With both reimbursement requirements and the solutions to manage them growing more complex, many practices may laugh at the notion of “streamlined” workflows in the office when it comes to their revenue cycle. Technology is supposed to help solve problems, after all, not add layers of technology that create more.

As the healthcare industry moves away from fee-for-service and towards pay-for-value, the number of government, insurance, and third-party programs looking to incentivize clinical quality is only going to increase. If you are a practice manager or owner, you will want to be particularly familiar with three of these programs in 2017. 

The practice of medicine is changing at an unforeseen pace.  With fee-for-service reimbursements declining, practices need to make sure they are maximizing productivity, collecting all they are entitled to, and making the important shift toward value-based care. So how does a practice know if they are doing their best?  How do they identify areas that need improvement?

The regular collection of data allows a practice to assess whether the correct processes are being performed and desired results are being achieved. If you can’t measure it, you can’t manage it.

As we generally do with proposed regulations that impact EHR developers and their customers, the Electronic Health Record Association (EHRA) carefully reviewed and collectively commented on CMS’s proposed rule on the Hospital Outpatient Prospective Payment Systems (HOPPS) and EHR Incentive Program on September 1. Our comments, submitted on September 1 and available here, are based on the collective experiences of more than 30 EHRA member companies who service the vast majority of hospitals and ambulatory care providers using EHRs across the United States.

The Department of Health and Human Services wants to improve your medical bills. So much so that they have launched a nationwide challenge called “A Bill You Can Understand,” to help create a clearer, less complex, and more understandable medical bill that improves the patient financial experience. 

Telehealth Services

Telemedicine is changing the way we experience healthcare. It allows patients to consult medical professionals via technology for a range of illnesses or follow-up care from the comfort of their home. While telemedicine has existed for more than a decade now, recent advancements in technology have seen it re-emerge as a tremendous force. 

According to a new study from TransUnion, three out of four consumers (76 percent) are extremely or somewhat concerned about increased costs from health insurer’s 2017 rate proposals.

Several major health insurers have indicated that they will seek premium increases in 2017 due to higher costs and lower than expected profits. The price hikes are causing anxiety among consumers of which nearly 65 percent report being more concerned about the total cost of their healthcare this year versus last year.

WEDI released the results of its final ICD-10 assessment survey earlier this month saying it was a “non-eventful transition” and because it went so well it should be considered a template for future mandates. "We wanted this post-implementation survey to be a closing chapter of assessment on why the transition went so well overall and to also leverage specific lessons learned for future large implementations," Jean Narcisi, chair of WEDI, says in the announcement.

With the accelerated adoption of electronic health records (EHRs), there is growing recognition of the benefits associated with the use of these technologies – reduced medical errors, faster access to complete information, more efficient communications among busy clinicians, and increasing patient engagement in their healthcare decisions.  At the same time, there is a dialog taking place among all stakeholders on the issues related to busy clinicians taking advantage of data re-use capabilities to avoid re-entering identical information as they create their encounter documentation.

According to a recent Wall Street Journal article, health insurers are struggling to offset rising costs and are proposing big premium increases for coverage in 2017. Humana, Providence Health Plan, Anthem, UnitedHealth Group and Aetna, are just a few of the insurers considering rate hikes for 2017.