1. Four Areas Where Technology Precipitates Clinical Success
Ryan
Ryan Hackett, Solutions Architect, GBS Corp.
Corine Binder, Healthcare Consultant, GBS Corp.
08/24/2017

2. Introductions Advanced Professional Services Team – Ryan Innovation
Wellness Assessment Tool (WAT)
Data Analytics
Consultative Services
Workflow Optimization
Team Reform – Corine
Government Incentive Programs
MIPS/CPC+/PCMH/Medicaid MU
Analysis and Guidance
Ryan – Touch on importance of collaboration amongst Team members (Ryan and Corine specifically)

3. Agenda
Provide a brief summary on the current state of Meaning Use and MIPS/MACRA – Corine
Expose attendees to several different approaches that will help keep your patients engaged – Ryan
Expose attendees to several different approaches that will help keep your practice engaged – Corine
Identify the current state and future vision of Revenue Cycle Management Services (RCMS) in the Healthcare industry – Ryan
Ryan

4. Government Incentive Updates
IPPS Final Rule – Medicaid EHR Incentive Program – 2017
EHR (Objective) Reporting Requirements
All Medicaid EP’s regardless of submission method are required to report any continuous 90 day period during CY 2017 versus previous requirement of a full year reporting period
Corine

5. Government Incentive Updates
CQM Reporting Requirements – 2017
Medicaid providers are required to report a minimum of any continuous 90 day period during CY 2017
Medicaid EP’s are required to report on any six (6) measures relevant to the EP’s scope of practice during CY 2017 to better align with MIPS Quality performance requirements
The reporting of zero denominators is still allowable during CY 2017
CQM’s being reduced from 64 to 53 to align with MIPS Quality reporting
Corine

6. Government Incentive Updates
Medicaid EHR Incentive Program – 2018
EHR Reporting Requirements
EP’s can upgrade to 2015 CEHRT but still report/attest to modified stage 2 measures
The EHR reporting period is any continuous 90 day period within CY 2018 for new and returning participants attesting to CMS or their state Medicaid agency
* Providers cannot attest to MU3 if on 2014 CEHRT
Corine

7. Government Incentive Updates
Medicaid EHR Incentive Program – 2018
CQM Reporting Requirements
The reporting period for CQM’s will be a full year during CY 2018
* Providers cannot attest to MU3 if on 2014 CEHRT
Corine

8. Government Incentive Updates
Proposed MIPS Program – 2018
Increase low-volume threshold
Integrate “Virtual Groups”
Continue to allow 2014 Edition CEHRT while encouraging the use of 2015 Edition CEHRT
Add bonus points to the scoring methodology for:
Caring for complex patients
Using 2015 Edition CEHRT exclusively
The reporting period for CQM’s will be a full year during CY 2018
Corine

9. Government Incentive Updates
Proposed MIPS Program – 2018 (cont.)
Incorporate MIPS performance improvement in scoring quality performance
Add new hardship exception for clinicians in small practices under the ACI performance category
Add bonus points to the “Final Score” of clinicians in small practices
Continue to award small practices 3 points for measure in the Quality performance category that do not meet the data completeness requirements.
AUC – Add to Improvement Activities Category to self attest if they use AUC through a qualified clinical decision support mechanism for all advanced diagnostic imaging services orders
Corine

10. Patient Engagement Leverage Big Data to Identify High-Risk Patients
Population Health
Utilize technology to analyze clinical data and automate patient alerts and appointment reminders
Designate a Patient Engagement Advocate
Identify Improvement Activities
Implement Programs
Monitor Progress
Ryan – Patient advocates should be charged with turning strategic ideas to concrete actions. Utilize payers as a reference when drafting your patient advocate job description.

11. Patient Engagement Assist with Medication Management
Patient Portal Integration
Appointment Scheduling
Account Payment Options
Access to “Office Visit” Documentation
CCDA Requirements
Patient Education (Related to 2018 MIPS/MACRA Requirements)
Ryan

12. Patient Engagement Shared Decision Making
Partnership between physician and patient
Patient involvement in “Care Plan” development
Leverage Interoperability Opportunities
Access to comprehensive data is imperative when cultivating patient engagement
Take note of payer and patient engagement strategies that set the stage for commitment to your patients’ long-term health
Ryan

13. Patient Engagement Goals Improve the overall patient experience
Quality of Care
Patient Satisfaction
Improve the overall health of particular patient populations
Decrease the overall cost of care
Ryan

14. Practice Engagement Goal Sharing Appropriate Staffing
Recruiting Requirements
Access to Education/Training Materials
Standard Operating Procedures (SOPs)
Staff On-Boarding
Clinical Workflow
Billing/Coding
Staff Retention
Employee Recognition Programs
Competitive Wages
Corine

15. Revenue Cycle Management Services (RCMS)
Choose a solution that encompasses the entire RCM continuum, from patient registration through billing and collections
Solution must focus on meeting and exceeding your needs while generating revenue and creating patient satisfaction
Develop Standard Operating Procedures (SOPs) to ensure that all billings are performed in a timely accurate manner
Develop KPIs to monitor progress and trends over time
Ryan

16. RCMS Statistics
85% of providers are looking to replace current RCM system
29% of hospitals are using advisors and consultants
70% of practices are considering outsourcing
93% of CFO’s report they will eliminate under-performing vendors
94% of CFO’s believe transformation can impact their financial health
$10.3B spent as of June 2016 (budget year) on RCM and Ancillary Services
Up to $11.9B by June 2018 (budget year)
33% who had a plan to replace in 2016 have failed
Ryan

17. Advanced Pre-Billing (APB)
APB is one method to proactively initiate the billing cycle in an effort to create efficiency and drive revenue in your Practice
Ryan – Automates EMR charge passing and cleans billing data before entering your Revenue Cycle System

18. RCMS Benchmarks
MGMA Benchmark Data (KPIs)
Ryan

19. RCMS Benchmarks
Additional MGMA Benchmarks (KPIs)
Ryan

20. RCMS in Review Traditional: 10% – 15% net revenue lost
30 – 45+ days in Accounts Receivable (AR)
Denial rates at 5%
Staff leaving equates to lost revenue
Dependent on PM system
Less time for Patient interaction
Potential:
10% - 15% improved revenue
Less than 25 days in AR
Denial rates below 1%
Staff focus on exceptions
Not focused on PM system
Focus on high priority items
More time for Patient interaction
Ryan

21. Thank you for your time today!
Questions
Thank you for your time today!