Healthcare IT News - January 2008 - (Page 33) www.HealthcareITNews.com payERS January 2008 law enforcement to risk management prevention when preventing money from “going out the door” ■ Healthcare IT News 33 New York health plans promote EHR uptake among docs By PaTTy ENrado, Contributing Editor NEW YORK – Two New York state health plans are working together to encourage eligible primary care physicians to take advantage of a proposed expansion of New York City’s electronic health record project. “Health plans should stimulate the adoption of EHRs as part of their effort to improve the quality of care and health outcomes for members,” said Ilene Margolin, spokeswoman for Group Health Incorporated, or GHI. More than 70 primary care physicians and office managers, representing some 45 physician practices, attended a recent seminar organized by GHI and HIP Health Plan of New York. Fifteen physicians signed up for the program within two days, and an additional 225 asked for more information. The New York City Department of Health and Mental Hygiene’s Primary Care Information Project was funded by Mayor Michael Bloomberg’s $27 million initiative to improve the quality and efficiency of healthcare in New York. “For most attendees, the question was no longer whether to get an EMR, but which one and when,” said Margolin. GHI stressed the value of the project. “It helps offices transition to a less-fragmented electronic world by connecting them in numerous ways, such as eRx, immunization registries, a data warehouse for quality reporting and eventually a full clinical information exchange,” Margolin said. The health plan has already helped more than 500 physicians adopt EHRs. “Plans should also fit EHR promotion into their overall strategic goals in public health advocacy, building relationships with providers, and being a good corporate citizen generally,” Margolin said. “Underserved patient populations tend to receive the most highly fragmented and inconsistent care. One of the ways to combat the problem is to place the information in a network so that it can be accessed when the individual moves or changes providers.” Sidd Shah, project director for eClinicalWorks, the healthcare IT vendor for the initiative, said that while physician adoption for the project is high, advocacy is necessary. “Not only health plans but everyone in the health industry should be encouraging physicians to adopt EHRs,” said Shah. “It brings synergy to this project. Health plans definitely benefit by having physicians on an EHR.” ■ More at HealthcareITNews.com e Connect: NewYork 0108 fraud Continued from page 31 identified 20 percent more in exposure than we knew about,” said Brennan, which meant 20 percent greater recovery for Highmark. The application also identified 39 new cases, and enabled Highmark to hand over a “significant” number of referrals and complete cases to law enforcement agencies. At a recent Webinar hosted by Gartner and Fair Isaac, Gartner analyst Joanne Galimi noted that available technology and best practices are making a positive impact on healthcare fraud by cutting costs in half. Anu Pathria Anu Pathria, vice president of healthcare analytics, said the healthcare fraud detection paradigm would shift from technology and best practices are making a positive impact on healthcare fraud by cutting costs in half. is the focus. Highmark will go live by midyear 2008 with Fair Isaac’s pre- payment application, which will identify aberrant claims postadjudication but before they are paid. “You only recoup 20 to 30 percent of what goes out the door,” said Brennan. The ability to identify aberrant claims post-adjudication but before they are paid will create a “huge impact on customers, premiums and the cost of healthcare,” he said. More at HealthcareITNews.com e Connect: FraUD 0108 ● When it comes to patient care, every employee counts. VIsIT us AT HIMss BOOTH #3849 At API, we understand patients are the driving force behind everything you do. From IT to human resources and every department in between, your employees are all working toward the same goal – the safe and effective delivery of care. Our suite of labor resource management tools is designed exclusively for the healthcare market. Each application empowers employees to get the job done quickly and cost-effectively so everyone can focus on what matters most. Learn more by calling 262-670-2784 or visiting www.apisoftwareinc.com/hcitn to request a case study highlighting one organization’s use of API’s labor resource management tools. e ● Connect: aPI 0108 ● ONLY HEALTHCARE | ONLY API http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8431 http://HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8426 http://www.apisoftwareinc.com/hcitn http://www.apisoftwareinc.com/hcitn http://www.healthcareitnews.com/eConnect.cms?id=8476 http://HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8431
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