We all know that the healthcare delivery system in the United States is decentralized. Patient information is in multiple sources and often times not even accurate or complete. This fragmented system leads to large gaps in care, contributing to poor quality, patient safety issues and increased costs. A nationwide audit assessing 439 quality indicators found […]
Regulatory Compliance
Do EHRs reduce test requests or make them (too) easy to order?
Two recent studies have published conflicting results regarding the correlation between EHR/ HIE usage and the number of tests ordered by physicians. First, a general comparison of the studies and their outcomes: The study Bridging the Chasm: Effect of Health Information Exchange on Volume of Laboratory Testing concluded that doctors order fewer lab tests when […]
ICD-9 to ICD-10: What’s in a Code Set Anyway?
While we discuss the ICD-9 to ICD-10 conversion mandate, many people are questioning the value of such a change. Questioning change is a good thing, but by now we all know that updating from an outdated 1970s code set to a more modern 1990s code set is critical for providers to be accurately compensated for […]
Change we can LIVE with
In a recent article by John Lynn, he explains that ACOs are a good idea, but physicians can influence the outcomes and not control the outcomes. In my earlier blog I started to explain that ACO success and longevity will depend on changing patient behavior. This starts with the physicians. For decades, patients, and some […]
Choosing a Clearinghouse/VAN
Choosing your clearinghouse or VAN is a very important step, especially if you are in healthcare. In healthcare you need to make sure they are HIPAA compliant, which means they will be able to handle all the mandated transaction sets. Other industries have different requirements. Whichever clearinghouse you choose, you need to make sure they […]
ICD-10 Neutrality: How will you use your deadline extension?
Since Health and Human Services Secretary Kathleen G. Sebelius announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10), the healthcare industry is still trying to figure out the scope and the impact […]
ICD-10 Revenue Neutrality Will Drive Collaborative Testing
I was reading my collegue Mike Berard’s blog, on ICD-10 Revenue Neutrality: A Strategic Approach. We have discussed the importance of testing before production between Payer and Provider (e.g., Physicians and facilities). In his 2nd to last paragraph Mike proposes the following: “The reality is that Revenue Neutrality verification is still subject to the availability […]
ACO: Maybe I am wrong and Payers will not be Partners
About a year ago I blogged, “Will we be reading in 2011 ACOs partner with large carriers?” I am hearing that carriers are staying away from ACOs and are not planning on partnering. What have you heard? Was my assumption incorrect in 2011?
Patient Ignorance is Not Bliss
Meaningful Use Stage 1 encouraged physicians to implement an EHR in order to capture discrete and some unstructured healthcare data with the future goal of sharing this across the industry. Stage 2 reimbursement (preliminary) will be based on the patient taking an active role in the sharing of this data. This is contrary to the […]
What does the Future of Healthcare Data Look Like?
Industry Today Healthcare ranks as the largest industry in the world and is responsible for generating over $4.5 billion in revenue. While the United States is home to only 5% of the total world population, US residences are responsible for nearly half ($2.2 billion) of annual healthcare expenditures. The industry provides employment to over 15 […]
Clinical Documentation – The Make or Break Component of ICD-10
Does the mere mention of “ICD-10” bring on an anxiety attack of some sort? For the majority, the answer is yes! This is probably because, like numerous organizations, you still haven’t begun the necessary planning for the transition from ICD-9 to ICD-10. Hospital administrators, physicians and medical coders are dropping to their knees and praying […]
What’s Really Driving EHR Implementations?
Health care organizations which do not qualify for incentive reimbursement have in large part not implemented EHRs, leading researchers involved in a study published in the March issue of Health Affairs to conclude that it is the incentives rather than factors such as improving patient care which are driving EHR adoption. Under the 2009 federal […]