Training Programs
Audits & Assessments
Regulatory MonitoringArchive for economy
As 2009 closes, HCCA looks to compliance professionals to see how the economy will affect business in 2010. To participate in this study, and to compare and contrast your plans with the rest of the compliance community, take the three minute survey here.
The last thing you want to learn at your hospital, as a patient sits at your registration desk:
- They can't pay, and no one knew prior to service
- Their insurance changed, and authorization is required
- They recently lost their job and have not paid their COBRA benefits
At this point, you may end up with an unpaid account—and in this economy, that's not good news when hospitals continue to lose reimbursement dollars.
Read the full story by Dom Nicastro.
The patient access team at Skagit Valley Hospital has many goals as it works through this economic recession: Sustain morale, maintain trust, minimize criticism, and acknowledge success.
Michele Hill, CHAM, patient access manager at the Mount Vernon, WA, facility, knows it's not easy considering what the hospital faces:
- Federal and state budget cuts
- Change in payer mix
- Increased charity care requests
- RAC audits
"Our facility, like many others, is facing significant challenges during this time of economic downturn," Hill says.
Read the full story.
Sometimes, your health information managers need to code. And your patient access managers need to register patients.
In these tough economic times, your hospital staff members should be ready for different roles on any given day. No one is immune to change.
At Albany (NY) Medical Center, managers in the patient access department are prepared to handle staff shortages.
During a recent string of illnesses and consecutives days with short staffs, department leaders took off their managers' hats and got on the frontline to register patients.
"The leadership team are working managers, much like any other patient access area," says Cathy Pallozzi, CHAM, patient access director at Albany Medical, noting the staff recently experienced colds and GI, which sprang the managers to action. "So the managers are on the front end, as well as the associate director. If I am needed, I will be on the front end as well."
Read the full story.
Hospitals can't escape layoffs these days, and they're not adding many jobs any time soon.
Bureau of Labor Statistics data released Friday say hospitals added only 300 payroll jobs across the entire nation, compared to 16,800 jobs in May 2008, and 8,700 jobs in May 2007.
So what are hospitals doing about it, especially on the front end where accurate registrations and upfront collections can mean the difference between a denial and a full return on a patient bill?
They are getting smarter, more technologically savvy, and analyzing their payer mix and what each entity requires.
Read the full story by HealthLeaders Media's Dom Nicastro.
Find out how the economic stimulus plan can help offset your EHR implementation costs
Title XIII of the American Recovery and Reinvestment Act of 2009 focuses on healthcare information technology (IT) and quality, with $19 billion in grants and loans set aside for infrastructure and incentive payments under Medicare and Medicaid for providers who adopt certified EHR technology. The grants and loans include $17 billion slated for incentives, with $2 billion allotted to jump-start health IT adoption.
The Act outlines incentive plans for eligible professionals for their ‘meaningful use’ of EHRs. The Act specifies that ‘meaningful use’ requires the following:
- Use of certified EHR technology
- Information exchange
- Reporting on yet-to-be-selected clinical quality measures using EHRs
Incentive payments begin in 2011, and they encourage early adoption. For example, when a hospital implements an EHR in 2011, it will receive 100% of the incentive amount for which the hospital is eligible. However, when the hospital delays implementation until 2012, it will only receive 75%. After 2015, there will be no incentive payment.
Nonhospital-based physicians will receive incentive payments based on a similar—though not exactly the same—payment structure; however, they will also receive payment reductions for failing to adopt by 2015.
Critical access hospitals are eligible for incentive payments; however, they will be subject to a different calculation that is not currently available.
See Title IV on p. 360 of the PDF for more information regarding payment incentives.
Economic stimulus act offsets costly EHR implementation, provides financial incentives
$19 billion in grants and loans earmarked for development of health information technology
By Lisa Eramo, CPC
Healthcare providers looking for assistance with the adoption of EHRs may be in for a pleasant surprise, according to the Health Information Technology (HIT) Extension Program included in the American Recovery and Reinvestment Act of 2009 that President Barack Obama signed today.
Title XIII of the Act focuses on HIT and quality, with $19 billion in grants and loans set aside for infrastructure and incentive payments under Medicare and Medicaid for providers who adopt certified EHR technology. The grants and loans include $17 billion slated for incentives, with $2 billion allotted to jump-start health IT adoption.
The Act also formalizes in statute the establishment within the Department of Health and Human Services an Office of the National Coordinator for HIT that was created during former President George W. Bush’s administration. In addition, the Act establishes HIT policy and standards committees to promote a nationwide infrastructure.
Effectiveness of the incentives remain unknown
Will this be the much-needed fire to spark a widespread EHR adoption? Industry experts remain skeptical.
“I think it will help the industry move forward over the long haul, but do I think that we’re going to see significant transformation over the next year or even two years? No I don’t,” says Chris Apgar, CISSP, president of Apgar & Associates, LLC in Portland, OR. “Yes, funds must be available, but ultimately, when it gets down to it, providers have to buy into it, and that’s not going to be quick.”
Others say the allotted funds may not be enough considering the colossal financial burden associated with an EHR implementation.
“Compared to the percentage of the GNP [gross national product] that healthcare is and the billions and billions of dollars that it costs to provide healthcare, it’s sort of a drop in the bucket,” says Darice Grzybowski, MA, RHIA, FAHIMA, president of HIMentors, LLC in LaGrange, IL. “However, any incentive for hospitals to adopt better electronic document management technologies is a step in the right direction. Motivation to get started is half the battle.”
Interoperability remains yet another challenge in fostering a nationwide infrastructure, Apgar says. “Just because I incentivize someone to purchase and install an electronic health record doesn’t mean that the electronic health record can talk to another electronic health record,” he adds.
Smaller providers, clinics, and physician practices may benefit most from the financial assistance because of their tighter budgets, Apgar says. The information that these providers-particularly primary care physicians-gather is also important from a health data exchange standpoint, he adds. These physicians hold the much-needed patient demographic information, medical history information, and anecdotal data that will help improve overall patient care across a variety of settings.
Still others have a more hopeful outlook now that Congress has stepped up to the plate. AHIMA, for example, has been a long-time proponent of widespread EHR adoption.
“Besides the overall impact of improving patient care through the adoption and use of standard electronic health records, AHIMA is pleased that Congress recognized the need for individuals educated and trained health information management and informatics to facilitate the adoption, implementation, and management of EHRs, and electronic health information exchange,” says Dan Rode, MBA, CHPS, FHFMA, vice president of policy and government relations for AHIMA in Washington, DC.
Funds to assist in a variety of initiatives
The $19 billion in state and federal funds will be available through the National Coordinator, Health Resources and Services Administration, the Agency for Healthcare Research and Quality, CMS, the Centers for Disease Control and Prevention, and Indian Health Services to provide the following:
- An HIT Research Center that will render technical assistance and publish best practice guidance
- Regional centers to assist and educate providers as well as disseminate information from the Center to various regions of the country
- Planning and implementation grants for states or state-designated entities
- Grants to establish loan programs to state or Indian tribes for the purchase of certified EHR technology, provide training, or upgrade systems to meet certification requirements
- Competitive grants to fund demonstration projects to integrate EHR technology into the clinical education of health professionals
- Assistance in the creation or expansion of medical health informatics education programs at institutions of higher education or consortia of institutions
And it doesn’t stop there. Aside from the planning and implementation grants and loans, the Act also creates several incentives for the adoption of EHRs. The allocation schedule (i.e., when and how monies will be distributed) has not yet been clarified.
Potential negative consequences for no implementation
Hospitals that don’t jump aboard the EHR bandwagon could see larger-and negative-ramifications down the line, Apgar says. “In the future, Medicare may require providers to have an interoperable EHR that meets national standards as a prerequisite for participation. Medicare will use its buying power rather than regulation or statute.”
But just because the funds are available doesn’t mean that they will benefit every provider, particularly those who may not need a certified system that includes all of the bells and whistles, Apgar adds. “From a business standpoint, it may not make sense to accept a couple thousand dollars and put it in a system that doesn’t do what you need it to do,” he says.
Incentives could boost health IT jobs
Aside from creating an impetus to implement EHRs, the stimulus plan could also significantly spark employment in the HIT sector, according to a January 2009 report published by the Information Technology and Innovation Foundation (ITIF), a Washington think tank. ITIF estimates that a $10 billion investment in HIT would create as many as 212,000 new or retained U.S. jobs a year.
“It will definitely have favorable implications from an employment perspective for those in the HIT or HIM fields,” says Daniel J. Pothen, MS, RHIA, CHPS, CHPIMS, CCS, CCS-P, CHC, director of clinical informatics and health information services at Mission Hospital/CHOC in Mission Viejo, CA.
Editor’s note: To learn more about HIT initiatives, view the American Recovery and Reinvestment Act of 2009. Click on “bill text division A” in the “conference report” column for more specific information related to EHRs and Title XIII.
The stimulus plan passed by the Senate Tuesday includes millions of dollars for Medicaid, meaning hospitals may see a lift in reimbursements.
The Senate voted to approve an $838 billion economic stimulus plan after the House passed a $820 billion version earlier, The New York Times reported.
“Throughout our history, the federal government has catalyzed a good idea, invested in the ingenuity and entrepreneurship of the American people, and let the private sector flourish,” the majority leader, Senator Harry Reid of Nevada, said before the vote, The New York Times reported. “Faced with an economic crisis today, we have an opportunity to make similar investments that will help our country prosper in the years to come.”
Read the full story in The New York Times.
Get blog updates in your e-mail
Subscribe to our free RAC Report e-zine
