There’s a new year and with that comes change and challenge, and to some degree confusion with respect to the ICD-10 codes. But rest assured that VersaForm will be there with its current and new customers every step of the way, and we’ve already made extensive changes to the newest version of the application for Stage 2 Meaningful Use and implementing the new measures, core objectives, coding requirements.
Some of the Stage 2 measures for eligible providers include:
Apparently, there could be some growing sentiments among physicians to put the brakes on meeting Stage 2 Meaningful Use, and opt to pay penalties instead. According to a story in Modern Healthcare dated December 21, 2013, some doctors may opt to exit the program altogether due to cost and clinical concerns.
Then there’s the recent post at the American Association of Family Physicians Website, in which AAFP director of HIT, Jason Mitchell M.D., noted that “Stage two is turning out to be a tremendous amount of work for all stakeholders, and there is still a significant risk that some physicians will choose to jump off the figurative meaningful use escalator.”
For one, the financial upside to Meaningful Use for independent physicians is waning as most of the stimulus funds have been linked in Stage 1. According to the AAFP, the average family physician receives only about $100,000 in Medicare reimbursements, so a three-year total penalty from 2015 to 2017 would be $6,000, an amount that the article states doesn’t represent a significant loss of income given the payments received for Meaningful Use attestation between 2011 and 2013.
As for the clinical angle, some physicians are questioning the patient benefits associated with some of the Stage 2 objectives. One objective requires that more than half of patients have timely online access to their health information, but will 50 percent of patients even consider using patient portals? What if the practice is in a rural area where Internet access is spotty? Better yet, what if the majority of your patient base is the elderly who may not have email and/or may not know what a Web browser is?
What is certain is that most providers are looking toward Stage 2 and that there will be some hold outs. The penalties for non-compliance don’t go into effect until 2015. Then there’s the possibility that CMS mandates may change again as the nation’s leading medical associations and large hospital groups are demanding a more flexible process for Meaningful Use vs. what some characterize as a broad pass/fail approach.
Stay tuned and Seasons Greetings!
Consistent with what CMS did for Stage 1 Meaningful Use, the government announced that they are giving eligible providers another year to show they’ve met compliance for the electronic health records requirements for Stage 2. As such, Stage 2 will be extended through 2016 and Stage 3 won’t commence for physicians until calendar year 2017. A formal statement from CMS noted that the extension will 1) allow the CMS and ONC to focus on helping providers meet Stage 2's demands for patient engagement, interoperability and information exchange; and 2) use data collected during that phase to inform policy decisions for Stage 3.
While the deceased Mrs. Thatcher can no longer comment on the state of the health care system in the United States, her quote rang as true when she said it many years ago, as it does now, given the ACA's low enrollment, and the Administration's apologetic stance. But beyond the faulty launch of HealthCare.gov on October 1st, the political battleground and questions on whether President Obama can fit Obama-care, the trend is unsettling to every facet and segment of the nation's healthcare system. Consumers who have been covered by Medicare are being asked to check their coverage now, or check their coverage at the door by opting for alternatives. And health care providers who may have been looking towards EHR software, or upgrading their existing applications, seem to be putting the brakes on such initiatives.
It is no secret that mobile medical applications continue to make novel splashes, and patient portals have become all the rage. But while many Americans have embraced mobile applications for paying healthcare bills, scheduling appointments, and correspondence with healthcare providers, the uses for healthcare IT are still very nascent and experts contend that broader, more impactful wireless apps will focus on patient monitoring and disease management.
A recent brief by the Robert Wood Johnson Foundation, published in the journal Health Affairs, forecast that that number of mobile health applications will increase 25 percent a year for the foreseeable future. The same study projects that at least 50 percent of the "3.4 billion mobile devices worldwide will download a health app", which will continue to drive changes in healthcare systems.
Of course, Capitol Hill is taking note. Earlier this month the Democrat-sponsored H.R. 3577, called the Health Savings through Technology Act, is looking to examine cost savings potential associated with wireless healthcare technologies, and to even incorporate them into Medicare and Medicaid. Bill sponsors note that remote patient monitoring, for example, may have cost-savings implications.
The bill calls for a commission to be formed on the potential for savings associated with wireless EHR and related HIT, including digital health, tele-health, telemedicine, e-Care, and patient monitoring.
The impact on managing the care of chronically ill patients could be significant. More than 300 million Americans have mobile subscriptions that could enable them and their providers to keep track of and direct care through a wireless device, and in turn, cut down on clinical visits. Rep. Scott Peters (D-CA), who is leading this commission, recently cited a 2007 study showing how remote monitoring programs reduced hospital admission rates and annual savings of more than $10 billion.
Electronic health record (EHR) software has been widely embraced due to the needs for regulatory compliance and qualifying for Meaningful Use attestation. But physicians have spoken loudly in citing that the two most important reasons they are dissatisfied with their EHR software, are spending more time on documentation, and seeing fewer patients. The irony here is that many software solutions are positioned to accomplish the exact opposite.
Those were some of the key findings of a recent study by IDC Health Insights that examines the results of an ambulatory EHR satisfaction survey of 212 providers conducted this past September by MedData Group. According to the results, 58 percent of ambulatory providers surveyed were dissatisfied, very dissatisfied, or neutral about their EHR experiences.
As someone who has been in the software business for many years, but relatively new to the medical field, I have been a bit shocked and stunned by the many physicians and hospitals that are still stuck in client-server systems, and who have not embraced the software as service model.
The benefits of this tried and true process have been widely documented and include, shorter implementations, cost savings and greater operating efficiencies, as well as enhanced collaboration among clinicians, staffers, and patients due to anytime/anywhere access which improves touch-points with patients and continuity of care.