Hospitals expand to attract well-insured patients despite pressures of healthcare reforms

Several hospitals are looking for well-insured patients beyond traditional market boundaries, both in prosperous suburbs and in nearby areas with growing, well-insured populations. According to a study by the Center for Studying Health System Change (HSC) hospitals seeking a competitive edge in the marketplace are targeting geographic expansion into new markets which are well-insured.

The study based on HSC’s visits to 12 nationally representative metropolitan communities, depicted that hospitals are expanding despite the pressures of the healthcare reform. Hospital strategies mainly include – building full-service hospitals, establishing freestanding emergency departments and other outpatient services, acquiring physician practices, and operating medical transport systems with several hospitals building near major highways to be accessible.

Hospitals expansions survey findings

• In all 12 markets surveyed results depicted that hospitals are looking for full-service hospitals or freestanding emergency departments, buying or establishing physician practices and developing a regional presence through emergency medical transport systems
• Recession rather than diminishing has heightened the drive among hospitals to pursue well-insured patients beyond traditional hospital market boundaries
• Expansion appears more frequent where large hospital systems were pursuing significant employment of physicians and where service-line strategies, such as cardiac or cancer care, were well entrenched

Impact on Hospitals & Independent physicians

The overall impact of hospitals’ geographic expansions is still to be observed, there are conflicting views within the industry regarding these new hospital competitive strategies, if they will increase costs, improve care or both. Hospitals are of the view that the expansions will increase efficiency, increase access and improve the quality of patient care, while payers and competitors argue such strategies will lead to elevated costs.

Also Independent Physicians in most markets due to health reforms who are faced with financial pressures along with difficulty in hiring younger physicians, who often prefer employment in larger organizations, are actively seeking the stability and security of employment in larger physician-owned or hospital-owned groups. According to the HSC study in fast growing and well insured Greer, SC, there are no more independent primary-care practices left.

Revenue cycle management amidst hospital expansion and reforms

Hospitals backing expansions as necessary countering that even though there are costs increases, their efforts provide increased high-quality care; will need to cater to higher patient influx and increased medical billing. Hence in this scenario along with the growing pressure of health care reforms, services of skilled service providers possessing the requisite credentials can be availed by hospitals and practitioners to maintain favorable revenue cycles management.

Medicalbillersandcoders.com the largest ‘Consortium of Medical Billers and Coders, servicing over 50 specialty US physicians, are constantly updated with the requisites of the industry and healthcare reforms are the right choice for hospitals and practices. Medicalbillersandcoders.com has in-depth knowledge and expertise in the delivering the best quality services to hospitalists. Hospital employment will affect patients, hospitals and doctors – as healthcare will require greater coordination, greater use of clinical data and collaborative provider teams — which MBC is best positioned to deliver.

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Orienting your support staff to the integrated EHR eco-system

“Before expecting your support staff or divisional departments to contribute qualitatively into the integrated EHR system, care must be taken to identify and train them for orienting them to the mechanism of the EHR”

By now medical practices must have realized that EHR is not just about technology but beyond that. As EHR becomes mandatory in clinical and operational management, practices’ responsibility to comply by EHR mandate would also double up: while they have to ensure EHR compliance for avoiding penalization for being below the EHR benchmark, they should also strive to be eligible for incentives under the ‘Meaningful Use’  criterion as determined by the HITECH Act. Therefore, the whole task of living up to the requisite level of compliance would surely demand not just physicians’ knowledge of EHR, but the integrated effort of functional divisions of medical practices/hospitals.

Before expecting your support staff or divisional departments to contribute qualitatively into the integrated EHR system, care must be taken to identify and train them for orienting them to the mechanism of the EHR.

• To begin with you have the Front Desk, which usually attends to Patient Registration and Admission. As EHR marks a deviation from paper filing to electronic registration, the Front Desk needs to be taught of ways to enter in registration and admission processes into an automated and networked EHR module, which enables viewing and interfacing across the all the connective eco-system of hospital management.
• Next, you have support staffs, who take of monitoring and administering physicians’ instructions for clinical management of patients inside the hospitals. But, for the medical support staff that hitherto has been following instructions orally or from notes, the transition to deciphering instructions from  an electronically automated EHR system would somewhat seem alien initially. But with proper orientation, they would not only be able to appreciate the change but also contribute positively towards the integrated EHR eco-system.
• Following the support staff is the clinical and diagnostic department, who play a vital role in screening and detecting the medical condition. With an integrated EHR in place, their task of collaborative sharing the clinical and diagnostic findings would surely get faster and more efficient.
• Then, you have the all important part in the hospital eco-system: the medical billing staff, who are crucial to the revenue generation from factual medical billing preparation, coding, submitting and realizing the medical claims from the Medicare as well as private insurance carriers. With a streamlined EHR that can ensure compliant billing and coding, you can always expect your billing staff to deliver efficiency and contribute to operational efficiency.
• Finally, you have the Executive Board or the Management, whose task of decision-making would surely be devoid of blemishes as they would have ready access to clinical and operational data from the integrated EHR eco-system.

But, when you consider the time and resource required for comprehensive orientation of all your functional entities, you would rather be well-off opting for outsourced services from credible and competent vendor. Medicalbillersandcoders.com – whose competence and credibility in advocating and practicing EHR implementation and training for diverse medical practices is well-known across the U.S – should be an ideal recourse for practitioners seeking to opt for orientating their support staff to the integrated EHR eco-system.

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Dispelling hospitals’ reluctance in adopting Alternative Therapy & Medical Billing

“As much as its popularity amongst larger population of patients, Alternative Therapy may well become a viable alternative in ensuring hospitals’ uninterrupted sustenance and growth. And, judging by its popularity, it may well become an integral part of comprehensive medical services offer by majority of hospital”

Many a times, proven medical treatment or intervention may not be able to ensure the requisite relief to patients. Especially, when it comes to clinical management of chronic ailments, proven medical procedures or therapies have been found wanting in as far as providing cure or relieving symptoms associated chronic medical conditions. As medical researchers try to seek answers to these elusive questions, parallel medicine has slowly been evolving as an alternative option – acupuncture, guided imagery, chiropractic, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage, and many others forming the composition of Alternative Therapy. More than a curative option in chronic disease management, Alternative Therapy is increasingly being used a proactive method for augmenting mental and physical well-being.

But, despite the enormous opportunities, both practice-wise as well as revenue-wise, medical practitioners and hospitals, in particular, have not been that inclined to adopt alternative therapies as part of their comprehensive healthcare service offer. While there could many reasons for the continued apprehension, the likely increase in workload and billing complexities associated with such appreciation in volume may well have been the prime reasons behind the reluctance. But, as the health radical healthcare reforms – Medicare cuts, Accountable Care Organization (ACO) concept, mandatory EHR compliance, and the ensuing ICD-10 and HIPAA 5010 – begin to impact on hospitals’ revenue generation, they will have to off-set the effect through alternative opportunities, such as Alternative Therapy.

As much as its popularity amongst larger population of patients, Alternative Therapy may well become a viable alternative in ensuring hospitals’ uninterrupted sustenance and growth. And, judging by its popularity, it may well become an integral part of comprehensive medical services offer by majority of hospital. As far as the complexities of voluminous medical billing, coding, claim submission, and realization are concerned, hospital can easily look to avail the services of competent and credible medical billing service providers, who along with the routine billing services, are willing to offer expertise in EHR implementation, denial management, and Revenue Cycle Management. Consequent to such combination of integrated medical billing management, hospitals can easily dispel the apprehensions associated with adopting Alternative Therapy as a viable option along with the regular medical service offers.

Medicalbillersandcoders.com (www.medicalbillersandcoders.com) – whose long-standing reputation as the largest consortium of medical billers and coders in the U.S. is built on its credibility and competence to offer comprehensive medical billing solutions comprising Patient Scheduling and Reminders, Patient enrollment, Insurance Enrollment, Insurance verification, Insurance Authorizations, Coding and audits, Billing and Reconciling of Accounts, Account Analysis and Denial Management, AR Management, and Financial Management Reporting along with advisory on EHR efficacy and implementation – should instill  the much needed confidence to go in for Alternative Therapy as a viable option along with the regular medical service offers.

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Increased usage of Mobile Devices by Physicians while accessing medical records

Smartphones and other mobile devices have made it easier for physicians to perform some of their duties from any remote location and have also pushed many physicians to test the plausibility of these technologies being used in the healthcare industry. CompTIA, an information technology association, survey reported that 56% of physicians are using smartphones, and 25% are using tablets for work. However, there have also been some concerns over the security of patients’ privacy and the information about the health of a patient. Hence advantages of using mobile technology come with its own risks and threats.

Some of the most common wireless threats to physicians include device risk content where the data on the device is susceptible to malicious executable files, unauthorized intrusion risk where unauthorized third parties may gain control and data integrity, confidentiality and authenticity risk where patients data could travel from the mobile device to the access point without being integrated and this can compromise the patients data to third parties. However, these threats can be reduced by protecting patient data when transferred between devices.

Usage of mobile devices by physicians in hospitals as well is advantageous to physicians as mobile access helps in drawing more value out of the big investments hospitals have made in electronic records. However, patient data needs to be protected and to further elaborate this – The National Institute of Standards and technology (NIST) has released a report regarding the security of information as far as storage devices are concerned.  Additionally a report by the United States Department of Health and Human Services titled “Reassessing Your Security Practices in a Health IT Environment: A Guide for Small Health Care Practices” states some of the methods in which HIPAA compliance can be maintained.

In the changing healthcare industry, usage of mobile technology to access Electronic Health Records is vastly advantageous and almost imperative, however physicians need to maintain patient privacy through administrative, technical and physical safeguards and observe HIPAA guidelines and physicians pressed for time can make this possible by outsourcing their services.

Medicalbillersandcoders.com well updated with HIPAA compliance and other issues related to the Health IT sector, maintain utmost confidentiality regarding client data. Equipped in handling all the administrative and technical details to preserve patient’s data security, MBC has guided thousands of practices across the 50 states in the US to exchange data securely and supported doctors to automate their practices making healthcare more electronically secure.

Meaningful Use’ Compliant EHR Technology Implementation – specialists’ perspective

“While specialist practitioners, such as Radiologists, Psychiatrists, Chiropractors, Urologists, etc. can claim exemptions and exclusion of certain objectives set out in the Meaningful Use Clause by CMS, they are not treated preferentially as far as documenting clinical processes using approved and compliant EHR software is concerned:  their responsibility for reporting clinical data using Certified EHR Technology and EHR modules remains as mandatory as for general practitioners.”

There has hardly been anything that has got as much an attention as the CMS’ Meaningful Use criterion for medical practitioners – a program for eligible practitioners to be able to qualify for Medicare incentives upon meeting a certain set of core objectives set out in the Meaningful Use Clause under the ARRA. Although CMS has laid down guidelines for general practitioners, who serve the bulk of Medicare beneficiaries, yet their specialist colleagues – such as Radiologists, Psychiatrists, Chiropractors, Urologists, etc. – are not out of the CMS’ Meaningful Use ambit; after all they too are indispensable to CMS’ initiative towards an efficient healthcare environment. But, because their service-composition and documenting varies from general practitioners, specialists’ requisite compliance with core objectives set out in the Meaningful Use Clause under the ARRA gets a little different.

Recognizing the diverse nature of specialists, CMS has allowed for certain exceptions and exemptions from complying with certain objectives that does not owe allegiance to these specialist practices. Therefore, of the 20 mandatory objectives to be met out a possible list of 25, specialist practitioners can still seek exemptions on the ground of being unique fields of medicine. Consequently, their mandatory objective-list ultimately becomes less than 20; while CPOE, eRx, Vital Signs, Smoking Status, Electronic Copy of Health Information, and Clinical Summaries are usually allowed exemptions from Meaningful Use objectives, the following exclusions may still be claimed under substantiated evidence: Drug Formulary Checks, Clinical Lab Test Results, Patients Reminders, Patient Electronic Access, Medication Reconciliation, Summary Care Record, Immunization Registries Data Submission, and Syndromic Surveillance Data Submission.

While specialist practitioners, such as Radiologists, Psychiatrists, Chiropractors, Urologists, etc. can claim exemptions and exclusion of certain objectives set out in the Meaningful Use Clause by CMS, they are not treated preferentially as far as documenting clinical processes using approved and compliant EHR software is concerned:  their responsibility for reporting clinical data using Certified EHR Technology and EHR modules remains as mandatory as for general practitioners. Thus, everything points towards sourcing and implementing EHR software’s that best serve unique needs of diverse practices while also being compliant with the CMS mandate on Certified EHR Technology for achieving Meaningful Use criterion bench-mark.

Despite the market being replete with numerous EHR software – a prior advisory on judicious selection is always advisable as any hasty selection can have multiple repercussions: adverse impact on clinical documenting, practice management, and revenue generation. Given the prevailing scenario, Medicalbillersandcoders.com proven credentials in advising and implementing certified EHR software platforms –  Medisoft , Misys Tiger, Eclinicalworks, Advanced MD, Office Ally, Sage Medical Manager, GE centricity, Lytec, Altapoint, Dentrix being some its leading names in an exhaustive portfolio innovative and futuristic models – for diverse clients comprising Allergy, Anesthesiology, Cardiology, Dermatology, ENT, Endocrinology, Family Med, GI, Geriatrics, Internal Medicine, Long-Term Care, Multi-Specialty, Neurology, Neurosurgery, OB/Gynecology, Occupational Medicine, Ophthalmology, Optometry, Orthopedics, Pediatrics, Plastic Surgery, Podiatry, Psychiatry, Psychology, Pulmonology, Rheumatology, Surgery, SurgicalCenter, Urgent Care, Urology, and the rest.

About Medicalbillersandcoders.com (www.medicalbillersandcoders.com)

Medicalbillersandcoders.com has been a leading source for comprehensive medical billing revenue cycle management. A talent-pool of qualified and competent medical billing professionals with diverse skills specific to unique needs of multiple medical disciplines has been instrumental in our being a leading consortium for medical billing management.