EHR Mantras For Going Beyond Meaningful Use
The $44,000 stimulus per provider via Medicare and $64,000 via Medicaid is just the tip of the iceberg when it comes to the manifold benefits of using a comprehensively equipped EHR like PracticeFusion, Kareo or eClinicalWorks. A properly implemented and supported EHR system can cover the complete costs of implementation when optimally utilized, either alone or in tandem with an EHR support vendor.
OTHER FACETS OF EHR USAGE:
The following are some of the savings that a clinic will most likely accrue even before laying their hands on that first dollar of stimulus incentives:
A. Transcription Cost Savings: The first is the most fundamental savings you will be able to make, most often in conjunction with an EHR support vendor. This involves your medical transcription requirement. No matter how top-of-the-line your EHR may be with many “point-and-click” options and voice recognition features, some amount of actual transcription may be required.
Let us suppose you’re a very small practice seeing only 5 patients per day 5 days a week. You still would have about 100 charts to be transcribed per month. Even if your EHR allows you to let go off a full-time transcriptionist (costing anywhere between $2500-$3500 per month), there still needs to be a personnel to use the EHR for chart creation and transcribe the missing portions.
Rather than employing a part-timer, costing anywhere around $1000-$1500 per month, who may not be that familiar with your EHR, you can opt for partnership with an EHR support vendor, who may provide free support for your EHR, while providing transcription for as low as $5 per chart and also coalescing all the different components of the reports in the EHR. This, at the least would save you $6000 every year.
B. More Optimal Coding Via EHR: A study was conducted and published in 2005 (way before meaningful use) that studied 14 single physicians or very small practices. The results were:
“Initial EHR costs averaged $44,000 per full-time-equivalent (FTE) provider, and ongoing costs averaged $8,500 per provider per year. The average practice paid for its EHR costs in 2.5 years and profited handsomely after that.”
How did they do this? That too without the federal stimulus of today…
1. Efficiency-Related Gains: The clinics used the EHRs for routine tasks, such as prescribing, documenting, data retrieval, and internal messaging, and almost all used it to assist in medical billing and revenue cycle management.
2. Less of under-coding: Under-coding is responsible for about 10% of loss of revenues for physicians even today. The EHRs automatically gave the providers the correct level of evaluation and management, based on the information entered during a patient encounter. This not only helped a medical coder to determine at which level a visit should be coded, i.e. level 1, 2, 3, 4 or 5, but also helped the coder to seek more supporting documentation. The clinics on average were able to increase their average coding level by 3.5 percent without running afoul of RAC audits.
C. Tax Code 179: The fiscal cliff brought changes to this code such that clinics can now enjoy benefits (to be added as an expense) upto $500,000 pertaining to software purchases. Thus, if your taxable income before the code application was $300,000 and the cost of your EHR software was $80,000, then your taxable after the application of the code is only a mere $220,000 (this is unless of course the high-quality, low-priced, cloud-based EHRs still won’t do for you).
D. Other Miscellaneous Reasons: Medicare’s Physician Quality Reporting Initiative (PQRI) & Medical Home Incentives are a couple of other non-meaningful use initiatives that yield sizeable ROI for your EHR. The former of course is a Medicare initiative that rewards physicians upto 1% of Medicare Part B charges for a particular year. The task on the part of the physician is to send special billing codes or certain quality metrics to CMS via certified EHRs.
The latter is an initiative participated by even private biggies like Blue Cross Blue Shield (across more than 40 states) benefitting more than 5 million patients and thus correspondingly their treating physicians. The idea under the program is for the physician and a select group of support staff to act as a single point of reference for the patient, thus creating a “virtual medical home.”
GOING BEYOND MEANINGFUL USE:
Thus, as can be seen, there is more than meets the eye, i.e. beyond meaningful use, when it comes to EHR usage. If you’re in the dark about some of the above, it might be a good idea to seek an EHR support vendor or a medical billing vendor now. Alternatively, if you already have one you may arrange a tête-à-tête with them to discuss how better you can wring your EHR to yield more ROI than presently.
