Healthcare IT News - November 2007 - (Page 23) www.HealthcareITNews.com PHYSICIaN PRaCTICES & amBulaTORY CaRE a medical home model should deliver to patients. They also affirmed that a medical home model could provide a more efficient and cost-effective delivery of care, especially if healthcare IT was adopted broadly. “Today’s reality is that only about 37 percent of AAFP member practices have implemented EMRs and practice management systems,” said Henley. “We need to move practices to a higher level of IT adoption to improve quality and cost efficiency.” ■ HealthcareITNews.com e ●Connect: ModeL 1107 More at November 2007 ■ Healthcare IT News 23 Model Continued from page 1 RoI Continued from page 21 are Aetna, Blue Cross Blue Shield Association, CIGNA, Humana, MVP Health Care, UnitedHealthcare and WellPoint, Inc. Healthcare information technology plays a critical role in the medical home model of care. Advocates of the model have said that health information exchange, chronic disease registries, secure e-mail consultations and electronic medical records will be central to care management in the model. The approach is based upon evidence that recipients of personalized primary care live healthier lives. By restructuring reimbursement practices to support this transformation and reward the comprehensive delivery of care, the model seeks to expand the role of primary care physicians as coordinators of the health needs of their patients. “In order for this model to work nationally, an interoperable health information system has to be in place,” Grundy said. “One place where this works now is in Denmark, which is about 10 years ahead of the United States. But over the next few years you will see pilot projects developing here that use this kind of care model.” In addition to the payers, membership in the collaborative also includes four major primary care physicians’ professional societies – the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians and the American Osteopathic Association – as well as national employers and their associations, quality advocacy groups, academic centers and consumer advocacy groups. Leaders of the collaborative say they have gathered momentum and national attention since last year, in part by creating a “critical mass of employer support.” “Having the health plans come to the table and show support means that the collaborative now represents all the major stakeholders,” Douglas Henley said Douglas Henley, MD, AAFP’s executive vice president. “I think everyone recognizes that the medical home model needs to be tested and validated, and that new payments strategies need to be supported.” In addition to joining the PCPCC, the health benefits companies have committed to work toward the development and implementation of a series of multi-payer medical home pilot demonstrations. “The biggest roadblock to the medical home model is Medicare, because they’re the largest payer and they pay for episodic care,” said Grundy. “All the other payers model themselves after Medicare. But I do believe that CMS wants to see this change.” Grundy said that stakeholder representatives have agreed that the principles embraced by the four primary care physicians’ professional societies broadly describe the services and conservative billing, according to Sami Aita, MD, MedComSoft’s founder and chief executive officer. “Doctors don’t have to be scared and under-code because they’re relying on a subjective code from a provider,” Aita said. “Here they know their coding can withstand any auditing.” He said practices using the MedComSoft record have seen increases in revenue of about 20 percent to 30 percent. “What we have tried to do differently here is that all the components flow through each other,” Aita said. “The coding for the services is done automatically, from the time the patient checks in, all the way to the clinical encounter, and all the way back to the back office for billing.” Alicia Valdez, MD, said the EHR made it possible for her inner-city San Antonio, Texas-based practice to stay in business. Roughly 80 per- cent of her patients are covered by Medicare and Medicaid. “Reimbursement for those programs is about 30 percent of what you bill,” Valdez said. “You don’t break even.” Moving to an interoperable EHR meant Valdez was able to take billing procedures in-house, cutting $30,000 in annual spending. The new system also enabled her to code more accurately. More at HealthcareITNews.com e ●Connect: roI 1107 e ● Connect: aLLSCrIPtS 1107 http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8044 http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8015 http://www.allscripts.com/red http://www.allscripts.com/red http://www.healthcareitnews.com/eConnect.cms?id=8092
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.