Government and Politics

As expected, Congress passes the tax reform bill along party lines, including a repeal of the ACA individual mandate. Commonwealth Fund President and former National Coordinator David Blumenthal, MD has penned a summary of the bill’s healthcare implications in the Harvard Business Review.


Telemedicine

Just in time for reading over the holiday break, the Center for Connected Health publishes its annual review of state-based telemedicine legislation. Thirty-five states (seven more than 2016), some with multiple entries, are featured.


Research and Innovation

The American Academy of Pediatrics selects Physician’s Computer Company to assist with its research on childhood obesity. PCC has already recruited 18 pediatric practices for the two-year study, and will also manage data extraction and sharing of health data between the practices and the AAP. “So much of what we have to deliver to pediatricians is about a government or insurance requirement,” says PCC Director of Pediatric Solutions Chip Hart, “so we’re delighted to be able to focus on the patients for once. We were also really impressed with our clients’ reaction to this opportunity – they have to do a lot of free work, but they do it because they are pediatricians.”


Other

Local public radio looks at the way the delivery of mental healthcare is being reimagined in Austin, TX. Travis County’s mental health agency, for example, has redesigned its bipolar disorder clinic to be more patient-centric. After checking in at the front desk, patients forego the traditional waiting room and are instead escorted to a private, almost apartment-like room equipped with chairs, a couch, and television. Staff come to them instead of patients being shuffled around to different exam rooms. The Austin-Travis County Integral Care clinic has partnered with Dell Medical School on the redesign experiment, which the two groups hope will ultimately lead to more mental health services being provided outside of hospitals.

In her letter to Santa, American Council of Science and Health Director of Medicine Jamie Wells, MD laments the lack of truth in medical advertising, pointing to Theranos, the over-utilization (and sometimes disingenuous) use of the word “provider,” the hype around value-based care, the debacle of EHRs, and the “fix” of interoperability: “Now, interoperability is the latest buzzword,” she explains. “Don’t get it twisted, this is not new, nor is it some breakthrough. It is an attempted fix to the nightmare of EMRs without being honest enough to acknowledge that EMRs were supposed to possess it in the first place. While we are at it, proclaim in their current form that they are little more than glorified billing platforms.”


Sponsor Updates

Blog Posts

Contacts

Jenn, Mr. H, Lorre

News 12/19/17

December 19, 2017 News No Comments

Top News

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Technology-enabled physician ACO company Aledade raises $23 million in a thus far hush-hush funding round, bringing its total raised to nearly $98 million since launching in 2014.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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ChenMed will expand its primary care services for seniors to four additional cities next year, and welcome back former president Jeffrey Kang, MD as a board member.


Announcements and Implementations

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Chronic disease management technology company Cliexa develops several new behavioral health apps for PCPs and family medicine physicians. The apps, which focus on reproductive health, mental health, and substance abuse, leverage assessment technology from Preventative Technology Solutions.

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Pulse Systems includes real-time billing analytics and enhanced reporting capabilities in the latest version of its PulseCloud EHR/PM/RCM software.

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Northern Ohio Regional Cancer Center selects oncology care coordination technology from Appian360 Healthcare Innovations.

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The Florida Association of ACOs will offer its members patient engagement and management technology from Care Angel, including AI-powered virtual nurse assistant capabilities.


People

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Beth Pausic (Big White Wall) joins InfoMC as VP of clinical solutions.

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Anesthesia and pain management services company PhyMed Healthcare Group hires Stephen Lorenz (Clinicalign) as EVP of operations and strategic development, and Stephen Mason (Managed Care Advisory Group) (not pictured) as VP of operations.

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Health Initiatives Consulting adds Russ Kolski, RN, (Ingham Community Health Centers) as VP of clinical and operational transformation, and Senely Navarrete (SN Health Solutions) as VP of practice transformation.

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Former Acting HHS Secretary and National Coordinator Karen DeSalvo, MD will join Dell Medical School at The University of  Texas at Austin as a professor in the fairly new school’s Primary Care and Value-Based Health Division. Her tenure will include a primary appointment in the school’s Department of Internal Medicine and secondary appointment in the Department of Population Health.


Other

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Two years after a huge natural gas leak, accountant and local activist Andrew Krowne develops an app to help fellow residents of California’s San Fernando Valley report and track symptoms that he believes may be tied to the local underground natural gas storage facility. The Environmental Health Tracker app already has 130 users and 2,000 reported symptoms – data that Krowne hopes will eventually be used to close down the facility.


Contacts

Jenn, Mr. H, Lorre

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From the Consultant’s Corner 12/19/17

Revenue Integrity – A Critical Factor for Revenue Cycle Success

Most healthcare organizations recognize the need for improving the efficiency and effectiveness of their revenue cycle operation. Efficiency refers to reducing the operational costs associated with billing and collections. Staffing and systems are the major expense categories. Effectiveness relates to maximizing cash collections and improving the timeliness of which that cash is collected. Revenue Integrity adds a third dimension to the discussion of revenue cycle performance. Revenue Integrity refers to the thoroughness, timeliness, and accuracy of the charge capture and coding processes.

An effective revenue integrity program ensures that every billable clinical activity is properly captured, coded, and billed in a timely manner. This starts the process by which clinical services are converted into cash.

The benefits of a revenue integrity program include:

  • Reduction in lost or missing charges resulting in enhanced charge volumes.
  • Reduction in charge and claim lag resulting in accelerated cash collections.
  • Improved clean claim rate resulting in reduced costs of collections and accelerated cash collections.

Traditional revenue cycle operations have historically been split between “front-end” or patient access-related activities (i.e. registration, scheduling), and “back-end” billing and A/R management functions. A revenue integrity program incorporates clinical workflow, and the actions and concerns of physicians and nurses into the revenue cycle. Clinical documentation, diagnostic and procedural coding, and the submission of charges are all generated within the clinical workflow, yet performance often appears on back-end revenue cycle reports. The result too often is that accountability falls on the billing office, yet the real performance improvement opportunity rests outside of a billing director’s direct control. Engagement of clinical staff into the overall revenue cycle truly integrates clinical operations and financial performance, assigns accountability to the proper source, and provides appropriate and actionable education to capitalize on improvement opportunities that benefit the entire organization.

As revenue integrity programs have matured, revenue cycle and financial leadership have incorporated new Key Performance Indicators to monitor the integrity of their revenue. These metrics provide a more granular analysis of common measures such as denial rates and A/R days, in order to address performance improvement opportunities directly at their source. Examples of metrics used to measure revenue integrity performance include:

  • Medical Necessity Denial volume and charges.
  • Charge lag and claim lag, and the degree of manual intervention to resolve pre-bill coding and claim edits.
  • Discharge Not Final Billed.
  • Documentation that supports 100 percent of all charges.

As referenced earlier, monitoring these indicators would be a fruitless exercise if physicians and nursing staff were not engaged in the process. Billing managers alone would have minimal ability to reduce medical necessity denials resulting from lacking diagnosis information. Reviewing this information with physicians, informing them of the financial impacts of lacking information, and engaging the EHR teams to optimize clinical documentation tools would be a much more effective approach that benefits all parties, including the patient.

To develop a sustainable revenue integrity program, or to improve the effectiveness of an existing RI program, I recommend the following activities:

  • Define goals, objectives, and scope for the program.
  • Develop a project plan.
  • Track and implement the project plan.
  • Design the organizational chart, with resource requirements.
  • Define roles, skillsets, and workflows within RI.
  • Create relevant RI job descriptions for human resources.
  • Identify and acquire tools needed for the department’s optimal performance; e.g. software coding references, library of coding books.
  • Develop RI workgroups and a steering committee to include key leaders from IT, clinical operations, compliance, RCM, and finance. (Depending on specific objectives, you may want to include RI SME’s and analysts.)
  • Identify and train RI charge capture resources (Charge Guardians) by departments and/or clinical product lines.
  • Develop best practice RI policies and procedures, to be reviewed annually and revised as needed.
  • Define baseline benchmarks and performance indicators to measure and trend performance over time.
  • Develop and implement RI training program content and timelines for RI analysts and auditors.

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Brad Boyd is president of Culbert Healthcare Solutions.


Contacts

Jenn, Mr. H, Lorre

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News 12/18/17

December 18, 2017 News No Comments

Top News

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An Atlanta business paper updates a story it published on Greenway Health’s layoffs last week, clarifying that the EHR vendor is only closing its Atlanta offices but will keep its Carrollton, GA offices open. Five hundred Greenway Revenue Services employees and those with other customer-facing functions will continue their work in Carrollton. The company will also hire another 100 RCM employees for that location in the next few weeks, and is hiring for its Tampa office.

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Not to be deterred by conflicting layoff reports, the company announces top KLAS ratings for ambulatory RCM services among small clinics.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Denver-based house call company DispatchHealth brings its app-initiated services to Las Vegas. The company has raised nearly $35 million since launching as True North Health Navigation in 2013. Co-founders Mark Prather, MD and Kevin Riddleberger both seem to have spent overlapping time at ITriage, a consumer healthcare app acquired by Aetna in 2011.

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Not to be outdone by the mega mergers of their hospital peers, Florida-based Primary Partners and Central Florida Affordable Care merge to form an independent group of 90 PCPs.

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Net Health’s management team will acquire the specialty-focused EHR company alongside financial partners Level Equity and The Carlyle Group. Terms of the deal were not disclosed. Net Health CEO Anthony Sanzo spent 11 years prior heading up TeleTracking Technologies.


Government and Politics

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Texas practices in areas impacted by Hurricane Harvey will not be subject to MIPS penalties thanks to the successful lobbying efforts of the Texas Medical Association.

Per the 21st Century Cures Act, OCR launches several new resources to help providers and patients better understand HIPAA and its role in sharing and protecting a patient’s mental and behavioral health information.


Telemedicine

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An Australian nurse becomes his own patient when he begins experiencing chest pains while manning a telemedicine clinic in the remote area of Coral Bay. After calling an ambulance and prepping his own adrenalin and shock pads, he called in to a physician in Perth using the Emergency Telehealth Service. Bea Scichitano, MD was on her first ER shift when she took the video call. “I think it probably took me a few seconds to cotton on to the fact that he was the nurse and the patient at the same time,” she said, “so that was a bit of a shock.”


Other

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No spoilers please: While I haven’t yet seen The Last Jedi, I am relieved to know that astronauts aboard the International Space Station will receive a digital copy they can watch via laptop or their on-board projector. Fun fact: The ISS has a digital library of over 500 movies (yes, including 2001: A Space Odyssey).

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NHS researchers highlight the need for easy-to-understand patient educational materials when it asks nine year-olds to write up leaflets explaining the before, during, and after of hip surgery. Turns out statements like “Your hip is old and rotten” and “Coca Cola, fries, and chocolate are not allowed before surgery” are easier for patients to understand than the reading proficiency level used to write most patient-facing health pamphlets. Healthcare facilities in the US have also faced their fair share of health literacy miscommunications, with the HHS calling low health literacy levels an ongoing public health priority.

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Bellevue Family Practice (NE) staff members get in the holiday spirit with an office decorating contest. I’d love to highlight more festive office spaces. Email me holiday-themed photos from your or your customer’s practice for inclusion in a post later this week.


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Jenn, Mr. H, Lorre

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