Columbia, SC-based Sisters of Charity Providence Hospitals will lay off about 30 employees as it seeks to hold off projected losses of $1 million this year and $7 million next year, officials announced. Providence is licensed for 304 beds and employs 1,900 people at two locations. The hospital posted a surplus last year of almost $6 million, but cuts in federal reimbursement, decreases in patient overnight stays, and an ongoing legal challenge from Lexington Medical Center has cut into the hospital's revenue and prevented it from attracting new business through improvement of its facilities and equipment.
A study to be released by Blue Cross and Blue Shield of North Carolina showed that companies willing to make small investments in wellness initiatives see long-term returns. The study showed that companies that offer comprehensive wellness programs see a 25% to 30% decrease in medical and absenteeism costs in about 3.6 years. These decreases will be more significant to employers as healthcare costs continue to rise, said Blue Cross representatives.
The World Health Care Congress Leadership Summit on ePrescribing and Medication Management is scheduled for Nov. 17 in Falls Church, VA. At the summit, IT leaders can "learn how industry stakeholders are pushing the envelope in terms of HIT integration and discover how e-Prescribing adoption can improve workflow, increase patient safety, and allow for the highest quality of medication management in your practice," according to the event's sponsors.
iMedica has announced the release of its 2008 iMedica Professional Services Portfolio, an implementation toolset designed to help physician practices manage the challenges of EHR and PM implementations. The Professional Services Portfolio is a matrix of services that offer practices the opportunity to fully utilize and benefit from their investment, according to a release. "iMedica's new toolset matches implementation services to the immediate needs of the practice and enables physicians to expand their utilization and expertise in the application at a rate of adoption which they find efficient and comfortable, without sacrificing patient care or practice productivity," said Michael Nissenbaum, iMedica CEO and President, in a statement.
The presidential candidates made mention of information technology during the debates last week. In this blog for Information Week, Mary Hayes Weier takes a look at the technology policies of Barack Obama and John McCain.
Medical records have faced an impasse preventing a transition to the digital age, and patient charts are still paper-based in most doctors' offices across the country, writes Kevin Pho, MD, in this opinion piece for USA Today. President Bush's goal was for every American to have an electronic medical record by 2014, and both presidential nominees Barack Obama and John McCain's health reform plans include language that modernizes the country's health information system. But despite the advantages of computerized records, adoption of the technology remains distressingly low due to several problems, Pho says.
There were two topics on everyone's lips this year at the American Health Information Management Association's 80th annual meeting: the upcoming conversion from the ICD-9 code set to ICD-10 and the permanent launch of Medicare's Recovery Audit Contractor (RAC) Program.
The changes to the code set combined with the announcement earlier this month from the Centers for Medicare & Medicaid Services that it is moving ahead with the RAC program have left many in the industry nervous about just how much the changes will affect their practices.
On the big switch
During the four days of sessions held last week in Seattle, panelists from throughout the industry tried to give some insight and relief to attendees who are puzzled about how to handle the upcoming ICD-10 conversion. CMS acting administrator, Kerry Weems stressed that stakeholders need to "be serious about the date" of the conversion, emphasizing that providers should not wait until the eleventh hour to begin learning the more than 155,000 codes associated with ICD-10 (compared to 17,000 in ICD-9).
The proposed date for implementation of the rule is Oct. 1, 2011, however, a final deadline for conversion won't be set until the agency has a chance to review comment from the public (comments must be received by EOB October 21). Weems says though the comments are largely in favor of the conversion, the proposed implementation date remains the primary point of contention. And, though the government has been known to waffle on important deadlines in the past (I know, it's shocking), Linda Kloss, chief executive officer at AHIMA, told attendees the time to make the switch is … well, yesterday.
"We are a decade behind the rest of the world in this vital element of patient care and control, and that just is not acceptable," she says. While Kloss says AHIMA recognizes there will be significant costs associated with converting to ICD-10 (ranging from $83,200 for a small practice to as much as $2.73 million for a large practice, according to a new study), the longer we wait, the more extensive those costs are likely to be, since more systems will have to be converted retroactively. The general consensus from all of the speakers is to act as if the Oct. 1, 2011 deadline is set in stone and begin preparing now. Get hospital staff up to speed and learn the new codes, because the switch, whether it occurs in three years or five, will happen.
Like it or not, RAC is here to stay
After recovery audit contractors reported recovering $1 billion (the government actually netted about $700 million after appeals) in improper Medicare payments during CMS' three-year pilot program, the feds decided to make the RAC program permanent, striking more than a little fear in the hearts of hospital administrators across the nation. During an informal panel on Sunday, conference goers were given tips about how to handle the auditing process.
"If they are able to take one thing away from this panel, we hope it would be an understanding that 8% of the RAC revenues came from technical denials, which means that the hospital simply didn't get the medical records to the RAC in time. That is not acceptable, that information has got to get out. No matter how you handle it, internally or externally, you have to be able to get a hold of those records and get them out," says Nancy Hirschl, president, Hirschl and Associates and a participant in Sunday's panel.
Hirschl and the other panelists recommended five steps to help hospitals prepare for RAC auditors:
Develop a RAC team dedicated solely to dealing with RAC inquiries.
Conduct a risk assessment and perform data mining to identify what the RAC will be looking at (hint: they are looking for improper payments, says Hirschl). By identifying where you could potentially have problems, you can mitigate your risk now.
Provide a financial reserve plan to your chief financial officer. "By letting them know what they will need to provide financially, you are one step closer to being prepared," Hirschl says.
Perform a needs assessment to understand operationally how RAC will affect your day-to-day staff. Do you need to hire more people? Will you outsource? Have these procedures in place ahead of time.
Understand and develop an internal strategy for how your organization will deal with disagreeing. Will you appeal every case?
And of course, take advantage of the technology available to you. There were plenty of vendors on hand this year offering a myriad of solutions for both ICD-10 and RAC.
Now that I'm home from AHIMA, sifting through my various press packets and session notes, I can see that the overall theme from this year's conference was that the next few years are going to be filled with change for healthcare—EHRs, PHRs, ramifications from next month's election, ICD-10 and RAC, genomics, and biometrics. It seems there is no end to the incredible (and sometimes trying) changes on the horizon for HIM and IT professionals.
Kathryn Mackenzie is technology editor of HealthLeaders magazine. She can be reached at kmackenzie@healthleadersmedia.com.
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The Health Resources and Services Administration is handing out $18.9 million in grants to 25 organizations nationwide. The grants are designed to help community health centers implement e-health records and other aspects of health IT. The bulk of the money, $14.3 million, will go to 12 health networks, clinics, and similar organizations, including one local government agency, the Yellowstone City County Health Department in Billings, MT. Another recipient is OCHIN, a regional health information network based in Portland, OR. Those grants are specifically for EHR implementation.
Doctors are expanding hours to accommodate the demands of busy, informed patients, as well as combat competition from retail health clinics popping up in drugstores such as Walgreens and CVS. "Given the choice, most patients who have a regular physician would prefer to see them on extended hours than go elsewhere for treatment," said Doug Henley, chief executive officer with the American Academy of Family Physicians.
Marshfield Clinic, which employs nearly 800 physicians in north-central Wisconsin, is one of 10 nationwide participating in a Medicare project that rewards doctors for providing efficient, quality care. But economists, policy analysts, and doctors contend that the incentives built into the system are one reason that healthcare costs in the United States are roughly 50% higher than other developed countries.
