EHR Frustration Continues

EHR FRUSTRATION Though the goals for Electronic Medical Records (EHRs) were commendable, the results have been awful. The objectives were to improve medical provider communication and share patient information. Providers have spent a ton of money trying to make them work, but so far it’s just created expense and frustration, and, in fact probably reduced the quality of medical care. The CMS (Centers for Medicare & Medicaid Services) added to the headache with mandates to use EHRs, and initiated the “Meaningful Use” program, but the AMA and many other state and county medical associations have challenged the timelines and their stages. CMS recently issued some final and proposed regulations for stages 2 and 3 of meaningful use in response. Though something like 80% of physicians adopted some form of an EHR, the results are dismal. Lots of them are so disgusted, they do not plan to continue their use, willing to accept financial penalties imposed by CMS. Providers hoped EHRs would provide the tools to improve patient care with the ability to exchange information and allow better tools for planning. Instead, the systems won’t talk to each, cost a lot to maintain, slow down the actual patient encounter process, and seriously impact cash flow. With so much competition in the vendor market, the expectation is that software systems will get better and the best ones will rise to the top, so providers are now waiting for that process to unfold. They don’t want to get it wrong a second time. Hopefully, in spite of the setbacks and costs, technology will ultimately be an integral part of patient care and...

Baby Boomers and Healthcare Jobs

Hard to believe but the Baby Boomers reached retirement age in 2011.  Having officially joined the aging population, more medical care is required, thus more healthcare workers.  Because of the significant increase, the industry is looking at where they will recruit the new workers since so many of the older ones will be retiring. For those who think they are over the hill, there is good news — it’s pretty much a foregone conclusion that workers 50 or over will be used because of their experience and the willingness to actually work.  AARP reports that 35% of the U.S. labor force will be 50 or older by 2022, an increase of 10%. Since older workers have largely been discriminated against, that’s great news.  Somewhere along the line, it was determined that older workers cost more and were not as productive, which of course was totally off the charts misinformation.  They are well known for their work ethic which is far more important in terms of productivity than what they might cost in insurance benefits. They are dependable and reliable, the last of the greatest generation along with the boomers.  The turnover is less too than the younger worker statistics. Companies are hiring older works and providing training programs as well. So, if you are an “older person,” don’t wait another minute to get trained for healthcare jobs.  A great place to start looking is www.med-certification.com where a variety of training is available at very affordable prices.  Just do...

Affordable Health Care 2015 Data

So, a year later, what’s the story on the ACA? 15 million Americans† who didn’t have health insurance before the ACA was signed into law are now covered, bringing the total uninsured adults in the US from 18% to 13.4%. During the year many dropped their plans, or didn’t yet renew them for 2015. Still, for open enrollment in 2015, there is a hint by the numbers that a larger number of total enrollees are anticipated.   Enrollment is expected to increase as people†respond to subsidies and to penalties for failure to†obtain coverage (imposed by the Internal Revenue Service). Arguments rage among the pundits about the actual numbers, suggesting that more people have dropped their plans because they can’t afford it, and that the coverage is not that good.  With deductibles as high as $6,000, before insurance pays anything is questionable. What about those penalties if you didn’t enroll? The IRS reports that 7.5 million tax filers paid the $200 penalty for no insurance for the year 2014.  Seventy six percent (76%) checked the box on the form showing they had insurance, about 76%.  Twelve million had exemptions.  Five million didn’t check the box so no information on those but IRS is sending them letters to amend their tax returns.  In all, the IRS said it has collected $1.5 billion on those penalties. Who paid for the insurance coverage? 2.7 million people had $9 billion in subsidies, the average for which was $3,400, with 40% claimed less than $2000 in subsidies, and 40% $2000 to $5000, with 20% $5000 or more. Want to learn more about insurance and how it...

ICD-10 Ready?

CMS (Medicare) is ready for full ICD-10 implementation. The entire Q&A document is available at CMS here: https://www.cms.gov/Medicare/Coding/ICD10/Clarifying-Questions-and-Answers-Related-to-the-July-6-2015-CMS-AMA-Joint-Announcement.pdf Some highlights: The provider groups have requested an ombudsman be in place and CMS plans to have that done by the ICD-10 implementation date of October 1, 2015. Will there be a delay in ICD-10 implementation?  No.  Any claims filed on service dates on or after October 1, will be rejected if they don’t have a valid ICD-10 code. Are all ICD-10 codes valid for CMS?  No, please visit the site for a list of valid codes. Example: Patient has a diagnosis of G43.711 (Chronic migraine without aura, intractable, with status migrainosus).  Use of the valid codes G43.701 (Chronic migraine without aura) or G43.719 (Chronic migraine without aura, intractable without status migrainosus) instead of the correct code, G43.711, would not be cause for an audit under the audit flexibilities occurring for 12 months after ICD 10 implementation, since they are all in the same family of codes. What is a family of codes? The 3 character category (codes which are clinically related and provide differences in capturing specific information on the type of condition) If you are a coder and have not yet learned ICD-10 coding or a provider who has not yet trained employees, or even a novice wanting to learn how to do medical coding, please visit www.med-certification.com and you will easily discover the affordable options available to meet the emergent...

Chocolate Rules!

Chocolate lovers benefit is proven. Findings of the Norfolk Study (with 155 participants) show that regular consumption of chocolate decreases cardiovascular risks, including strokes. This was a 12 year monitoring project with the people in the test group eating 7 grams or more per day (some in the study group ate much more than that, up to 100 grams per day). Higher levels were associated with lower CV risks. The higher intakes projected an 11% lower risk and 25% lower in associated death. Hospital admission likelihood was 9% less. Other related observation showed that chocolate eaters were actually healthier. They had lower weight, more energy, were more active with physical activity (a major factor in reducing CV events, e.g., stroke, heart attack), less alcohol consumption. It was also interesting that fewer of the study group developed diabetes. The flavanols in dark chocolate stimulate the endothelium (lining of the arteries) which helps lower blood pressure. Dark chocolate is the most beneficial though the lighter ones still work. Chocolate is derived from cacao beans which are loaded with minerals and antioxidants. Dark chocolate has 11 grams and for the average RDA has 67% iron, 58% magnesium, 89% copper, 98% manganese, and potassium, phosphorus, zinc and selenium. It is recommended that the chocolate contain at least 70% dark chocolate. Oh, happy day! Rejoice chocolate addicts! But, don’t overdo...

ICD-10 Countdown

With 3.5 months to go for the implementation deadline, new bills in the house trying to delay it once more.  Calling it the “safe harbor” supporters are asking for a transition period for up to 2 years during which time, providers using the codes wouldn’t be panelized for their errors. Detractors argue that the bills are really based on some incorrect assumptions.  First, payments aren’t determined with the ICD codes; these codes are for diagnoses.  CPT code are used to describe services.  Secondly, ICD-10 details aren’t readily available in the record.  The record should include all of the information to determine the ICD code.  The argument that payments will be delayed has been put to rest by actual claim processing results tested by the Centers for Medicare & Medicaid Services (CMS).  Their results show that only 2% of the test claims submitted were denied based on coding errors. The bills claim that the code switch will place an undue burden.  However, the magnified detail includes, for example, the body part(s) affected in the injury or disease process, all of which information is available in the record. The Coalition for ICD-10 arguing against the safe harbor bills on the fraud and abuse issues says that if the coding errors were accepted by CMS without fear of audit, the agency could see a rise in deliberate reporting of incorrect information. The bills also fail to address all payers, that is would the safe harbor provisions only relate to CMS or to all insurance companies. Bottom line, virtually everybody in the healthcare industry that understands and works with codes and reimbursement agrees...