Physicians start or join small practices expecting autonomy and financial security. But both rewards are under siege from regulatory and compliance pressures which demand that practitioners improve clinical outcomes, better engage their patients, maximize the use of enabling EHR technologies and respond to complex conversions such as the 2014 cutover to the ICD-10 coding standard.
As many providers are now learning, meaningful use Stage 2 greatly ups the ante on patient engagement. Beginning in 2014, physicians will be required to attest that they provide 50 percent of their patients with online access to their health information, such as recent lab results or a continuity-of-care document (CCD). The rules also require that more than five percent of a physician’s unique patients view, download or transmit their health information to a third party and more than five percent exchange secure messages with their practitioner. These last two provisions have practitioners mulling over their future patient engagement strategies.
Similarly, providers are staring down the burden of ever-rigorous quality reporting standards designed to help elevate clinical outcomes. The good news is that eligible professionals who satisfactorily participate in the Physician Quality Reporting System will qualify for a half percent bonus in Medicare payments. Those who fail to report quality measure data in 2013 will be subject to a one and a half percent payment reduction in 2015, which escalates to two percent in subsequent years, according to the new Medicare Physician Fee Schedule.
And many practitioners are rightly worried that they will not be fully prepared for the conversion to ICD-10. As a result, they could encounter coding errors and claim denials, which would negatively impact practice revenue.
Many practices look to technology to help elevate quality and maximize reimbursements. In fact, more than a third of physician practices plan to purchase, replace or upgrade ambulatory EHR systems, according to HIMSS Analytics' recent Ambulatory Electronic Health Record and Practice Management Study. Because, as it turns out, physicians are not always satisfied with their IT solutions, with more than 17 percent expected to switch systems by the end of 2013, according to a recent Black Book survey.
As they ramp up for patient engagement and other provisions of Stage 2 meaningful use, many practitioners are finding that their ambulatory EHRs, often delivered as a bolt-on solution from legacy vendors, contain awkward layouts that do not enhance physician efficiency, promote patient engagement or help to increase quality outcomes. As a solution, many practitioners will consider hiring staff to handle their IT challenges -- only to find that qualified personnel are often prohibitively expensive.
Even with their bevy of challenges, physicians have an opportunity to find support -- and succeed -- in today's healthcare environment. Namely, practices should seek out partnerships for professional billing services and solutions. It takes time upfront to find the best partner, but with a well-executed search and foundation for moving forward, these solutions can provide tools to help practitioners increase billing accuracy and enhance practice efficiency. Further, a solid billing service solution with comprehensive analytics can be a great resource to help navigate complex regulatory initiatives such as meaningful use and ICD-10.
Increasingly sophisticated yet user-friendly EHRs, personal health records and web portals are also helping practitioners respond to quality reporting standards and better engage their patients, driving additional value for both their own practices as well as the entire healthcare delivery system.
From professional services to advanced technology resources, small practices don't have to go it alone. There is support out there to help physicians improve health outcomes while maintaining their independence.
Sajid Khan is the executive vice president of ambulatory services at Emdeon, a provider of revenue and payment cycle management and clinical information exchange solutions, connecting payers, providers and patients in the U.S. healthcare system.