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Webinar Q&A As a follow up to our recent webinar, Patient-Centered Practice: Meeting the Demands of Health Reform, speaker Judy Capko and Kareo have answered the many questions posed by participants.

Q: Will you provide the slides from this presentation? A: Yes, you should have received links to the slides and recording via email. If not, here are the links to the recording and slides. Q: Is there a way that I can get CEU credit? A: To apply for PAHCOM CEUs you have to register and attend the event with your name and email address. To request the CEUs, please email marketing@kareo.com. For more information about PAHCOM, visit their website. Q: Can you provide Judy Capko’s contact information? A: Capko & Company www.capko.com judy@capko.com 805-499-9203

Q. How does the patient-centered care concept impact specialists? Can we participate in the Patient-Centered Medical Home (PCMH)? A: The basic concepts behind being a patient-centered practice apply to everyone. There are many things that any practice can do to be more patient-centered, and, as a result, engage patients more and participate in programs like Meaningful Use. Some of these things may result in higher reimbursement down the road. While the PCMH is really geared towards the primary care provider, there is another program that is directed more towards specialty providers. It is the Patient-Centered Specialty Practice (PCSP) and focuses on the specialist’s role in coordination of care with the primary care practice. To be involved the provider offers superior access (including electronic when patients need it), has care agreements with the primary care providers, and tracks patient care over time and across clinical encounters. For more on this topic, visit www.ncqa.org.

Patient-Centered Practice: Meeting the Demands of Health Reform

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Q: We are a physical therapy practice. Where do we fit in, and are there any incentives that apply to us? A: Patient satisfaction is measured and monitored across the continuum of care and coordination of care with PT is an important factor. I am not sure if you would fall under the new NCQA PCSP program, but suggest you contact NCQA to obtain more details or go to www.ncqa.org. At any rate new opportunities are sure to emerge, so focusing on the things I mentioned in the presentation are very important.

Q: With the projected shortages of physicians and cuts in reimbursement, how can practices find the time to engage patients to the degree that is expected? A: Engaging patients is a process of “everyone” in the practice building a strong patient relationship. This includes using clinical support staff well in contributing to engaging the patient pre-and-post physician encounter. This may take some time to get set up on the front end, but pays off with big dividends in the long-run. Maximizing the use of your practice management and electronic medical records software will also contribute to more efficiency throughout the practice. As you get more comfortable, you will become more efficient and improved patient cooperation and engagement will lead to time savings. Patient-centered and shared decision making increases patient satisfaction, which can also be a time-saver in the big picture. The important thing is moving the culture in this direction and getting buy-in from the entire team. I know this can work because I have seen it in my consulting. Q: Who defines "things that matter": patients or physicians? A: Good question. It’s a dual effort that starts with engaging the patient and finding out what really matters to him or her in their health issues and moving on to shared-decision making. The dialogue with patients is a critical factor. Q: Lack of a social worker to coordinate care seems like a roadblock to some of the requirements for PCMH? Are there are other strategies we could use? A: Most likely. But I am not prepared to answer this without having more information about your particular organization. You may need to involve a consultant to direct you appropriately in what options best fit your situation. Q: How do you get started with PCMH? A: I recommend visiting www.ncqa.org/pcmh for a free copy of the PCMH Standards and Guidelines. You can also email me to request the Patient-centered Quality Care Check List to gain a quick understanding of internal processes at judy@capko.com. Q: Can you provide more information on PQRS? A: Kareo has a simple overview of PQRS that provides some guidance on what the program is and how it works. You can download this for more information. Then, visit the CMS PQRS website for more detail and to get started.

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Q: Can you provide more information on Meaningful Use? A: Kareo has recently hosted a couple of very informative webinars on Meaningful Use. Check out these recordings for a very good overview: What Small Practices Need to Know about Meaningful Use Now and Listen, Learn, Implement. The Ins and Outs of Meaningful Use Stage 2. To confirm eligibility and get started with Meaningful Use, visit the CMS EHR Incentive website. Q: Are there payers who are providing incentives for PCMH? A: Under the PCMH model, physicians and other caregivers are collectively financially rewarded for improving outcomes and reducing costs through well-orchestrated coordination of care. Different payers are also continually evaluating payment models to reward the PCMH. NCQA can help you understand this program in more detail. Currently, payers are not increasing payments for practices that are certified as a PCMH, but this is definitely something that this coming. In addition, there are other programs with features related to patient outcomes and engagement that are tied to payments like Meaningful Use. Some commercial payers are also paying incentives for tracking some preventive care measure and outcomes. To find out more, you will need to look at your payers specifically. You can call and talk to them about any programs that they have. You can also contact your specialty society for help with this or contract with a consultant. Q: We are concerned about getting negative reviews or surveys, particularly from difficult patients. Should we do a survey or enable sites with online reviews? How do we deal with that? A: A lot of people are concerned about this, but I really see it as an opportunity. First, it can give you a chance address legitimate concerns that will affect other patients’ perceptions of your practice—for example, if the scheduling process is causing complaints because it’s too difficult, or if wait times in your reception area are more of an annoyance than you realized. Studies also show that the majority of reviews posted about physicians are positive—and the negative ones are mostly related to fixable administrative issues—so, some of the fears that people have are misplaced. Finally, if there is a truly illegitimate review that has been posted maliciously, most sites provide a means to get those removed. When there are negative comments, address them. Be proactive and responsive to comments. Engage the commenter if you can. For example, if someone says they had a bad billing experience, respond right away with something like: “We are so sorry that you have had a poor experience and we want to know more. Can we talk on the phone to discuss it and see if we can address your problem?” Often this is enough for someone to follow up with a more positive review and others see that you are responsive to problems and concerns. Making it possible for patients to give feedback before they leave your practice is an even better way to head off bad reviews. Often, just being asked about the experience, and given the chance to share concerns or vent a little bit, is enough to make a person feel better about the care and service they received. And, you will then have important information to improve your practice without experiencing a negative online review. This is a very good habit to instill in staff!

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Doing your own surveys can give you insight into how well you are serving your patients. The important thing is to develop a statistically valid survey instrument and methodology for assessment so it provides real value. Q: Will Kareo be doing any upcoming events on ICD-10? A: Yes. Kareo currently has an event on ICD-10 schedule for November. More information will be available soon. Watch for an email or check back at www.kareo.com. Q: Does Kareo offer the ability to conduct patient surveys or get patient reviews? A: Through a partnership with Demandforce Kareo customers can now access powerful patient survey tools, proactively build their online reputation on popular Internet review sites and gain customer traction through online marketing. Demandforce automatically tracks results and revenue from all communications and online marketing efforts to provide real-time visibility into the success of the small medical practice. To find out more about this recent partnership, read the full press release or call 1-888-775-2736. Q: Does Kareo enable patient eligibility? A: Yes. Kareo Practice Management (PM) allows you to check eligibility in two ways. You can check the eligibility of an individual patient or you can run batch eligibility for all patients scheduled on a specific day. Q: Can physicians send and receive labs in Kareo? A: Yes. Kareo EHR provides electronic lab connectivity that enables providers to request lab tests and receive results. Those are saved in the patient record and can easily be reviewed. For faxed lab results, the documents can be easily scanned and uploaded to the patient record in the EHR. Q: Are the CPT and ICD codes already loaded in Kareo? A: Yes. Kareo PM is setup and ready to use for your medical billing. You can be up and sending claims very quickly. If you use Kareo EHR and the physician completes the superbill in the EHR, it can be saved and sent electronically to Kareo PM. Once it is in Kareo PM, you can review, approved and submit very quickly. If you use a paper superbill, you can enter the information in Kareo PM and create a claim by selecting the appropriate codes and then you can submit the claim. Q: Is Kareo still associated with Practice Fusion? A: Yes. Kareo has maintained a close interface with Practice Fusion as well as several specialty-specific EHRs. In addition, we now offer the Kareo EHR, which is much more integrated with the Kareo Practice Management system. Both options—Kareo EHR or third-party EHR partners—provide many of the tools and features that you need to manage the clinical side of your practice. However, if you would like a solution that is more closely tied together, using the Kareo suite may make the best sense. For a little more detail on the integration of the Kareo PM and EHR, see this video.

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Small Practice & Billing Company Resources Please visit Kareo Resources at www.kareo.com/resources for helpful tools, webinars, whitepapers, and tips for how to help small practices become best practices. You can also view recorded webinars or register for our next event at www.kareo.com/resources. About Kareo Kareo is committed to providing education and insights to small medical practices. We work with in-the-trenches influencers, consultants, and Kareo customers to provide relevant tips on how to successfully manage medical practices and medical billing services. Find out more at www.kareo.com. About Speaker Judy Capko www.capko.com judy@capko.com Judy Capko is a practice management and healthcare industry consultant with Capko & Company. Judy is the author of Secrets of the Best-Run Practices, a best-seller in the healthcare market. Her consulting focus is on building patient-centered strategies, improving leadership and valuing staff’s contribution.