As I work closely with many healthcare professionals, I am hearing all the latest and greatest (and usually false) rumors about Covid-19.
The latest one is of special importance to independent healthcare providers, many of whom are turning to telehealth sessions during shutdowns to help enforce social distancing. There is a rumor going around, especially on social media, that the government has essentially suspended all HIPAA privacy rules and is allowing all forms of communication for telehealth sessions. This is simply untrue. To read the full, official statement, please click here (link to HHS.gov article).
In a nutshell, it says this: yes, as of this past week, the government will be temporarily suspending enforcement and fines for some non-compliant platforms, but not all of them, including FB Live, Twitch, and other public platforms.
However, we are advising clients, prospects, and all providers we know to be careful about employing non-compliant platforms, even in light of the new, temporary waivers. We have four main reasons for issuing this advice:
1) Privacy rules are in place to protect patients, and our ethical duty to do that does not end just because we (temporarily) cannot be fined for failing to do so. Applications like FB Messenger, consumer Skype, and FaceTime are not subject to BAAs and you (and by extension your patients) are therefore not protected in case of breach.
2) From an operational point of view, consumer applications like FaceTime are not optimal, since they are not integrated into a practice's workflows. A good telehealth platform should simply be another feature in an overall patient portal that allows you and your patients to manage the entire interaction, from setting the appointment to holding the secure, HIPAA-compliant telehealth session, to having the patients pay their co-pay/fees, to following up with messaging/labs retrievals/notes/prescribing (as applicable). Burnout among healthcare professionals was already high before this crisis; let's not make it even worse by forcing staff to jump through extra hoops.
However, if you do choose to go with a standalone telehealth offering, it should at least be true telemedicine, not simply a video chat tool. Our platform- and vendor-agnostic Blum Telehealth, for example, is a true telehealth app: it is the first Bluetooth-enabled telemedicine app, allowing physicians to monitor vital signs such as temperature and blood pressure, and even to look into patients' eyes and ears.
3) From a best-practice point of view, we do not recommend that practices get in the habit of using non-compliant platforms. Sooner or later (and quite likely sooner), HHS will rescind the enforcement waiver. So we recommend asking yourself this: were you aware of the article linked above? Possibly. Also quite likely you were not, given how chaotic everything has been. So will you be equally unaware when the rescission of the waivers is published? HIPAA fines range anywhere from $100 to $50,000 per violation. That's a lot of long-term downside risk to save very little money in the short term.
4) We all need to start thinking about the "New Normal." Practices of almost every kind are under tremendous financial strain thanks to this crisis. And let's face it, with all the rules, regulations, bureaucracy, paperwork, bad technology, and the constant insurance company push-back on claims, it was already a challenge to be an independent provider to begin with. For example, on average, the insurance companies make a practice resubmit one out of every three claims at least once, with an average re-work/re-submission cost of $25 a claim. We are projecting those rejection rates to climb in the months to come as insurance companies scramble to cut their losses from Covid-19 coverage. (That's a polite way of saying they are going to try and claw back as much as possible from you, the healthcare providers.) I bring this up in the context of these waivers because we are concerned that this is just another opportunity for many independent practices to delay making the changes they already needed to make to stay financially viable in the long term. Practices that fail to adapt to the New Normal, practices that were already under pressure to begin with, are going to struggle to stay afloat if they do not act now.
In summary, please be careful about the decisions you make regarding telehealth, and be sure to consider those decisions in the larger context of your practice's long-term health. Reach out to us today and we can get you up and running on a safe, fully compliant teleheatlh platform at a reasonable cost and in a very short time frame.
In closing, a heartfelt thank-you to everyone in the medical and mental health community. Your dedication during this dark time for our country is an inspiration and gives us all hope. Please stay safe!
Covid19, the deadly and highly contagious disease caused by the novel coronavirus that was first reported late last year, has already tested our country’s healthcare delivery system, and it is almost certainly not even close to peaking yet. Here at Fast Layne Solutions, we are, as always, focused on how to help small- to medium-sized independent medical practices, so today’s blog post is about how technology can assist these vital players (and the patients who rely on them) in this crisis in their tireless efforts to serve patients, while also helping them keep their offices operationally and financially viable. We will conclude with some specific additional measures that Fast Layne Solutions will be taking to help out.
Let’s start with social distancing. It is absolutely vital that we minimize human-to-human contact to stem the spread of the virus. For any medical procedure that does not require in-person consultation, we strongly recommend e-visits, aka telehealth. If your office is not already equipped to do telehealth visits, please contact us. For the duration of the Covid19 pandemic, we are waiving much of the implementation cost for our clients and, for qualifying practices, will amortize the rest over one year. We will work to get you set up on telehealth extremely quickly, as it is embedded into the patient portal that we provide with our EMRx and Revenue Cycle Management offering (see iClaim below). With just a few clicks, you can be seeing a patient anywhere in the world in a secure, HIPAA-compliant environment. (Because Apple will not sign a BAA, FaceTime, for example, is not compliant. Do not make that risky and potentially expensive mistake.) In the same portal, your patients can make appointments and even pay for their visits, as well as message your office, review their records, and check lab results.
Another way your office can facilitate social distancing is to get rid of the old practice of having patients arrive early to fill out paperwork. Using our portal, patients fill in their paperwork online in advance, and your office staff see it as highlighted entries ready for them to check and confirm before making them permanent entries into the patients’ records. As noted above, that same portal can also minimize face-to-face interactions by facilitating online payments, scheduling, records and results retrievals, and messaging.
Now we need to discuss an unpleasant topic, doctors and practice administrators. The insurance companies have waived certain co-pays related directly to testing, but this will not impact any other costs to patients, including actual treatment. Independent doctors already struggle with denials, claim rejections, and outstanding patient debt even at the best of times. During this crisis, those problems will only grow. So let’s look at how we can use technology to help minimize the impact on your practice so that you can continue serving your patients:
By ensuring that every single one of your patients who is covered by insurance has their claims properly submitted and paid by the insurance companies, you can not only survive but thrive in this challenging time.
Technology has an important role to play in this crisis, and we are ready to help you implement it quickly and efficiently to minimize negative outcomes for both you and your patients.
To further assist doctors and their patients at this difficult time, Fast Layne Solutions is also offering a monthly 5% rebate to any of our clients who are in a position to offer medical care to uninsured patients, in order to help them defer those costs. This offer remains in effect until the pandemic is declared over by the WHO.
For the duration of the crisis, we will also be donating 5% of our clients’ monthly invoices to the Center for Disaster Philanthropy’s Covid19 Response Fund.
We want to close by thanking our tireless and brave healthcare workers who will be on the front line in the battle against Covid19. You are our heroes and America’s best hope.
Last week, we talked about the challenges facing a fictional doctor, Dr. Janelle Smith, a young endocrinologist trying to serve the South Side of Chicago as an independent practitioner. When we left off, she was facing an impossible choice: stay in her private practice but barely scrape by, or join a large hospital and let go of her dream to serve her community. But it's a false choice, because all those problems we described actually have solutions.
Let’s take her EHR. Her total annual costs, including maintenance, updates, and training, for her current system exceed $25,000 for the practice. And that’s just what she pays to her provider. What she’s not capturing in that figure is the value of the time wasted by her and her PA due to how complicated and user-unfriendly her system is. So she sits down and runs the numbers: she and her PA are averaging 10 minutes per patient encounter and they see 40 patients a day. To her horror, she realizes that almost an entire headcount is dedicated just to charting. But a tablet-optimized, Cloud-based EHR like NextGen’s EMRx costs a fraction of that, and because it was designed by doctors, it’s intended to get doctors through the charting process as quickly as possible, in an average of just two minutes per encounter. Her first year savings alone are going to be almost $10,000 just for the software, and it leads to productivity gains equating to getting ⅔ of a new headcount for free. She almost has enough to add a second PA and expand her practice. And she’s just getting started.
Now let’s look at her overhead. She has a staff of five, including herself. Of those, three produce no revenue whatsoever and are not involved in providing care to her patients. They spend their days in purely administrative tasks, as noted above. But how much of that work is even necessary? Very little of it. With a full-feature practice and revenue cycle management suite, claims are generated automatically based on the integrated EHR, and reviewed by experts who handle claims for many offices, getting her practice out of the billing and claims business. (Any self-pay bills can be printed with a push of a button.) And because those claims are scrubbed by the advanced iClaim claims management system, the rejection rate is under 2%, and the payments hit Dr. Smith’s account within just a few days, thanks to the separate clearinghouse the system uses.
Patients can now fill out their paperwork in advance through the patient portal. They can also submit their medical records requests there, make appointments, and even pay their bills. And all benefits verifications are now automated and executed with the push of a single button when the patient checks in. And denials? A thing of the past thanks to a rigorous and automated verification system.
So the work of three staff who had been working 45-50 hours a week can now be done by two staff members working 40 hours a week. Now Dr. Smith has a receptionist/admin working no overtime and a far less stressed-out office manager working a normal schedule. Including overhead, salaries, and overtime, she is saving over $50,000 a year. That’s the rest of the money she needs to add that second PA or a nurse practitioner!
She also implements ChoicePay, cutting her credit card transaction fees to 1.79%, saving her money, allowing her to take payments online, and giving her a fully HIPAA-compliant merchant services solution that is seamlessly integrated with her billing system.
Her overall financial situation starts to improve dramatically as her AR days fall and she all but eliminates write-offs and bad patient debt caused by denials. Cash flow is excellent, with payments coming in within days of service provision. She’s no longer worried about making payroll. Her staff of five is now three healthcare providers, all of whom are caring for patients and generating revenue. She’s thriving. She’s able to dedicate more hours to her free clinic. She’s no longer living month to month; on the contrary, she’s making bold plans to expand to a second location.
As you look back through this scenario and consider the impact on the South Side, you can see the obvious benefits in terms of keeping quality care in the area and helping a local practice thrive. But you might have one concern. What about that biller? Yes, the practice still employs five people, but that biller is out of a job, and that isn’t good for the community. That’s why Fast Layne Solutions is proud to announce an initiative to create jobs in the communities we serve by training and equipping claims handlers in those neighborhoods. For example, we are committed to adding one new job for every five providers we serve on the South Side of Chicago. Note we’re saying providers, not clients, here. So a single office with, say, three doctors, one physician’s assistant, and one nurse practitioner would lead to a new job on the South Side. We will provide the training and the equipment, and the claims handlers can not only work from home, but also set their own hours, since we require only that a certain number of claims be processed within a given week. Think about what that means for, say, a single mother. Single mothers in economically vulnerable neighborhoods often struggle to find sustainable employment because working outside the home simply doesn’t pay once you account for childcare. But if you have a job that can be done from anywhere and at any time of day, you have the flexibility to earn a good living while still caring for your children.
The term “win/win” is thrown around a lot, but that’s truly what this is. We are giving practices the tools they need not just to survive but thrive in a challenging environment, while also creating new jobs in the community, jobs that involve highly valued, transferable skills.
Want to learn more? Email us today and let’s set up a free, no-obligation practice analysis. If we can’t prove that we’ll save you more than we will charge you, we just won’t ask for your business. It really is that simple.
February is Black History Month, and to celebrate, Fast Layne Solutions would like to pay tribute to some of the key African-American pioneers in the field of medicine.
Dr. James McCune Smith (1813 – 1865) was the very first African American to hold a medical degree. He was the valedictorian of his graduating class in medical school at the University of Glasgow in Scotland. After completing his degree and then an internship in Paris, he returned to the US, where he had a long and successful career that included being the first Black man to run a pharmacy in the United States; publishing articles in respected medical journals; and conducting extensive research, especially in the area of refuting racist theories about the connections between race and intelligence. He accomplished all this despite the many obstacles 19th-century America put in his path: he was refused admission to medical schools in the US due to his race, and was never accepted by the American Medical Association or even local medical groups. He was even once refused passage on a ship to return to America due to his race. Smith was an ardent abolitionist, and died just before the ratification of the 13th Amendment abolishing slavery.
Dr. Helen Octavia Dickens (1909 – 2001) was the first African-American woman to be admitted to the American College of Surgeons. She completed her medical degree at the University of Illinois College of Medicine in 1934. In 1942, she passed the boards to become the first Black woman to become a board-certified Ob/gyn in Philadelphia. She served as Director of Obstetrics and Gynecology at the Mercy Douglass Hospital in Philadelphia for almost 20 years, and did extensive research into the areas of teen pregnancy and sexually transmitted diseases, using the results to educate young women. As a doctor who faced the double challenge of overcoming both racism and sexism in her personal and professional lives, she was a true pioneer in both medicine and the fight for equality.
Dr. Robert Fulton Boyd (1855 – 1912) was the first president of the National Medical Association, an organization he and others founded in response to the racial segregation of medical facilities and schools and of other medical associations. Born into slavery, he went on to become a superlatively qualified healer, earning a degree not only in medicine but dentistry, on top of a Master of Arts degree. In 1893, he was appointed professor of gynecology and clinical medicine at Meharry College in Nashville.
Mary Mahoney (1845 – 1926) was the first African American woman to be awarded a nursing degree in 1879. She was also among the first Black women to be admitted to the American Nurses Association (ANA). She was a co-founder of the National Association of Colored Graduate Nurses (NACGN), which made significant contributions in the area of ending racial discrimination policies in their field. (The NACGN later merged with the ANA.) She was a civil rights pioneer in other ways, too: she was among the first Black women to register to vote in Boston after Suffrage. She was honored with induction into both the ANA’s and the National Women’s Hall of Fame.
Despite the great strides made by these and other brave African American pioneers in the field of medicine, to this day, Black medical professionals face challenges unknown to their white counterparts. Sociologist Adia Harvey Wingfield of Washington University has studied this subject extensively and her work shows we still have a long way to go. That’s doubly true for African American women working in medicine. Wingfield reported cases of Black female doctors regularly being called “miss” by people who assumed they must be nurses or orderlies. And the “new economy,” with its emphasis on contract work, has presented even more challenges, as Black medical professionals are disproportionately pushed into such arrangements, limiting both job security and upward mobility.
Every February, Black History Month provides us with myriad inspirational stories telling us how far we have come as a society, along with new milestones showing that we continue to make incremental improvements. But it also a sobering reminder that we still have miles to travel before we arrive at that “not too distant tomorrow [when] the radiant stars of love and brotherhood will shine over our great nation with all their scintillating beauty.” But we will get there. Dr. Martin Luther King never doubted that vision of his, and he never abandoned hope. Nor should we.
We often hear about so-called ‘food deserts,’ areas where it is difficult to impossible to purchase healthy, nutritious foods. But did you know there are also healthcare deserts? These sections of both rural and urban America have a shortage of doctors and healthcare facilities, and the impacts are deadly. And the effects disproportionately fall on minority communities. For example, on Chicago’s South Side, the death rate from diabetes is twice that of other neighborhoods in the same city. The result, when compounded by other factors such as poverty and poor access to nutrition, is that America has a huge life expectancy disparity, and it’s getting worse, not better. In fact, the gap is now 20 years when comparing the wealthiest zip codes to the poorest.
Fast Layne Solutions is dedicated to fighting this trend by helping doctors in these areas to become more financially viable and to thrive in these environments, even as we also develop plans to help these communities in other ways. Today’s blog is an introduction to how our solutions can help, and next month's installment will reveal exciting news about how we plan to do so while keeping jobs in the community.
First of all, why is it so hard for independent doctors to thrive in these communities? Mainly it’s a question of economics. It is extremely expensive to be an independent doctor these days. Quite aside from the fact that new doctors are starting their careers hundreds of thousands of dollars in debt, it is also financially burdensome to practice in the current regulatory and competitive environment.
This month and next, we are going to be looking at the journey of a fictional doctor, Dr. Janelle Smith, a young endocrinologist determined to make a difference in her South Side neighborhood, but who’s struggling to overcome the obstacles facing so many independent doctors, especially in the more economically-challenged areas of America’s cities.
Dr. Smith has just finished medical school and residency and is now ready to dedicate her life to fight diabetes among the area’s poorer residents. Dr. Smith is already in debt from medical school. She owes $200,000 in student loans. But she’s determined to help fight the diabetes epidemic that is cutting so many lives short in her neighborhood. So she raises some money and opens her clinic. She plans to stay viable by serving a wide range of patients: those who have private insurance, a few who are self-pay, some Medicare, and a very large portion of Medicaid patients. She also hopes to do a free clinic session every Saturday for four hours. She hires a biller, a receptionist, an office manager, and a physician’s assistant.
Once she is up and running, she quickly builds a large patient base. Yet she’s not thriving, and her cash flow is terrible, with her average accounts receivable days at around 75. Reimbursements are slow, expenses are high. Her biller spends all day fighting the insurance companies over rejected claims. She’s paying over 3% on credit card transactions for co-pays and self-pays. Her staff seems to spend endless hours on mundane, unproductive tasks like setting up appointments and doing reminders by phone, calling insurance companies for verifications, reworking the hundreds of claims that get kicked back from insurance for seemingly pointless reasons, dealing with write-offs over unexpected denials, going through mountains of paperwork for patient forms that the receptionist must then manually enter…...the list is endless. And Dr. Smith herself has no life. If she isn’t seeing patients, she’s catching up on charting in her tortuously cumbersome EHR (that she can barely afford). And it’s not like she has a choice: as a doctor taking Medicare, she has to start reporting her MIPS performance by her second year, and her state Medicaid program also has reporting requirements. She MUST use an EHR.
Dr. Smith is getting by, but she’s frustrated. She thinks of the stereotypes she grew up with: rich doctors driving Mercedes, taking off Wednesday afternoons, living in mansions. Not that she became a doctor for those reasons: if she had, she could have taken a cushy job with one of the large hospital systems. But still, it would be nice not to feel that her practice and her own financial situation was a month-to-month crisis waiting to happen.
One evening, after yet another 14 hour day, she gets a phone call. It’s a recruiter from the large hospital system in town. He’s familiar with her work, knows her impressive education and residency history. He throws out a number. A number that would mean no more stressing out about student loan payments. No more worrying about making payroll next month.
And no more independence. And no more serving the community she grew up in. In fact, no more living or practicing in her old neighborhood at all. To avoid an excessive commute, she’d have to move to the north side of town. And it means working as an employee for a corporate provider. No more being her own boss. No more serving the South Side.
Is this really what it comes down to? A choice between doing what’s right and barely scraping by on the one hand versus giving up her independence and her dream of serving the community where she grew up on the other?
Absolutely not. She’s facing a false choice, because, like so many doctors in America, she simply does not know that there are solutions to all her problems. Tune in next week and we’ll see how Dr. Smith can turn her practice around and live her dream of serving the South Side as a thriving, independent doctor.
This month's blog is by our guest-blogger Ken Vaughan of Record Storage Systems, a Charlotte-based company specializing in helping doctors securely store their vital paper records. We’ve partnered with Record Storage Systems to help doctors manage their records storage and scanning in a secure, cost-efficient, and convenient way.
Although in recent years Electronic Health Record (EHR) systems have begun to replace paper documents, many medical practices still find themselves drowning in a sea of paper. Even without paper charting, doctors’ offices produce a lot of paper, and they still have to contend with years, sometimes even decades, of pre-EHR paper charts. So what should a modern medical practice do to strike the right balance between responsible, safe, and efficient document management and affordable, common-sense storage?
Generally, practices should make decisions as to the disposition of paper files based on state and federal record retention guidelines and compliance regulations, as well as how much access will be needed in the future. For documents that are routinely accessed and/or distributed, scanning is the preferred solution, since it allows for multi-user access and the ability to electronically route information via automated workflows. Record Storage Systems offers a scan-on-demand service that allows practices to access their records without removing the physical document from our document storage facility. This enables practices to enjoy timely, convenient electronic record retrieval. By storing offsite, and taking advantage of scan-on-demand, practices can enjoy secure hard-copy storage with quick access to records while reclaiming valuable space in their offices for revenue-producing activities.
But can’t practices just store their own documents? Sure, if they’re fans of high risk and huge HIPAA fines! Doctors’ offices and self-storage facilities don’t have full-service security monitoring. Self-storage units are particularly risky, since you have no idea what is being stored nearby (e.g. hazardous/flammable materials), security is lax, and there is no disaster relief plan in place. Other risks of storing your own documents include potential liability from having employees moving heavy boxes, occupation of valuable staff time and storage space that could be dedicated to revenue-producing activities, and potentially huge HIPAA fines in the event of document misplacement or theft.
Meanwhile, a professional records storage provider like Record Storage Systems has everything you need to ensure your peace of mind: a highly-secured, climate-controlled environment with full fire protection on site. The facility floors, walls, and ceiling are equipped with 6-inch precast ribbed concrete reinforced with rebar steel. The site is inspected twice a year with ultrasound technology for the detection of wet spots/leaks. There is a fully documented disaster relief and recovery plan in place. And if you ever need access to your files, our staff can retrieve the relevant files quickly to ensure you always have access.
When deciding whether to scan records or store them offsite in a secure facility, consider how often they will need to be accessed. If most of the documents are archived medical records or files that the practice will rarely reference in the future, the most cost-effective option is to securely store the hard copy files offsite and retrieve them occasionally when needed, either through scan-on-demand or physical delivery. For documents requiring regular access and retrieval, document scanning and electronic document management software will offer long-term conveniences and cost-saving benefits. Going paperless requires planning and consulting. Record Storage Systems works to identify challenges in your current practice processes and find opportunities for increased efficiency and streamlined workflows. No matter what your paperless goals are for 2020, we can work with you to find a customized solution that fits your needs.
And of course a medical practice isn’t just about medicine and medical records: practices are like other businesses, with paper-intensive business processes such as human resources and customer service. By implementing a record management system like Fast Layne Solutions’ iDocsNow, a practice can use a day-forward approach to ensure that such processes convert from paper to electronic storage daily, continually pushing out all documents to a safe, secured, HIPAA-compliant cloud storage platform. iDocsNow can also be used to store old charts to which you need regular access or, for whatever reason, that you choose not to store physically.
For practices not already on an EHR (or for those who are on overpriced and/or user-unfriendly EHRs), we encourage practice administrators to consider a cloud-based, tablet-optimized EHR like Fast Layne Solutions’ EMRx to move away from paper charting entirely. This reduces errors, helps cut down on insurance rejections, and improves patient outcomes. It also requires less personnel to handle and support paper files and to organize countless documents. And EMRx requires no physical storage space, or even a server, since it is cloud-based, meaning it also has zero maintenance costs. In addition, switching over to electronic medical records provides a practice with more safety and security for their patients' confidential data, thus reducing the risk of HIPAA violations, all while increasing staff efficiency and driving profitability.
If you would like to discuss how Record Storage Systems and Fast Layne Solutions can partner with you to help your practice get out of the paper business, please visit our website or drop us a line.
In December, Fast Layne Solutions CEO Christopher Hughey sat down for an interview with Business Innovation Factory founder and author Saul Kaplan to discuss the state of healthcare delivery in the United States and how innovation must play a role in fixing the complex issues facing it.
According to Kaplan, the current American healthcare delivery system is a product of the industrial revolution and, in its current state, leaves too many people behind. It is a hard-working system with a lot of well-intended actors trying their best to help people. The question is how do we open it up to change, given that it is a self-fulfilling system, a system set up to protect itself and the status quo?
What people fail to understand is that the drive to provide universal healthcare is not a fix, but rather a precursor to the actual fix itself. Getting everyone covered is important, but will do absolutely nothing to address issues like trying to change incentives, innovate, disseminate information to stakeholders more efficiently, educate patients, and motivate people to take responsibility for their health.
Technology is an important component, but it is a double-edged sword: it can help innovate, but it is often used to simply reinforce the weaknesses of the current model. Kaplan cites the example of artificial intelligence (AI): look how many healthcare and pharmaceutical companies are using it not to improve patient outcomes, but simply to make themselves more efficient and profitable.
At the core of the challenge is the very nature of the system itself. We built an Industrial Revolution-based system to help people who are sick, and America is excellent at providing that expertise. But what we are failing to do in the post-Industrial modern age is proactively help people stay well in the first place. It is therefore an antiquated, reactive sick-care system, not a proactive wellbeing system. Ideally, we want both: help people stay well and address their issues once/if they get sick.
A big challenge to changing the system is that so many people start with the financial considerations and work backwards from there. At the Business Innovation Factory, Kaplan’s team starts at the front end: what is the problem we are trying to solve and how can we solve it in a way that delivers value in an economically viable model? That idea is at the heart of Kaplan’s new initiative “Luna You,” a woman-centered maternal wellbeing program that is focused on helping minority women improve pregnancy outcomes by educating and empowering them through outreach, personal coaching, and connecting to the needed medical and social service care. It is centered on the idea that health outcomes are better when patients have increased agency and can take ownership of their health once you give them the tools they need. It kicked off on 1 January of this year in Providence, RI, and will hopefully expand nationally once established.
Why start with one of the toughest problems in the American healthcare system? After all, many articles have cited minority maternal health and pregnancy outcomes as one of the greatest failures of our delivery system and it is a problem fraught with big social issues as well, not least of all the racial component. According to Kaplan, it’s part of his counterintuitive approach to innovation: “Never mind the low-hanging fruit. Give me the absolute hardest problems first. If I can solve those, the rest is easy.”
Does Kaplan expect resistance from the medical community in his attempts to intervene in these challenges? That is actually the beauty of such empowering programs: instead of asking permission of the Powers That Be, the large institutions, they are going straight to women, empowering them, and then going to the providers with them, hand-in-hand in partnership. The goal is to get outcomes on par with the those of the general population, and Kaplan’s team will be measuring their success accordingly.
To close out our interview, I asked Saul what he would change about how healthcare in America innovates if he could wave a magic wand and get those changes done immediately. He focused on three things: 1) Changing mindsets. Too many are at one extreme or the other: they either want to tweak timidly and incrementally or blow up the whole system and start over. So first and foremost we need to define what we mean by innovation and get everyone on the same page. 2) We must get far better about focusing on human-centered design and “shifting our lens” to move away from views that see the world in terms of what’s in the best interests of the existing institutions and towards what is in the best interests of the people those institutions are supposed to be serving (i.e. patients and those seeking to avoid becoming patients by improving their overall wellbeing). 3) We have to get more comfortable with exploration. Our current mindset is that we can analyze our way to solutions, that if we just capture enough data we can predict the future and increase profits. But that is antithetical to exploration and innovation because it leads to safe, risk-averse, incremental improvements at best. We have to be more comfortable with failure, with risk, with true exploration, because otherwise we will stay mired in the status quo.
We’d like to thank Saul for sitting down with us and sharing his unique vision. For more information on how the Business Innovation Factory is helping bring innovation to the healthcare system, please visit the BIF website.
What are the top challenges facing small- to medium-sized, independent physicians as they fight to maintain their independence and compete with the large, corporate providers? This month, we are looking at the top 10 challenges, so please join us for this informative series and tune back in every Tuesday! If you're reading this post first, please go back and read Part 2 from last week and Part 1 from the week before, where we looked at why doctors should even be fighting the battle for independence, as well as challenges one through seven (high insurance claim rejections, slow reimbursements, and clunky, user-unfriendly, overpriced EMR systems, high merchant services costs, scheduling nightmares, struggling with HIPAA and coding compliance, and dealing with old paper files ). Let's move on to causes eight through ten today!
8) Bad debt. Doctors often hate talking about money. What they hate even more? Chasing it. Nobody likes asking people for money, and doing so aggressively often alienates patients. But it’s hard enough operating a profitable practice without having tens, sometimes hundreds, of thousands of dollars in bad debt. That’s why we offer QuickCollect, a soft approach to collecting from patients, and one that allows you to maintain full visibility and control. Eighty percent of all patients who ever will pay, do pay through this process. It relieves your staff from this troublesome burden but without doing traditional collections, which has a low success rate.
9) Marketing. Large, corporate providers have marketing budgets in the six- to seven-figure range. How can a smaller provider compete with that? Again, we bring technology to the table to solve a problem. We offer AutoCard, an automated mailer marketing service to help doctors stay in touch with their patient base and even market to prospective patients. In an age when it seems that most emails are ignored and/or go to the spam folder, physical mailers are the new email. It’s both affordable and effective.
10) Verifying benefits. You often find even smaller practices dedicating up to half a headcount solely to this task. That number should be exactly ZERO. With the right technology, you should have this process fully automated. Our iClaim solution solves benefits verifications with the push of a single button. No more phone calls, no more chasing. And that also means fewer denials.
So how successfully is YOUR practice facing these challenges? If you could use help, contact us today to set up a free, no-obligation, 30-minute practice analysis. We will either show you how we will add more value than we cost, or we simply won't ask for your business.
What are the top challenges facing small- to medium-sized, independent physicians as they fight to maintain their independence and compete with the large, corporate providers? This month, we are looking at the top 10 challenges, so please join us for this informative series and tune back in every Tuesday! If you're reading this post first, please go back and read Part 1 from last week, where we looked at why doctors should even be fighting the battle for independence, as well as challenges one through three (high insurance claim rejections, slow reimbursements, and clunky, user-unfriendly, overpriced EMR systems). Let's move on to causes four through seven today!
4) High merchant services costs. Not a lot of physicians think about this one, but it’s yet another way smaller providers pay more than larger providers. Many smaller practices pay well over 3% on credit card transactions and can’t even take online payments. We have changed all that. By leveraging the buying power of thousands of doctors, we get rates as low as 1.79% on merchant services for Visa, Mastercard, American Express, and Discover. And we can help doctors accept payments online and even offer a free, full-service patient portal. All in a fully HIPAA-compliant payment solution designed especially for doctors.
5) Scheduling nightmares. Unlike the larger providers, many smaller practices do not offer online scheduling. And they often find that their waiting room times are unpredictable and unmanageable, leading to decreased patient satisfaction. Again, we bring technology to bear to solve this: we offer a system that not only allows for online scheduling, but even helps doctors optimize their patients’ waiting room experience and reduces patient dissatisfaction by minimizing waiting room times.
6) Struggling with HIPAA and coding compliance. This is a constant challenge for all providers, but it hits smaller providers harder because the costs of compliance are higher in relation to their revenue, especially if they manage compliance entirely in house. We can help doctors get and stay HIPAA compliant and we also do coding audits to ensure they aren’t overcoding (dangerous!) or undercoding (costly!). By outsourcing this, smaller providers can leverage the expertise they need but at a cost they can afford.
7) Drowning in paper. While most practices are trending towards paperless environments thanks to EMR systems, many still have large volumes of old paper files they have to manage. It’s not just costly to store these, it’s also a giant HIPAA-violation waiting to happen. We have a solution that is a very cost-effective hybrid: by partnering with local, secured-site records companies and using our own iDocsNow technology, we can help smaller providers get rid of all paper in their offices. For files they don’t need to access very often (potentially ever), we can have the documents stored for as little as $0.30 per box per month, then have them safely destroyed once they no longer need to be maintained. For paper files the office may need to access more frequently, we can have them scanned and entered into iDocsNow, our paperless file management system that converts paper files into OCR-based, fully searchable PDFs in our Cloud system. Then, going forward, any new paper files would be scanned into the system and destroyed immediately. We can even provide discounted pricing on HIPAA-compliant shredders.
Tune in next week as we look at causes eight through ten!
What are the top challenges facing small- to medium-sized, independent physicians as they fight to maintain their independence and compete with the large, corporate providers? Over coming weeks, we are going to look at the top 10 challenges, so please join us for this informative series and tune back in every Tuesday!
First of all, why should independent physicians even try to maintain their freedom? Isn’t the corporate takeover of our healthcare system inevitable? In 2018, employed physicians outnumbered independent physicians for the first time ever, according to Medical Economics. Many independent physicians are despairing that selling out is just a question of when, not if. That’s especially true in the era of Obamacare and MACRA, when the increased rules and regulations are making it more and more challenging for physicians to operate confidently and profitably while complying with all the Byzantine rules.
But it’s a fight worth fighting! Studies show patients of small- to medium-sized independent physicians fare better. Medscape recently highlighted several studies that bear this out. Smaller practices have “ambulatory care-sensitive admission rates fully 33% lower” and lower overall costs for care for diabetes, for example.
So we need to win this battle for our patients. But how? Let’s look at the biggest issues the independent doctors face.
1) High insurance claim rejection rates. On average, 34% of all insurance claims submitted to the insurance companies are initially rejected. Many are eventually paid out, but only after resubmitting, often multiple times. When you consider that each reworked claim adds an average of $25 in cost to the practice, you can see how this is one of the biggest burdens for small providers. But isn’t that just how the game is played? You submit, they reject, you resubmit? Many practices, even smaller ones, have entire headcounts dedicated to nothing but fighting this battle. But they don’t have to! In fact, it makes no sense to. Doing your own claims, especially if you are doing them manually, makes zero financial sense for providers with under 25 staff. The math simply doesn’t add up. Using a resource like Fast Layne Solutions solves this in two ways: it brings advanced Revenue Cycle Management technology to bear on the problem (thus slashing that rejection rate to under 2%) and brings economies of scale to bear to cut your claims management costs by on average 60%.
2) Slow reimbursements. Even when you do get paid, it is often taking far too long. The solution: use a provider that has an independent clearinghouse connected to all insurance companies and that gets your claims paid the first time. That’s why our doctors get paid in days, not months.
3) Clunky, user-unfriendly, slow, overpriced EMR/EHR systems. It is the shame of our industry. Talk to any doctor pretty much anywhere in the United States and they will tell you the same story: I HATE MY EMR! There is even a popular parody account on Twitter dedicated entirely to how awful the leading EHR system in the US is perceived to be by the doctors and other healthcare professionals forced to use it. And to add insult to injury, these systems are incredibly expensive. And on top of all that, most are PC- or laptop-based, which interferes with the doctor-patient interaction. And many are so complicated that even a smaller practice often has to have a full-time IT headcount to maintain their systems. The solution: EMRx, a Cloud-based (read “zero maintenance and no IT staff needed”), software-as-a-service EMR designed by doctors, for doctors, and currently used by thousands of doctors nationwide. EMRx is tablet-optimized, meaning you can maintain eye contact with the patient. It is so user-friendly that our average documentation time per patient encounter is just two minutes for general practitioners, somewhat greater for certain specialists. (And yes, everyone always thinks that’s a lie….right until they see the demo.) And because it is software-as-a-service, the start-up costs are far more reasonable, there is zero maintenance for you, you have access to award-winning support, and the ongoing costs are reasonable. Also, you aren’t stuck in multi-year contracts.
Tune in next week for challenges 4 to 7!