Greenway Health’s blog
July 26, 2016
The telemedicine market is expected to grow more than 50 percent annually through 2018, reaching an anticipated $34 billion by 2020.
That’s a huge opportunity — and for good reason. Both healthcare providers and patients see the potential for telemedicine to improve care. According to a recent Greenway Health survey, 39% of providers and 33% of patients see telemedicine as one of the greatest healthcare opportunities over the next five years.
How, exactly, can telemedicine improve care? Here are just a few ways:
July 21, 2016
The Comprehensive Primary Care Plus (CPC+) program is rethinking primary care delivery — including the way providers are paid. CPC+ calls for extensive collaboration with private payers, including commercial plans, Medicare Advantage, Medicaid managed care plans, public employee plans, self-insured businesses such as IBM, and more. This will ensure the broadest coverage of patient populations possible in diverse regions.
But what does that collaboration mean, and why does it matter to providers interested in participating in the program? We’ve answered some common questions about private payer collaboration in CPC+ below.
July 19, 2016
Picture this: You call a restaurant to make a reservation, and they tell you they don’t have any openings for several weeks. But because you’ve heard such good things about the food, you decide to book it anyway. Then, after weeks of waiting, you show up right on time — only to be seated two hours later.
Would you return to the restaurant? Probably not.
So it shouldn’t be surprising that when patients have a negative experience at a healthcare practice — for example, waiting weeks for an appointment or enduring excruciatingly long wait times — they aren’t likely to return.
As patients evolve into consumers, their experience at your practice is vital. In fact, your profitability depends on it. According to the Advisory Board Company, 60 percent of factors that drive loyalty in primary care are related to experience. And practices with loyal followings have double the revenue growth rate compared to those without. Plus, by building loyalty, you can increase your patient share of wallet — and just a 10 percent improvement in share of wallet generates an average value of $22 million.
July 18, 2016
Like the classic Tootsie Pop query, the answer to this question is different for everyone — but for a number of providers, the response is “too many.”
Say it takes 24 clicks to complete an encounter at your practice, and four encounters (or 96 clicks) equals an hour of your time. Wouldn’t you rather spend that hour at home with your family or enjoying a round of golf?
But it’s not only about how long it takes you to complete an encounter — there’s also the question ofwhen you find the time to document. Seventy-six percent of providers document a patient encounter either in the exam room with a patient or immediately after the patient encounter. That means that the remaining 24 percent of providers have to actively remember what needs to be included in the patient story, so they can complete their documentation at the end of the day.
July 15, 2016
By Alexandria Goulding
The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) has created quite the stir over the last few months, based on the changes it makes to the way clinicians are reimbursed via Medicare. One of those changes creates a new framework that rewards healthcare providers for delivering better care, rather than just more care.
So it’s no surprise that MACRA’s recent proposed rule highlighted telemedicine, which can increase access to and convenience of care. Multiple U.S. states are also ramping up telemedicine options in response to increasing consumer demand and growing healthcare needs.
July 14, 2016
On the surface, it may appear that your practice is sustaining its finances and collecting adequate reimbursements. But sometimes it’s not that clear — there may be areas of your practice where you’re slowly leaking money or simply aren’t collecting as much as you could.
How can you know for sure?
Start by asking yourself the following three questions. Your answers will illuminate if your practice finances are where they should be, or if you still have some work to do.
June 21, 2016
Many clinicians celebrated the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) for its repeal of the sustainable growth rate, but the legislation also came with a couple of catches.
MACRA reforms Medicare reimbursement and offers two tracks to compensation: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).
Advanced APMs are risk-bearing contracts that require providers to put up more than “nominal financial risk.” Why would a provider organization want to take on more risk than it already has through meaningful use investments, the physician quality reporting system and the value-based modifier? Because MIPS is budget neutral, each incentive dollar earned by a doctor is a penalty for another. In total, there’s $888 million in penalties that could end up being paid out under MIPS.
Advanced APMs can keep you from being hit with those penalties, but there are some questions you should ask yourself to see if it is the right path for your organization:
June 14, 2016
You know the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is right around the corner, and under the legislation, clinicians will choose one of two payment pathways: the Merit-Based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs).
What you may not know is how much of an impact the transition could have on your practice revenue. The Centers for Medicare & Medicaid Services (CMS) expect that the majority of eligible clinicians (ECs) will fall under the MIPS pathway and more than half of solo and small practices will face penalties within the first year of the program.
That said, understanding MIPS today is key to your success. CMS recently issued a Notice of Proposed Rulemaking (NPRM), further detailing the expectations under the two pathways.
June 6, 2016
While declining reimbursements have led practices to take a hard look at their revenue collections processes, many are still making mistakes that are negatively affecting profits. Fortunately, these mistakes can be corrected, but only after they are properly identified.
Allowing high turnover
If your practice’s billing staff isn’t sticking around or your practice is frequently switching vendors, you can almost guarantee that your practice isn’t bringing in as much money as it could. There’s no substitute for experience, and creating an environment where those responsible for billing have the opportunity to learn and grow with your practice will allow them to develop innovative and efficient methods to keep your revenue as high as possible.
With new billers, however, you have to invest time and money into their training. If this investment is occurring frequently, your practice won’t see the returns it needs.
May 12, 2016
Value-based programs aren’t just for Medicare and primary care physicians; they’re also for pediatricians. From Medicaid Children’s Health Insurance Program Reauthorization Act (CHIPRA) programs to patient-centered medical homes (PCMHs) to the Patient-centered Specialty Practice (PCSP) program, there are ample opportunities for pediatricians who want to benefit from value-based programs.
May 11, 2016
By Alexandria Goulding
Weeks of lobbying has resulted in modified Medicare Advantage program policies and lowered average pay raises for 2017 Medicare Advantage plans. While The Centers for Medicare & Medicaid Services (CMS) decided not to immediately enforce all of the cuts, plans will still receive much lower revenue by 2018.
The Medicare Advantage program serves as the private managed-care version of Medicare. The government pays health plans’ monthly amounts for every member they cover and those taxpayer-funded payments are adjusted based on how sick someone is. For example, members who have chronic conditions receive higher risk scores and therefore, higher payment.
May 5, 2016
By Alexandria Goulding
On April 27, 2016, the Department of Health and Human Services (HHS) released the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) notice of proposed rulemaking (NPRM). The MACRA legislation is backed by a bipartisan majority.
The NPRM outlines and details the two pathways under MACRA: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). While pieces of the NPRM remain consistent with previous language, there are several big changes worth noting.
May 3, 2016
By Alexandria Goulding
With the presidential election quickly approaching, there is a narrowing window of time to reach congressional members about the pitfalls and benefits of upcoming bills that may affect healthcare organizations.
However, it is important that you’re aware of this legislation (including three major bills on the horizon: Senate TRUST IT Act, House 21st Century Cures and the Senate Medical Innovation Bill) and understand how they may affect your practice.
April 22, 2016
Patient-centered medical homes (PCMHs) seek to transform the way healthcare is delivered by providing comprehensive, quality and efficient care to their patients. While implementing process changes and new technology and focusing on opportunities for continuous improvement can be a challenge, becoming a recognized PCMH can benefit patient health and your organization’s bottom line.
Once NCQA-recognized, PCMHs can participate in private payer contracts that financially reward quality outcome measures with incentives based on shared savings, per member per month payments or care management fees. The four steps below will prepare you for managing your PCMH contracts effectively.
April 21, 2016
he people who come into your practice aren’t just patients anymore — they’re consumers. Today’s mobile- and technology-savvy customers have become accustomed to convenient communication and instant access to information, and they expect their healthcare providers to offer the same.
To attract new patients and retain current patients, practices must develop an effective digital marketing strategy, starting with these four essential steps.
April 11, 2016
By Tina Graham
Measuring the financial health of your organization isn’t quite like predicting the weather, but when we’re talking about money, we do want to make it rain.
Determine the best revenue cycle management (RCM) strategy for your financial future by analyzing the following three key processes.
April 5, 2016
By Alexandria Goulding
Big decisions are always stressful. But when it comes to your practice’s finances, the burden is even greater.
Under the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA), providers must choose between two new pathways to receive Medicare payments — the Merit-based Incentive Payment System (MIPS) or eligible alternative payment models (APMs).
For your practice to stay profitable and receive maximum reimbursement, you need to choose the pathway that’s right for your organization. It’s a big decision, but fortunately, a few simple questions can help you make the right selection.
March 25, 2016
By Alexandria Goulding
Over the past few years, a trend has emerged in healthcare reimbursement: Increasingly, payments are tied to quality, rather than quantity. The Medicare Access and CHIP Reauthorization Act (MACRA), which became law in April 2015, sets forth a plan that will make the final push toward quality-based care. Through MACRA, Medicare aims to tie 85 percent of payments to quality by 2018.
In short, the legislation means that changes are coming for your organization and the way you get paid. Here’s what you can expect.
March 14, 2016
It is said that money is the root of all evil, but it’s poverty that is often to blame for many chronic conditions. Impoverished populations are more vulnerable to chronic conditions because of increased exposure to health risks and insufficient access to medical services. And that’s only the beginning of the cycle.
Once affected by a chronic condition, individuals and their families often spiral deeper into poverty because of the costs associated with treatment and the possibility of a hospital admission when health deteriorates.
March 11, 2016
Managing transitions of care is increasingly important for organizations that seek to improve population health. But did you know that community health centers (CHCs), healthcare organizations that serve the most disadvantaged communities, managed transitions of care before population health even became a buzzword?
CHCs have a wealth of experience meeting the objectives of many value-based programs, all while managing challenging populations. They serve, among others, the 46.7 million Americans who live below the poverty line. And inability to pay for care isn’t the only thing that makes this group difficult to treat. In fact, one study found that low-income patients are almost 30 percent more likely to be hospitalized.1
By carefully managing their transitions of care, however, CHCs help patients get the best treatment possible in challenging situations. Let’s take a look at some of their habits.
March 8, 2016
We all have a bad habit or two. Some people pop their chewing gum; others can’t lay down the cigarettes. While buying a $1 pack of gum every week may not break the bank, what happens when your practice makes a habit of neglecting to collect $10 copays or forgetting to bill secondary insurance? Even seemingly innocent habits, like the following examples, can eventually burn a hole in your pocket.
February 24, 2016
PQRS, MU, MIPS, MACRA … sometimes the healthcare industry is an alphabet soup of reporting requirements and regulatory change. But despite the jumble, your practice needs to be ready to rumble. Join Greenway Health as we decode value-based programs, physician reporting and reimbursement, and detail how you can succeed despite the industry’s many hurdles.
February 23, 2016
By Alexandria Goulding
The deadline to attest for meaningful use (MU) — March 11, 2016 — is quickly approaching. As eligible professionals (EPs), eligible hospitals (EHs) and critical access hospitals (CAHs) prepare to attest, some are left wondering if they’ve collected all the right data and checked the correct boxes.
For those who determine that applying for a hardship exception is the right course of action for their organization, the Centers for Medicare and Medicaid Services (CMS) have made several adjustments to make the hardship exception process easier.
February 18, 2016
Taking the road less traveled may be poetic, but following best practices to improve patient collections will put you on the tried and true path to financial success. In an industry where 68% of patients never receive a collection letter from their care providers, it’s painfully clear that there’s room for improvement in the collections process.
Here are the top six practices you can implement at your organization to avoid revenue loss due to the increase in high-deductible health plans and patients’ resulting financial responsibility.
February 16, 2016
Accountable care organizations (ACOs) provide a great way for healthcare organizations to increase revenue and accomplish the triple aim of improving quality, lowering healthcare costs and improving the experience of providers and patients. The Medicare Shared Savings Program (MSSP)is one ACO model that incentivizes providers to accomplish these goals.
But how do providers earn these incentives? The answer isn’t simple.
February 3, 2016
Running a healthcare organization has never been a simple matter. After all, medicine is complicated, requiring several years of education to practice, and managing any type of business comes with its own set of challenges.
Lately, however, it’s gotten even more difficult. Reimbursements are declining 2-3% each year,1 the physician fee schedule isn’t keeping pace with inflation — costs have outgrown physician reimbursement by 25%2 — and payers are moving away from the fee-for-service payments this industry has depended on for years, representing both an opportunity and a risk. While traditional fee-for-service payments decline, there are new incentives for care management. The Medicare chronic care management fee, for instance, offers most physicians a $142,156 opportunity.3
All of these factors are combining to force healthcare organizations to look to value-based programs in an effort to remain profitable.
So where do you start?
January 25, 2016
The New Year has a way of creating new gym goers, healthy eaters and thrifty spenders, but the sobering reality is that New Year’s resolution success rates aren’t as cheerful as the holidays — according to one study, only about 8 percent of those who make resolutions meet their goals.
This year, ensure your success by transforming your organization’s intake process with Phreesia, the nation’s leader in patient intake management and Greenway Health’s January Partner of the Month and Partner of the Year for 2014 and 2015.
Phreesia leverages the power of patient self-service to boost cash flow, improve efficiency and increase patient satisfaction. With Phreesia, patients enter their demographic and clinical information, verify insurance, complete clinical assessments, and pay copays and outstanding balances — all before seeing a provider.
January 22, 2016
These days, you can do almost anything on your mobile phone, from banking to shopping to ordering takeout.
Now, healthcare is going mobile, too. With convenient mobile access to your practice’s electronic health record (EHR) system, you can support your patients, improve your work-life balance and boost the effectiveness of your practice when you find yourself in the following situations.
January 21, 2016
Industry changes, reporting expectations and the sheer amount of capital it takes to be a provider these days all interfere with your mission to improve health. The medical billing partner you select to take on your journey to success should be one that relieves your frustrations, not creates them.
Whether you currently bill in house or outsource, these seven questions will help you decide if revenue cycle management (RCM) services are right for you, identify the right RCM partner and keep your headache medication in the bottle where it belongs.
December 29, 2015
On Dec. 28, President Obama signed the Patient Access and Medicare Protection Act. Among several Medicare provisions in the law, the Act provides for a more streamlined, or no-questions-asked, approach to granting hardship exceptions for providers unable to attest to meaningful use for the current 2015 reporting period.
Within the language, providers would need to submit that they didn’t have time to properly attest, given that the Stage 2 final rule was issued with less than 90 days remaining in the 2015 calendar year. (Even through the rule allows attestation for any continuous 90 days throughout 2015, Congressional sponsors of the act felt that a lack of 90 days remaining was an undue burden. The attestation deadline of Feb. 29, 2016, for the 2015 reporting year remains.)
December 18, 2015
New Year’s resolutions often involve a pledge to eat healthier, exercise more and improve relationships with those around you — but what about the health and wellbeing of your practice? If you haven’t examined your practice’s medical billing finances for next year, it’s time to make a list and check it twice.
Here are the four financial metrics you should be familiar with to prepare for 2016: Net collections rate, reimbursement per encounter, days in A/R, clean claims rate.
December 16, 2015
While a healthcare practice makes the most significant impact on a patient during an appointment, the way practices interact with patients outside the office plays a major role in patients’ success — for example, whether they keep their appointments and adhere to previously established care plans. With automated messages, you can encourage your patients to get the preventive care they need, without taking your staff’s focus away from other obligations.
Automated messages are sent to patients in response to events in your electronic health record (EHR) and practice management (PM) system. For example, you may set up birthday messages to send when the current date matches a patient’s date of birth. This can be a simple birthday greeting, or it can be more involved. If you set birthday messages based on age and gender, you can use them to tell a male patient turning 50 that he is due for a colonoscopy or a female patient turning 45 that she is due for a mammogram.
December 10, 2015
In the wake of the Oct. 1 transition to ICD-10, very few issues have surfaced. However, providers and billers have experienced difficulty with coding for medical necessity, receiving denials due to outdated Local Coverage Determinations (LCDs) that do not include current diagnosis codes.
LCDs are coverage decisions made at the discretion of a Medicare Administrative Contractor (MAC) for a specific geographic area. These documents provide guidance to the public and medical community, outlining coverage criteria, defining medical necessity, and describing covered or non-covered services when diagnosis codes are integral to supporting medical necessity.
December 4, 2015
As a founding member of the CommonWell Health Alliance, Greenway Health is excited to see the organization’s progress over the past year — most recently enabling Greenway to offer CommonWell services to its customers, beginning with Prime Suite users.
Announced at HIMSS 2013, the CommonWell Health Alliance is a nonprofit vendor organization and national clinical data network that aims to make clinical information available to providers, regardless of the point of care.
The CommonWell Health Alliance’s mission aligns with our own — to make clinical connectivity affordable and pervasive. With thousands of practices registered to participate in all 50 states, CommonWell’s membership covers 70 percent of the acute care electronic health record (EHR) market and 24 percent of the ambulatory market. In addition to EHR vendors, the network includes industry stakeholders, such as CVS Caremark, Sunquest and Merge. This broad-level backing helps the network provide consistent implementation, standardized processes and support.
December 3, 2015
The Centers for Medicare & Medicaid Services (CMS) released the 2016 Medicare Physician Fee Schedule (PFS) final rule on Oct. 30, 2015. Practices that rely on Medicare payments should understand the upcoming changes, as well as their effect on revenue.
One of the most important updates in the 2016 Medicare PFS is the transition to the Merit-based Incentive Payment System (MIPS). This program, which is scheduled for a 2019 implementation, will consolidate the incentives and penalties associated with meaningful use (MU), the Physician Quality Reporting System (PQRS) and the Value-based Modifier (VPM) program.
The 2016 Medicare PFS also includes several other payment updates to services and programs, such as:
- Advanced care planning
- “Incident to” policy
November 13, 2015
As a pediatrician, you collect data every day. Each time a patient walks through your door, you take his or her weight, height and temperature. You gather demographic data to learn where he lives and the health history of his family members. If this data is used to drive decision-making, it can help improve the lives of those you care for.
The information you collect in a just single exam can benefit patients in powerful ways. If you see that a child isn’t hitting developmental, cognitive or emotional milestones, for instance, you can recommend exercises or activities to boost growth in those areas.
November 12, 2015
The Centers for Medicare and Medicaid Services (CMS) released the final rule for meaningful use (MU) Stage 3 on Oct. 6, 2015. This stage is significantly more complex than stages 1 and 2, and it requires practices to confront difficult challenges, such as patient-generated health data, public health data reporting and interoperability.
November 10, 2015
Healthcare practices are facing a whirlwind of financial challenges — from the rise of high-deductible health plans to the shift to value-based payments.
How can practices stay profitable in such a challenging environment? The answer lies in data-driven decision-making that improves the financial viability of their organizations.
November 9, 2015
The Centers for Medicare & Medicaid Services (CMS) issued the final rule on 2016 Medicare payments on Oct. 30, set to go into effect on or after Jan. 1, 2016, in part because the agency tacked on a second comment period through Dec. 29 for stakeholders with outstanding issues on the provisions.
Important updates and highlights include:
FQHC and RHC chronic care expansion, Telehealth expansion, with a catch, Advanced Care Planning, Physician Quality Reporting System, Medicare ACOs, and CMS overview link
October 29, 2015
The transition to ICD-10 may have evoked memories of Y2K: Similar to the fear and warnings leading up to Jan. 1, 2000, healthcare organizations dreaded the complexities of the new code set and the potential loss of productivity and revenue.
However, much like the uneventful first few weeks of the new millennium, the initial implementation of ICD-10 created very few bumps for practices.
To continue on a path to ICD-10 success and minimize denials, practices must be proactive when submitting charges. Continue reading to learn five common payer rejections due to the implementation of ICD-10 and how to avoid them in the future.
October 20, 2015
Every year in October, the health information technology (HIT) industry gathers in Washington, D.C., for a collaborative policy summit known as National Health IT (NHIT) Week.
The summit is a shared-voice outreach to Congress and federal agencies with oversight of health IT policies and legislation that impact healthcare providers, consumers and the HIT companies that serve them.
October 19, 2015
To successfully treat each patient, physicians must first assess the individual’s chief complaints. In the same way, to develop effective processes and succeed in their specialty, orthopedists must first identify their practices’ main challenges.
Greenway Health recently surveyed providers from across the country about their habits, workflows and day-to-day practices. From that data, we’ve identified five of the top challenges facing orthopedic providers.
October 13, 2015
Oct. 1 has come and gone, and like it or not, ICD-10 is officially here. While many practices benefited from their preparations and handled the transition well, others have struggled to keep up.
Whether your transition has been smooth or bumpy, looking at how ICD-10 implementation has affected the industry can provide valuable insight into what’s ahead and show you how to position your practice to succeed.
October 8, 2015
After much anticipation from the healthcare community, the Centers for Medicare & Medicaid Services (CMS) published the final rule for meaningful use (MU) Stages 1 and 2 on Oct. 6, 2015. The finalized rule aligns closely with the proposed rule, which was released in April.
The meaningful use final rule changes very little for 2015; however, it does establish some threshold increases over time and decreases eligible professionals’ (EPs) public health options. The rule does not change exclusions for each of the 10 total objectives or extra exclusions for EPs in Stage 1.
October 1, 2015
Healthcare providers have long heard about the shift from fee-for-service to value-based reimbursements, but the transition hasn’t been immediate or clearly defined. But the Centers for Medicare & Medicaid Services (CMS) took the next step toward payment reform on Sept. 28, by releasing a long-term framework for how value-based medicine will take shape and how providers will be paid by Medicare in the coming decades.
The CMS Request for Information (RFI) seeks recommendations on how the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) — passed into law in April — should be implemented on a programmatic level. Essentially, this opportunity to provide feedback gives providers and healthcare IT (HIT) vendors the chance to direct their own destinies.
Healthcare stakeholders can make recommendations (due by Oct. 31, 2015) on payment methodologies, quality-reporting alignment and technology requirements, and which types of clinical quality measures should be used and updated annually.
September 29, 2015
When practices shop for electronic health record (EHR) or practice management (PM) solutions, they often search diligently for popular features such as usability, intuitive interfaces, comprehensive templates and the number of clicks required to perform certain functions. Those priorities make sense because that’s the type of functionality that dictates how well providers and staff use the solution.
Equally important, however, is deciding where and how to store the data within the EHR and PM systems. In most cases, there are two options: cloud-based or on-site.
September 17, 2015
Primary care practices using Greenway Health’s electronic health record (EHR) solutions report higher satisfaction than more than 400 other vendors, according to a recently published Black Book Rankings survey.
Approximately 3,000 EHR users participated in the 2015 Top Black Book Electronic Health Records Survey for Primary Care, which found Greenway Health customers reported the highest satisfaction scores among primary care physicians, including those in the general practice and family practice subsets.
According to Greenway CEO Tee Green, service and innovation equal growth. This equation, which has become a company mantra, is likely the driving force behind high customer satisfaction momentum measured by internal figures and independent research firms, such as Black Book.
September 15, 2015
It’s a simple truth: To continue providing care for patients, practices must maintain healthy finances. However, the way that healthcare organizations get paid is changing — instead of receiving fee-for-service payments, practices are evaluated and paid based on the quality of care they deliver.
That means to maximize payments, practices must track and report on care quality, and many organizations have adopted population health management solutions to assist in meeting that goal.
However, population health management technology doesn’t only benefit the practice’s bottom line; it benefits everyone in your practice, from physicians to patients.
September 14, 2015
As the healthcare industry continues to push for electronic clinical data sharing between healthcare entities — known as interoperability — you’ve likely heard a lot about the promise of seamless information exchange.
The Institute for Healthcare Improvement’s Triple Aim outlines three of those benefits: improving patient care, improving the health of populations and reducing the cost of healthcare. In addition, interoperability can improve patient safety, enhance provider efficiency and streamline qualification for value-based and quality programs.
September 11, 2015
Do you know your practice’s vital signs? Whether you measure practice success by performance metrics, phones ringing, patients in the waiting room, sphygmomanometers hissing or reimbursement rates, ICD-10 threatens practice livelihood by multiplying billing codes and plundering documentation, coding and billing processes — all beginning on Thursday, Oct. 1.
Many practices still express concerns about going into the ICD-10 changeover unprepared — especially as the Centers for Medicare & Medicaid Services (CMS) continues to reveal new information regarding the change and corresponding year-long transition period.
September 9, 2015
Precision medicine – the process of leveraging genomic data to offer targeted treatments and identify predispositions to a particular disease – is gaining popularity in the healthcare industry. The Precision Medicine Initiative, a new nationwide effort to revolutionize healthcare delivery, aims to improve health by empowering providers with advanced tools, information and therapies to determine appropriate treatments on an individual level.
Until now, healthcare has focused on treating the “average” patient. But as clinicians know, every patient is different, and treatments that are successful for certain patients can be ineffective – or even harmful – for others.
September 3, 2015
As the ICD-10 deadline nears and healthcare organizations complete final preparations to brace for the impact, attention has largely shifted away from 2015 meaningful use (MU) attestation requirements and deadlines.
But several organizations that haven’t overlooked MU concerns, including Greenway Health, recently wrote a letter urging CMS to release a final rule based on changes to MU reporting requirements proposed earlier this year. The letter expressed concerns that providers’ ability to meet the demands of the incentive program in 2015 and 2017 is at risk as they continue to wait for the requirements to be defined.
Yet with only four months left in this attestation year and the anticipation of the final rule beginning to grow, practices can prepare for 2015 MU now by understanding how the proposed changes — which Greenway Health expects to be made final around Labor Day — will affect them.
August 26, 2015
Choosing the right population health technology for your practice is a big decision — one that will impact your practice’s finances, workflow and time. With the right solution, your practice can effectively collect and use data, coordinate care and benefit from value-based reimbursement programs.
To make the evaluation and decision-making process a little easier, here is a breakdown of some of the most important population health solution features, and how they can help you thrive in the changing healthcare industry.
August 17, 2015
Many patients wince when asked to adopt a new diet, exercise program or medication regimen — or, they nod enthusiastically at the recommendation, but fail to actually implement it in their daily lives.
Studies indicate that patients who engage in their care are more likely to adhere to providers’ recommendations. However, turning engagement efforts into a commitment from patients often depends on the strength of the patient-provider relationship, which can be nurtured even outside of the exam room.
With the help of a patient portal, providers can facilitate better relationships with their patients, encourage patient engagement and lead to improved health outcomes. Keep reading to learn how.
August 13, 2015
Cloud technology is becoming increasingly prominent in the healthcare IT industry. That shouldn’t come as a big surprise, as cloud-based solutions — also known as Internet-based solutions — deliver clear advantages over locally hosted solutions such as improved security, accessibility and convenience.
While many practices have already experienced the benefits of using email, software and data storage tools through the Internet, cloud-based solutions were not accepted or adopted overnight. Here’s a brief look at the history of cloud use in healthcare, and a glimpse at what’s coming next …
August 11, 2015
Electronic prescribing of controlled substances: A convenient tool to improve patient care and safety
Although electronic prescribing of controlled substances (EPCS) was legalized in 2010 and is now legal in 49 U.S. states and Washington D.C., many providers aren’t adopting the process. In 2014, EPCS increased by 400% overall — but still, only 1.4% of providers nationwide have the tools needed to send paperless controlled substance prescriptions.[i]
Soon, however, providers may not have a choice. Effective March 27, 2016, electronic prescribing of both controlled and non-controlled substances will be mandatory in the state of New York — and other states may soon follow.
Despite the low adoption rate, EPCS promises providers cost savings, increased efficiency and, most importantly, the ability to better care for patients through these key benefits:
July 30, 2015
By Greg Fulton, Industry & Government Affairs Program Manager, Greenway Health
The Centers for Medicare & Medicaid Services (CMS) has issued an expanded set of guidance FAQs offering more details on the recently announced one-year ICD-10 grace period. The 13-point document covers several highly anticipated details, including when the ICD-10 ombudsman will be in place (Oct. 1, 2015), reinforcement that the grace period is not an ICD-10 delay, and clarification of what is meant by “family of codes.”
July 28, 2015
As the U.S. population ages, more Americans are suffering from one or more chronic conditions, including diabetes, heart disease and depression. Currently, care management of chronic conditions accounts for 85 percent of all healthcare expenditures — and as high-deductible health plans become more popular, patients’ out-of-pocket payments also increase.
Realizing the effect that these and other healthcare changes have on providers and patients, payers have developed new ways to positively influence care delivery and treatment decisions, called value-based payment programs.
These programs incentivize practices to improve patient health while reducing the per-capita cost of healthcare, which encourages participating providers to concentrate on disease prevention and management, and pursue low-cost treatment options first, when clinically appropriate.
July 24, 2015
For OB-GYNs, change is a constant. At the practice level, their patients’ conditions can change by the day — or in the case of labor and delivery, by the minute. On a larger scale, they’re charged with staying up to date on new medications and procedures to provide for the women in their care.
To stay profitable, OB-GYNs also need to stay aware of industrywide financial changes. For example, the annual Medicare Physician Fee Schedule often includes the addition of new codes, the deletion of outdated codes and revisions to reimbursement amounts of existing codes.
The 2015 Medicare Physician Fee Schedule will affect certain practices more than others — OB-GYNs will especially feel the impact of changes to global period services and billing, particularly for hysterectomy services.
July 21, 2015
Some healthcare leaders have referred to the ICD-10 transition as the medical industry’s Y2K, noting similarities between the fear, warnings and preparation leading up to Jan. 1, 2000, and the healthcare industry’s buzz about the consequences of the new code set implementation on Oct. 1, 2015.
For example, The Centers for Medicare & Medicaid Services (CMS) estimates that in the early stages of ICD-10 implementation, denial rates will rise by 100-200 percent and days in A/R will grow by 20-40 percent. Many other organizations have also warned of the significant potential for large revenue losses if practices aren’t adequately prepared for the shift.
July 20, 2015
Clinicians have known for decades the importance of making care decisions based on patients’ health information and medical histories. Now, by accessing patient data collected by other providers and payers, clinicians can be sure they have the most complete information possible.
Population health solutions combine the power of data analytics with the ability to seamlessly exchange information to give providers access to individual patient and communitywide data. However, not all population health solutions are created equal; most tools available today can only provide a partial view of that information — either claims or clinical data — and only from a single source.
July 17, 2015
By Greg Fulton, Industry & Government Affairs Program Manager, Greenway Health
Following the April enactment of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) — which aims to phase out fee-for-service reimbursement and abolish the annual “doc fix” Medicare payment patches — the task of implementing the new reimbursement process fell to the Centers for Medicare & Medicaid Services (CMS). CMS released its proposal for 2016 Medicare reimbursement on July 9, 2015.
This proposal formalizes two main elements of MACRA:
1. A 0.5 percent annual payment increase through 2018
2. A new quality reporting payment formula, the Merit-Based Incentive Payment System (MIPS), which will take over in 2019