Host

Tim Coan, CEO ALN Medical Management

Guest

Eliot Payson, CIOALN Medical Management

Revenue Cycle Management: What Matters NowInteroperability: The Coming Merger of Clinical and Financial Data

Information Exchange Vendors

Source: KLAS Health Information Exchanges Report, June 2010

Medicare Incentives/Penalties

Source: MGMA In Practice blog, June 25, 2010

YearMaximum Benefit per Provider using EHR

Total Medicare Payment Reduction- not using EHR

First Year $15,000(if 2011 or 2012, $18,000) 0%

Second Year $12,000 0%Third Year $8,000 0%Fourth Year $4,000 0%Fifth Year $2,000 2015: 1% (in some cases 2%)

Sixth Year 0 2016: 2%2017 0 2017: 3%Beyond 0 Beyond: 3% (up to 5% starting in 2019)

Information Exchange Structure

Source: RelayHealth

Next 5 years = Constant Change Meaningful Use Stage 1: 2011-2012

> Physicians must demonstrate compliance with 15 core MU objectives and 5 of 10 elective MU objectives.

> Expected release of Stage 1 compliant versions of EMR software: Q1 2011.

HCFA 5010 claims standard: Jan 1 2012> HIPAA 5010 compliant transactions will be required by Jan. 1, 2012. > Software updates will become available in Q2-3 of 2011.

ICD10: October 1, 2013> ICD-10 codes must be used on all HIPAA transactions on and after Oct.1, 2013.> Software updates will become available in 2012

Meaningful Use Stage 2: 2013> Additional, yet to be defined, objectives will need to be met in order to continue

receiving HITECH Meaningful Use incentives.

Meaningful Use Stage 3: 2015> Additional, yet to be defined, objectives will need to be met in order to continue

receiving HITECH Meaningful Use incentives. > Providers that do not achieve meaningful use by 2015 will start to receive

penalties in their Medicare reimbursement.

Each year, practices will need implement significant Practice

Management and EMR Software updates.

These technology updates will require

process changes that will have a significant impact on providers

and staff.

How to Manage the Transition

Critical Success Factors1. Commit the right leaders

2. Choose a partner that can deliver long term

3. Talk about why you are doing this

4. Fix office workflow

5. Define milestones along the way

6. Develop a plan for converting from paper

7. Dedicate ample time for training

8. Invest early in “champion” users to lead the effort

9. Provide real user support

10. Celebrate successes along the way

Failure Factors1. Unsatisfactory project

management and control

2. Lack of communication

3. Fuzzy goals

4. Underestimation of project complexity

RCM: What Matters Now

Revenue Cycle

Management

Why RCM Performance is More Important

Than Ever

Managing Day to Day RCM Performance

with Data

Technology Enhanced RCM

The Future of Coding and Compliance

RCM Reporting:

What to Watch, When to Watch

Interoperability: The Coming

Merger of Clinical and

Financial Data