RBMA Hot Topic: ICD-10 Implementation Perception

RBMA’s Hot Topic Question of the week relates to the impending implementation of ICD-10. For the last year the date of implementation has continued to be pushed back, leaving providers unsure when it will really go into effect.  Most providers seem to be pleased by it’s delay because it means they don’t have to learn the new coding system, but it is only a matter of time before we all will need to adapt to the ICD-10 protocols.

The RBMA took to the forums to find out for real how health care professionals in radiology feel about ICD-10 and how it will affect their practice.  The survey is still running, but the largely negative response is overwhelming.  Participants were asked, “How do you think ICD-10 will affect your practice? Check all that apply.”  Options included:

•  Decrease in coder productivity
• No change in coder productivity
• Increase in coder productivity
• Decrease in coding denials
• No change in coding denials
• Increase in coding Denials
• Delay in reimbursement
• Decrease in reimbursement
• No change in reimbursement
• Increase in reimbursement

Participate in the survey > Click Here

Currently, the most popular responses reflect the belief that implementation will bring decreased coder productivity, increased coding denials, delayed reimbursement and decreased reimbursement overall.

So, what’s with the all this ICD-10 hating? First of all, there are SO many changes with the new codes. (Review them all here: ICD-10 Education) It is intimidating, especially for those who are already not experts with ICD-9 coding.  Many practices and organizations have kept their revenue cycle management in-house for so long, in an effort to cut costs and keep control, but that trend will come to an end. 

In theory, ICD-10 should help physicians improve their reimbursements and cut down denials, however that is only if the codes are used appropriately. Heed the warning signs and start preparing now, because ready or not… ICD-10 is coming.

Health Care Problems Solved: Lowering Costs With Behavior Modification

The creative and innovative minds here at Atlantic Health Solutions are consistently searching for ways to transform the health care industry, growing to improve every aspect of care for patients and the providers we work with across the country. We pride ourselves on being the minds at the forefront of industry changes and that often means taking the road less traveled in health care.  The newest hot topic on the minds of the leaders in healthcare is population health management.

It’s believed that the improvement of the world’s health will lead to lower health care costs and spending but more importantly, healthier and happier lifestyles.

Elise Gould, the Directory of Health Policy Research at The Economic Policy Institute, reported that a whopping 80% of health dollars are spent by just 19% of health consumers. This essentially means then, that by targeting healthy patients to take actions to cut their costs is ineffective because we aren’t focusing on those who are responsible for the high spending. It seems that by improving upon modifiable risk factors in that pool of patients, we could save the U.S. billions of dollars. In fact, in 2011, the Institute of Medicine conducted a study, which showed that in 2009, $765 billion of health care expenditures were spent on things that could have been prevented.

According to a study by Deloitte, the uninsured are half as likely as the insured to go see a doctor for a routine check-up and 9 out of 10 consumers would classify themselves as being in good health but more than half of those patients ended up being diagnosed with one or more chronic conditions in 2010. What this study proves is that patients are, for the most part, unaware of their health conditions until it is too late, leading them to be responsible for high cost care when they could have just opted for lower cost preventative measures.

The new HABIT program, brought to you by Indaba Health & Wellness, solves the problem of health awareness and more. It is an interactive, online health management tool. Users take a health risk and DISCflex behavior assessment to create a customized behavior modification plan to become healthier.  People can set goals and objectives for themselves and participate in targeted eLearning programs to become more aware of their personal risk factors. 

Full behavior modification is a cycle of awareness, analysis, learning, goal setting, monitoring and achievement; HABIT makes it all possible and focuses on lowering risk pools and targeting chronic disease prevention.  Patients that use HABIT can take their health into their own hands.

Having this interactive tool as a resource for your patients also keeps your organization compliant with sections 4103-4108 of the Affordable Care Act, which discusses new compliance and billing requirements. The program tracks members’ annual wellness visits and includes digital timestamps, which is key for ACA compliance records.  The HABIT eMessaging then pushes out timely notifications to patients and providers to remind them of upcoming visits and steps they can take to become healthier like developing an exercise routine or remembering the monitor their cholesterol levels.

HABIT isn’t just a great program for health care providers. It has also revolutionized the way insurance groups, commercial insurance brokers and PEOs manage their members and helps corporate wellness groups motivate, monitor and incentivize their employees.

Want to give it a whirl yourself? Email marketing@atlantic-hs.com to get your free access login!

ACO Update: The Rise of Physician-Led ACOs

In the June issue of Health Affairs a study was published discussing ACO’s and the rise in physician leadership within the organizations.  One of the goals of the Affordable Care Act was to hold physicians more responsible for the care of their patients, by rewarding healthcare providers for improving the quality of care and lowering healthcare costs, the ACO model was born. Slow to start, ACOs have no risen in popularity, with more than 600 Accountable Care Organizations operating throughout the U.S.

“What is an ACO? — An ACO is an accountable care organization made up of doctors, medical groups, hospitals, and other healthcare professionals who work together to deliver high-quality, coordinated care to the patients they serve.”

— Healthcare Partners

There are many various types of ACOs, some are made up of solely primary care providers, others include a variety of specialists and others encompass hospitals and post-acute care providers. However, the study showed that physician-led structures seem to be operating best, meaning they are more likely to have complete care management programs, advanced IT programs and the most satisfied patients.

Former CMS Administrator, Dr. Mark McClellan attributes this to physicians’ personal experience and ability to identify areas for improvement firsthand and measure the impact of their efforts. The Director of the Dartmouth Institute and co-author of this study, Elliott Fisher, MD, MPH stated, “Physicians’ buy-in the payment reform is likely to be critical to the success of the health care reform.” He continued to say; “The findings suggest that physicians are taking seriously their responsibility to lead change in the health care system on behalf of their patients.”

It is certainly pleasing to know that physicians are in support of these changes and are taking on the responsibility of helping to ensure the betterment of care for their patients. As more ACOs are brought together, this report will help providers determine if the path is right for them and consider which structure is best.

To read more about how ACOs originated and to view statistics on the success some organizations have found, check out the Health Affairs blog here: http://healthaffairs.org/blog/2014/05/30/aco-results-what-we-know-so-far/

Tips for Using New Media Channels in your Health Care Marketing Strategy

If your organization is using old school advertising and marketing techniques, you’re living in the past. The glory days of big budgets are over so if you’re throwing away the few dollars you have on standard commercials, newspaper ads, Yellow Page listings or billboards; you’re wasting your money.

Nowadays kids, there are new channels for reaching patients and not only are they more effective, but they are more easily measured.  We constantly preach the importance of tracking the success of your marketing campaigns. As a marketing professional, if you are unable to point to your success, you’re only doing half of your job.

These channels that provide newfangled digital marketing opportunities include:

1.     Social Media – Use social media campaigns to engage your followers/target market, meaning patients and referring physician offices. You can also create very customizable ad campaigns on various social media websites.

2.     Digital TV/Streaming – Traditional TV ads often play on deaf ears now. DVR has helped people fast forward through that expensive ad space, but on sites like Hulu your ads will be seen because viewers cannot skip them.

3.     YouTube Advertising – On many videos, ads will play before the video starts. After 5 seconds the user can skip through to the video, but if you catch their attention, they will watch the ad before their video.

4.     PPC/Search – PPC campaigns and search campaigns are a great way to get in front of patients that are already searching for practices like yours.

5.     Mobile (messaging, display ads or apps) – Walk down the street and you’ll see just about every person glued to their mobile device, so mobile advertising is a great way to get in front of patients.

6.     Internet Radio – Spotify, Pandora and Sirius XM have increased their user base exponentially over the last couple of years so this ad space has grown in popularity as well. It’s great because you’re able to deliver a message audibly while also having a visual/interactive ad in front of the user where they can take immediate action, i.e.: signing up for something, liking your page or exploring your website.

7.     Advertorials – This is not a new concept but advertorials are basically “sponsored” articles written by someone who is promoting their own services or product. They are designed to look like articles but they are really advertising pieces. Buzzfeed is well known for this but newspapers and blogs regularly utilize these as well.

Looking to try something new to reach a different patient base this year? Consider implementing a couple of these initiatives into your marketing plan!