EHR Medicare and Medicaid Incentive programs are NOT Jeopardized

We've been hearing about the Republicans trying to repeal "Obama Healthcare" in very general terms. What does it mean specifically? How does it impact the Medicare and Medicaid EHR Incentive programs?


Let me dive in a bit more in detail. 


Rep. Jim Jordan (Republican, Ohio), introduced the Spending Reduction Act of 2011 (H.R. 408) on January 24. This bill seeks to reduce federal spending by $2.5 trillion over the coming decade! How? It singles out many federal programs for elimination.

Section 302 of the bill, titled "REPEAL OF CERTAIN STIMULUS PROVISIONS," states that "effective on the date of the enactment of this Act, subtitles B and C of title II and titles III through VII of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5) are repealed, and the provisions of law amended or repealed by such provisions of division B are restored or revived as if such provisions of division B had not been enacted."

Here's where it gets messy. The $27 billion earmarked for Medicare and Medicaid EHR incentives falls under division B.

If firmly believe the bill will not pass.

The GOP holds majorities in the House, but the Democrats control the Senate. President Obama will surely veto this bill if it ever comes to him.

I (and many other analysts and industry experts) am not worried about the bill being signed into law. What is worrisome is the confusion this bill creates. Providers are skeptical of anything that CMS does. This bill compounds the skepticism. I suspect many providers may hold off their purchasing decisions.

Providers should be looking at EHR technologies for the benefits it accrues to them and their practice. Stimulus incentive should be an added bonus. They should not be putting the cart before the horse. I hope this message comes out loud and clear.

What is Leadership?

Control is not leadership; management is not leadership; leadership is leadership. If you seek to lead, invest at least 50% of your time in leading yourself your own purpose, ethics, principles, motivation, conduct. Invest at least 20% leading those with authority over you and 15% leading your peers." 


- Dee Hock, Founder & Chairman Emeritus of Visa International

Preparing your Practice for Meaningful Use with EMR/EHR software for Incentives

There are some of the steps you need to take to prepare your practice for Meaningful Use. There are many things you need to comply with, but here's a small list that typically gets overlooked in a specialty practice. Please bear in  mind this is not supposed to be a comprehensive list.

1. Record chronic conditions in the medical history section of your EMR
2. Record preferred language, race and ethnicity in patient demographics when registering a new patient. For established patients, update this information. It is used by immunization registries and recording this is part of the meaningful use requirements.
3. Print Patient Education material from EMR.
4. Record Vital signs for patients. Record height and weight on each patient for at least one visit.
5. Record blood pressure on any patient especially those with a history of hypertension.
6. Record smoking / tobacco use.
7. Reconcile medications.
8. Provide a printed copy of the Continuity of Care Record when a patient is referred out to another doctor.

Paving the Way for providers to adopt and achieve Meaningful Use of Electronic Health Records

In the latest news update from Health Information technology newsletter from The Office of the National Coordinator for Health Information Technology, Dr. David Blumenthal has letter on the 2010 ONC Update.

In his latest letter, Dr. Blumenthal, National  Coordinator for Health Information Technology, gives an overview of the important policies and programs established this year that are paving the way for providers to adopt and achieve meaningful use of electronic health records.

Dr. Blumenthal also provides information about the 2010 ONC Update meeting on December 14and 15, which will give participants a better understanding of the role of Health IT in health system change and health care reform.

Read Dr. Blumenthal's new letter: 2010 ONC Update to learn more.

Is your Medical Practice Trying To Do Too Much?

In a downturn in the economy, many practices are trying to cope with decreased reimbursements, dwindling patient visits and increased pressure to keep employees happy. They are either adding products or services, or trying medical marketing to target a new patient base.


So, if your practice is experiencing problems, it might be a good time to ask if you are losing focus or you are simply trying to do too much with limited resources? 


For many medical practices, 'marketing' is a bad word. They've never had the need to do marketing. The medical profession is about service to the community, it is said. But you can't serve if you can't eat. Times have changed. 


When your total revenue and revenue per patient has dropped and continues to drop without any good news in sight, what are you to do? Some medical practices have been stripped to bare bones, offering bare bones services. You work harder, longer hours, employee productivity goes down. You even postpone those much needed renovations, replacing a dirty carpet, dirty walls that can use a fresh coat of paint, watching every penny.


Some practices engage consultants to show them how to bring in more revenue, how to manage their practice more efficiently, how to manage collections and receivables. Some practices have resorted to medical marketing, healthcare advertising. The problem is, if not done properly, more dwindling resources go down the wrong path.


Lost productivity and wasted energy can lead to poor moral around the medical practice, which can scare patients off. 


Use technology that is inexpensive and already available to you such as EMR. Here are some strategies that can help:

1. Managing better patient care. Using ePrescription instead of paper.
2. Reducing appointment no-shows by optimizing appointment reminders
3. Streamlining Accounts receivables, even considering outsourcing your billing has been known to help.
4. Using Social media and social networks in the new age of internet, to promote your practice.
5. Creating a patient friendly website that can showcase providers, staff and facilities.
6. Producing Videos that put a real face to a brick-n-mortar practice

If your medical practice is trying to do too much, scale it back and see if you cannot identify areas that need improving. Involve all your employees. Sometimes they come up with the best suggestions. You can build your medical practice's name recognition. Over time, more people will seek out your medical practice; it especially helps if you offer something no competitor does, demonstrating technology savvy leadership such as using Electronic Medical Records, Internet and Social Media. Look at all your options, a balanced approach is often needed when running a business.

7 Tips for Recognizing your Employees

Everyone talks about the value of Employees. It becomes fashionable to talk about 'employeeship' and 'employee recognition'. Empowerment became a big word in the Management Consulting arena. Managers love to say they believe in empowerment.

While employee recognition is much talked about, it is often sadly overlooked. Recognizing and rewarding employees is not easy. It can backfire very easily. It seems managers either get it, or they just don't.

Recognition has to be sincere and genuine. If it isn't your employees will know it- wouldn't you?

Here are 7 tips for recognizing your employees. These are great ideas that educate, motivate and inspire your team. Even better, these tips are not going to cost you a dime. A happy, invested team will always outperform bitter employees that are just doing a job.

7 Tips for Recognizing your Employees

1. Proactively Inform. Employees feel empowered when they are better informed. Not just when they ask or demand it, but when it is volunteered. Many Practice managers and owners make the mistake of keeping all the information to themselves. Instead, share them with your team. Don't just share the bad or negative information as in, 'our reimbursements are really going down so we need to cut costs', but also when times are good and revenue is up. By giving your employees information, you empower them to make informed, confident decisions and choices which not only benefit them but your entire Practice.
2. Mr. and Miss Independent. No one likes being micromanaged - do you? Employees value independence, so give it to them! When you work with your front desk person, or MA, or Nurse, or biller, tell them what needs to be done and then give them the ability to decide how to do it. You will increase their independence and ability to take more ownership of their role. If you have employee(s) that cannot think independently, you need to question if you've hired the right person.
3. Be Flexible. Everyone appreciates flexibility in their work. I know flex hours or working from home is not an option in a medical practice setting. However, there are ways to afford flexibility in terms of accommodating personal lives. Find ways to be flexible and employees will always respond positively.
4. Give more, Get more. Training and development is an ongoing process. It is not a one-time event. Provide employees opportunities to grow and learn by investing in their development. If they want to learn a skill, facilitate it, even pay for it. It shows your employees that you trust, respect and want the best for them. You will be rewarded when they perform at higher levels with each opportunity. This is one of those things you must genuinely believe in.
5. Decisions. Not even a 10 year old likes decisions being made for them all the time. So don't make the mistake of making all decisions for your employees all the time. They are closer than anyone to the work, to the patients; they are really the best decision makers. Of course, I'm not saying leave the practice to them. Take a step back and ask them what they think and what they recommend. They'll be more involved in the process and therefore more invested in the outcome.
6. How am I doing? Everyone wants to know how they are doing at any time, so hold frequent check-ins throughout the year so that you can have honest conversations about their performance. It will give you an opportunity to implement some things we are covering here.  You don't need a formal 'Review Process' as held by larger corporations. The more feedback you give your employees, the more they will be equipped to respond to the needs of your Practice.
7. Celebrate! Often we are so busy with the Practice, working, strategizing, executing ideas that we cruise through the year without taking time to celebrate all the successes along the way.We do have successes and it is paramount to celebrate them. Celebrate small successes, celebrate often and you'll get more back in return. Don't wait for the big event. You will foster a culture of recognition. 

House Approves Temporary Medicare Fee Schedule Fix; 2011 Rates Include 30% Cut

Here we go again! Reimbursement rates for 2011, scheduled to take effect January 1, include a 30% cut. 

On November 30, 2010, the U.S. House of Representatives approved the Senate-passed bill that stops a projected 23% cut in the Medicare Physician Fee Schedule and extends the current payment rates through December 31. The legislation pays for the extension by implementing a policy that reduces the payment rate for second and subsequent speech-language, occupational therapy, or physical therapy treatments provided to the same patient on the same day.

However, most Medicare observers expect Congress to enact legislation to prevent implementation of these dramatic cuts.

In spite of Electronic Medical Records incentives, whether client server based EMR or EHR where there is a substantial investment or Web-based EHR or web-based EMR, where upfront investments are less or next to nothing, physicians are still reluctant to adopt electronic medical record systems and are adopting a wait and watch policy when it comes to any incentives from CMS.