There is no doubt that the emergence of the Electronic Health Record (EHR) program is changing the way providers capture documentation on the front end. According to the 2012 NCHS Data Brief, 55 percent of physician groups have already adopted an EHR. Among the 45 percent that have yet to implement an EHR system, nearly half plan to purchase or use a system already purchased this year.1 Hospitals are also purchasing and installing EHRs at a rapid rate.
EHR templates are rapidly gaining footholds despite some growing pains. CMS has issued advice on the use of checkboxes and drop-down menus accommodating discrete data capture. Despite access to such “documentation tools” via point-and-click templates, most physicians are complaining that it takes longer to document an encounter in an EHR than to previously dictate it. The RAND Corporation released a paper describing the phenomenon that occurs when an industry’s technological capabilities improve at... 
In last week’s Alert, we summarized the requirements for participating in Medicare’s Physician Quality Reporting System (PQRS) in 2013. One of the major changes to the PQRS program—which we deferred until this week—is the implementation of the Value-Based Payment Modifier (VBM) for groups of 100 or more eligible professionals (EPs), consisting of physicians and CRNAs and others described in detail below.Groups of 100 or more EPs — Watch out for the Value-Based Payment ModifierThe Patient Protection and Affordable Care Act (ACA) requires that Medicare implement a Value-Based Payment Modifier (VBM) that would apply to Medicare fee-for-service payments beginning in 2015. The VBM is intended to pay physicians differentially based on the quality and cost of their care.While CMS must adhere to certain statutory requirements, such as using the modifier to promote shared responsibility and systems-based care, the ACA gives CMS considerable flexibility in terms of implementing the VBM. The 2013 Medicare... 
The anesthesia business, regardless of whether one chooses to define it as the practice of medicine, nursing, or some hybrid, is in the midst of upheaval. Increasing market consolidation, mergers, acquisitions and introduction of private equity funding have made the business of managing anesthesia delivery services increasingly complex. Bear in mind that delivering anesthesia and managing the delivery of anesthesia services are two very different things.
Our unparalleled improvements in patient safety, quality, and, ultimately, morbidity and mortality make us justifiably proud of the specialty’s success and the envy of the rest of health care. One would think that this remarkable history of clinical success would provide stability for the business side of anesthesia practice. After all, the clinical product that we provide is orders of magnitude safer than when I entered the specialty 25 years ago. If anything, however, I believe our advances have actually laid the foundation for the...
Participating in Medicare’s
Physician Quality Reporting System (PQRS) has taken on a new flavor this
year. While until now participating has meant a potential annual bonus
of several thousand dollars, not reporting in 2013 will entail
a penalty in 2015. Losing out on a bonus is less galling than
forfeiting a percentage of each remittance. No anesthesiologist, CRNA
or pain physician is doomed to lose money for failing to report the
applicable PQRS measure(s). This Alert will provide a reminder of the
steps you need to take to earn the bonus and to avoid future penalties.
It is a testament to the
undue complexity of the program that we are now in its seventh year, and
yet uncertainty lingers. As a reminder, the incentive payments and
“payment adjustments” for each year are as follows:
YearPayment/AdjustmentMadeReporting YearPayment or (Adjustment)
200820071.5%2009 20081.5%
201020092.0%
201120102.0%
201220111.0%
201320120.5%
201420130.5%
201520140.5%
20152013(1.5%)
2016 onward2014 onward(2.0%)
...
Several recent publications
have described strategies for hospitals and ambulatory surgical centers
to improve their operational health—their profitability, to be blunt.
Anesthesiologists are well aware of the role that they can play in O.R.
management and of the need to assume O.R. leadership responsibilities in
order to remain competitive. There are some valuable ideas to be
gleaned from articles and presentations directed to O.R. managers.
Anesthesiologists can take charge of most, if not all, of the processes
described below.
Many ways to improve O.R.
efficiency are already familiar. The value of on-time starts, fast
turnover times and block scheduling, to name but a few such ways, is a
given. Jeffry Peters’s February 28, 2013 webinar hosted by Becker’s
Healthcare and entitled Managing Surgical Services Lines under Accountable Care and Value-Based Purchasing
identified some additional operational changes that would help
hospitals obtain a “sustainable competitive advantage.” Peters is the
president and CEO...