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...

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...

Medicare Tests ICD-10 Claims Submission

Medicare Fee for Service (FFS) health care providers, clearinghouses, and billing agencies participated in a second successful ICD-10 end-to-end testing week with all Medicare Administrative Contractors (MACs) and the Durable Medical Equipment (DME) MAC Common Electronic Data Interchange (CEDI) contractor from April 27 through May 1, 2015. CMS was able to accommodate most of the testing volunteers with approximately 875 participants. They were successfully able to submit the ICD-10 claims through the Medicare billing system. The acceptance rate was higher for this round of testing than the first and a lower error rate related to the codes than the previous testing. 23,138 test claims were submitted 20,306 claims were accepted (88%) 2% were rejected due to invalid submission of ICD-10 (and in some cases the ICD-9 codes) Less than 1% were rejected due to invalid ICD-9 codes. Additional rejections were not related to the codes themselves, but to other incorrect information on the claim form, e.g., provider numbers, claim identifiers, place of service. Medicare has plans for using the test results to prepare a provider educational process to help with successful claims submission. As of October 1, 2015, Medicare will no longer accept ICD-9 diagnosis codes and they will be rejected. If provider offices are ready to submit the new 10 codes, great; if not, better contact www.med-certification to learn how to code the new diagnostic...

Electronic Medical Record Software

Once Electronic Medical Records EMRs were mandated, vendors put together a variety of software options. Now there are dozens of vendors with a variety of products ranging from $400 per month to several thousand dollars. One of the EMR vendors does not charge anything at all (it is truly free) for using its EMR, Practice Fusion, a free, cloud-based EHR. It is the most popular for small practices since the economics to purchase higher priced systems doesn’t work very well. Practice Fusion rates very well with comparable products too and is in the top 10. The primary function of an EHR system is to integrate the patient information to other providers and facilities, to include labs, pharmacies, referring physicians, etc. Of course, patients are the most important part of health care, so good medical software gives them access to tools and information to help improve their care, including a patient portal where patients can perform a variety of tasks, such as requesting appointments, get copies of medical records, and access educational resources. The EHR solution was supposed to meet government regulations, particularly the Meaningful Use (Medicare) which has created such a nightmare for providers even though the government provides financial incentives for implementation. A workable system was ideally supposed to link with outside systems and provide online access to those directly involved with a given patient’s care. And of course that integration would then allow practices to meet government regulations and guidelines. As we have reported previously, a real quagmire is now the operational standard since all of those independent vendor products cannot communicate with each other, thus we...