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Newsletter 2013 Q3

Don’t Throw Out Your EHR with the Bathwater Just Yet

The Medicare Electronic Health Records (EHR) Incentive Program finished its second year with over 195,000 eligible professionals (EPs) attesting as of June 2013, according to data published by the Centers for Medicare and Medicaid (CMS). While the first-time attester rate was higher in 2012 than in 2011, further review of the data reveals that 17% of EPs who had attested in 2011 did not re-attest in 2012 (roughly 10,000 EPs). There were several reasons behind the dropout rate including: missing the attestation deadline (28%), switching to a practice without an EHR (17%), and retirement (5%).


The remaining 50% of providers who did not re-attest were surveyed to identify what factors caused them to dropout. Respondents cited having missed the deadline, not being able to meet one or more program objectives, or participating in the program was too complicated and time consuming. In addition to these reasons, 21% of respondents said they did not attest because they were either dissatisfied with their current EHR or had switched systems. Over the past two years, dissatisfaction with EHR systems and vendors has been increasing.

According to a 2013 Black Book survey of 17,000 EHR adopters, 17% of those polled responded that they were dissatisfied enough with their current EHR vendor that they planned on switching vendors within the next year. Another 14% said they would like to switch but were not currently able to. The top three reasons for considering switching vendors were that the individual needs of the practice were not being met, the practice did not adequately assess its need before selecting an EHR, or the design of the system was not suited for the physician specialty.

Another survey released in 2013 by the American College of Physicians and AmericanEHR Partners found that 34% of respondents were very dissatisfied with the ability of their EHR system to decrease workload, 32% stated that productivity had not returned to its pre-implementation level, and 37% were dissatisfied with the system’s ease of use. These numbers all increased from the 2010 survey, suggesting that while EHR technology has been improving, successful implementation has been lagging.

We believe that switching EHR systems is not necessarily the answer. It is a time-consuming and expensive process that, if configured the same way as your existing EHR, may not produce better results.  Alta Partners has long counseled our clients that EHR implementation is not an IT project and that requires training and support staff that not only know the system, but also have an intimate knowledge of the practice’s day-to-day activities in order to truly recognize the efficiencies that are available with this technology.

Before abandoning an EHR system, consider the alternative ways of addressing the issues, such as process review and redesign, additional training, or configuring the EHR to meet the specific needs of your practice. If you are considering switching EHR systems, stop and take a moment to review the services offered by Alta. With Alta, you can receive personalized help for your specific EHR and practice management issues and concerns. Our healthcare consultants specialize in all aspects of EHR systems, from pre-implementation readiness assessments, to training and support, to post-implementation review and optimization. Instead of taking on the expense and stress of a new EHR system, let Alta’s consultants help you make your current system work for you.


Insurance Database Streamlining! Making Vision Easier for You to Use

You have spoken and we have heard you. One of the biggest complaints we’ve had in using our system is with front desk staff having to scroll through dozens of insurances that were used back in an era when “PPO”, “PSO”, and “HMO” meant something. Fast forward to today and we recognize that things can be better if they are simpler.

As a result, Alta Partners is currently working to streamline its insurance database, making plan selection quicker and easier. This process includes removing several of the current categories (HMO, PPO, etc…) and co-pay plans and replacing them with “STND”. This will reduce the number of options to choose from, improving efficiency and reducing the risk of errors on the front-end.

Exhibit A is an example of the current system set-up, with the Category field set to PPO and the Plan field set as CO20. After the database has been updated, these fields would both show STND, as seen in Exhibit B. 


Due to the size of the insurance database and the number of active accounts, this process will be taking place during the next several months.  Alta will attempt to keep the process as transparent as possible for users.  

During this process, insurances listed on a patient account will remain active until the insurance master file has been inactivated. Once this is done, the insurance on the patient account will become inactive. Patient insurance registration will need to be verified at the time of check-in and the correct insurance added to the account, to make sure the registration is for an active insurance and the insurance priority is correct. Practices do not need to be concerned about current claims. Any claims with an inactivated insurance will be updated to the correct, active insurance.  

The Grand Lake database is not part of this process.

We hope that you and your staff find the change to be beneficial, making the tedious process of selecting the correct insurance to be a much easier task. We plan to have the project completed for all insurers by the end of November.

If there are any questions about the insurance clean-up, please call the client contact number at (440) 808-3651.


Allscripts Vision User Tip – How to Correctly Use Medicare as a Secondary Insurance

Remember when billing out Medicare as a secondary insurance, the Insurance, Category and Plan fields need to be set as CARE, MSP, and MSP, respectively, as shown in Exhibit A.

Exhibit A

The EDI Coverage Type also needs to be updated with the correct code. The coverage type will be one of the following:

  • 12 – Beneficiaries aged 65 or older insured through their or their spouse’s current employment

  • 13 – Beneficiaries enrolled in Medicare due to End-stage Renal Disease (ESRD) and curently insured through employment (self or spouse)

  • 14 – Medical expenses for injuries covered under no-fault insurance

  • 15 – Injuries covered under Workers’ Compensation Insurance

  • 16 – Services are a direct obligation of another governmental agency

  • 41 – Beneficiaries covered under the Federal Black Lung Program

  • 42 – Beneficiaries eligible for Veterans Administration (VA) benefits

  • 43 – Beneficiaries under the age of 65 disabled and insured through their or their spouse’s employment

  • 47 – Payment has been made, or is expected ot be made, under a liability insurance plan

For more information on determining the coverage type, please visit http://www.cgsmedicare.com/pdf/MSP_JobAid.pdf.

If there are questions on this, please call the Client Tech support line at 440-808-3651.


Introducing Lacy Sharratt, New Consultant at Alta Partners

Alta Partners, LLC is pleased to announce the addition of Lacy Sharratt as Healthcare Consultant to our team.

Lacy is a recent graduate of Cleveland State University, receiving her Bachelor’s in International Business and Finance in 2010 and her MBA in Health Care Administration in May 2012. While pursuing her graduate degree, Lacy interned at the Cleveland VA Medical Center (VAMC) in Cleveland, Ohio in the Fiscal department. Her work with the VAMC exposed her to the various aspects of managing a medical center, including the budgetary process for a complex health system, the implementation of programs and technology, project management, and the communication skills necessary to coordinate with various departments throughout the medical center to accomplish goals.

After completing her internship at the VAMC, Lacy joined a pharmacy benefit management company in Twinsburg, Ohio as a Medicare Part D Claims Analyst. Her work included managing monthly reporting for clients enrolled in the Medicare Retiree Drug Subsidy program. Lacy worked closely with clients to make sure deadlines were met and data was accurate in order for the clients to receive maximum subsidy amounts. Her review and improvement of the reporting procedures led to clients receiving over $35,000 in additional subsidy. She was also part of a team responsible for reviewing prescription drug claims for over 354,000 Medicare beneficiaries; ensuring claims were processed according to federal guidelines to improve the company’s compliance rate and to maximize federal reimbursement dollars. This work involved evaluating claims to identify systematic processing errors, reviewing data management procedures to improve the accuracy of data, and working with teams to develop both short- and long-term resolutions for various problems. These actions led to improved internal financial reporting, new techniques for identifying and correcting errors, and a proactive approach to managing the process.

As our healthcare consultant, Lacy will be working on many of our financially oriented engagements including practice assessments, practice valuations, and physician practice budget review. In addition, Lacy will be assisting our billing clients with various financial analyses as needs arise. 

Contact information:
Email: lks@altapartnersllc.com
Phone: (440) 808-3644