History of independent physicians

In the very early days of rural America, doctors often went to patients’ homes in a horse and buggy and took care of the entire family’s ailments and injuries. Doctors in the late 1700s and 1800s were generally not formally trained, but were expected to treat everything from a broken arm to contagious diseases. They probably learned their trade from the town doctor who was retiring and needed a replacement. Fees were direct pay and may have involved livestock or even baked goods. These were the first independent physicians in the US. Many were dedicated and qualified, while some were considered “quacks.” By the mid-1800s, those physicians who were concerned with the path of their profession saw the need for formal training and regulation. In 1846, the American Medical Association (AMA) was formed and in 1900, the Journal of the American Medical Association (JAMA) was founded. According to an American Academy of Family Physicians (AAFP) Foundation paper, by the turn of the 20th century, the AMA set objectives to: Purify the profession from quackery Establish an orthodox medical education based on natural science Promote standards for public health (sanitation, food and drugs) Standardize medical education Subspecialties then began to be established, along with more formal education and tighter regulations. As providers began to align themselves with hospitals and other healthcare facilities, the number of truly independent physicians began to decline and is now less than half of all providers. In 2016, an AMA study found that only 47.1% of physicians held ownership in their own medical practice. This number was down significantly from four years earlier, when 53.2% practiced independently. Many physicians cite burnout or financial considerations as their reasons for giving up their independent practice and seeking employment in a larger organization. However, the independent physician is not close to being extinct. Autonomy and independence will continue to be important factors for this group of dedicated doctors and the independent physician is now and always will be a permanent fixture on the healthcare landscape.  

Tyler Comstock
January 16, 2018

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Tips for physicians considering entering into ACO agreement

The decision to join an Accountable Care Organization (ACO) can be challenging for independent physicians. Some providers might be skeptical as to whether joining such an organization might reap more rewards than restraints. For independent physicians, there are many considerations involved but there can also be many potential benefits. Physicians who are considering entering into an ACO agreement might want to consider the following: Independent physicians may qualify for the Medicare Shared Savings program as part of the ACO. Establishing strong partnerships with other physicians within the ACO and coordinating services can result in increased savings for all. A recent article in Referral MD advises, though, that “to reduce costs and increase savings, practices and physicians should carefully consider which healthcare providers they choose as partners.” The independent physician’s “data will need to be more accessible, more accurate, and more appropriately used to align with the greater ACO value proposition.” The article, “Preparing for accountable care organizations: a physician primer,” points out that data will “become of paramount importance” for a physician joining an ACO. Managing the necessary data is a more efficient process with an electronic health record (EHR) solution. Patient information is available with one click, during and after the patient visit. In addition, coordinating with other providers is less time consuming when collaborative takes place electronically rather than through faxes or a series of phone calls. Independent physicians should “have a clear understanding of patient attribution, financial incentives, and quality metrics within any ACO agreement,” according to the Primer. Going into the agreement with a clear picture of responsibilities and ramifications will help ensure the ACO and the independent physician are successful. Patient engagement and retention are enhanced in an ACO. According to Referral MD, providers “communicate more efficiently and tend to make better-informed decisions because of specific quality standards that determine the savings they receive,” resulting in higher quality care and patient satisfaction.

Nick Dealtry
January 9, 2018

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How EPCS will grow in 2018

The US Department of Health and Human Services (HHS) reports that 116 people a day die from opioid-related drug overdoses. Prescription opioid painkillers account for at least half of these deaths. Technology can play a significant role in preventing such prescription abuse and, subsequently, in combatting the opioid epidemic that has become a national emergency. Electronic Prescribing for Controlled Substances (EPCS) was introduced as a way to address the high rates of drug abuse across the country. By making prescriptions harder to forge or steal, EPCS reduces the ease with which teens and other citizens can access prescription drugs. The electronic prescriptions, referred to as eRx, allow physicians to create e-prescriptions that can be received and acted upon by pharmacies. In 2017, six states - New York, Maine, Connecticut, Rhode Island, Virginia, and North Carolina -  mandated the use of EPCS. In 2018, that trend is expected to grow. Legislation has already been introduced in New Jersey, Massachusetts, Texas, Pennsylvania, and Illinois, with several additional states anticipated to follow suit. Federal legislation was introduced in 2017, mandating the use of EPCS for Medicare Part D patients. More movement on the national level is also expected for 2018. The use of EPCS in 2018 is expected to grow as an effective tool in the battle against opioid addiction. As HITConsultant points out, “technology now enables the delivery of prescriptions in a trusted, secure, compliant, and truly efficient manner.” Stemming the abuse of paper prescriptions is an important step toward combatting the opioid abuse epidemic. Electronic health records (EHRs) that are certified for EPCS will also play a growing role in 2018. EHRs transmit information electronically, so that only a verified recipient, in this case the pharmacist, can access the information. EHRs certified for EPCS use a two-step authentication process to ensure that those using the system have the authority and the appropriate need to do so. Elation’s EHR solution provides EPCS capabilities for many of our independent physician customers.

Tyler Comstock
January 8, 2018

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Why independent private practices will continue to be a permanent fixture

Contrary to popular belief, the private practice is not headed toward extinction. Though the numbers are down slightly, just under half of all physicians owned equity in their practice in 2016. Even with the added administrative burdens of regulations and reporting requirements, independent physicians are still focused on providing quality care and on developing productive relationships with their patients. For many independent physicians, that autonomy is more important than the potentially higher income they might see as employees of larger healthcare facilities. Independent physicians are able to manage their practice to be sustainable while at the same time providing quality healthcare to their patients on a more personal level. As recently reported in Medscape, the independent private practice is here to stay, as a permanent fixture on the healthcare landscape, mostly due to “emerging new business models, cost-saving technological advancements, and the tenacity of physicians determined to practice medicine on their own terms.” Independent physicians are exploring a number of alternative practice models, including the direct primary care practice (DPC). Some smaller independent practices have also made the move, literally, to share office space and other resources in an effort to be more efficient with their financial investments. Many independent physicians actually leave employment in a larger healthcare facility to launch their own practices. According to the Medscape article, “more than half (52%) of all self-employed doctors responding to Medscape's 2014 Employed Doctors Report say they were previously employed.” Technology tools such as electronic health records (EHRs) help independent physicians manage their patients’ medical information, their billing and scheduling records, and their communication with patients, adding to their opportunities for success. Elation Health continues to support independent physicians with our EHR solution, fulfilling our mission to strengthen the relationship between patients and physicians, and enable phenomenal care for everyone.

Nick Dealtry
December 20, 2017

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How to meet patient demand at your independent practice

In today’s digital world, patients want to be able to interact with their healthcare providers online as well as in person. From communicating with the provider to scheduling appointments and paying bills, convenience and access are becoming priorities for consumers, including consumers of healthcare. Independent physicians can better meet patient demand and, as a result, improve the sustainability of their practice, by providing the digital tools their patients need and want. Electronic health records (EHRs) enable both physician and patient to view the patient’s medical information with just a few clicks on a user-friendly screen. Patients who have access to their own medical data tend to take a more active role in managing their own healthcare. A patient portal gives patients the information they need about visit summaries, lab results, specialty provider visit notes, medications, and reports, to view for themselves or to share with other providers. EHRs also provide patients with a convenient communication tool for asking questions of the independent physician or requesting additional information about appointments, referrals, prescriptions and refills, labs or other test results. Patients can send and review messages online on their own schedule, instead of having to wait for office hours to make a phone call and then potentially have to wait for a call back from the provider. Today, independent physicians need an additional online presence through a website and social media. These tools enable the patient to review current information and news about the practice and enable the practice to provide helpful tips and updates in real time. As Physicians Practice suggests, “Using your site as a reference tool allows you to refer patients to the site to 'self serve' rather than use time and resources within your practice to educate patients.” When patients have electronic access to practice information, their own medical records, appointment scheduling tools, and communication options, their in-person interactions with the independent physician become more efficient and effective. As a result, your independent practice is better able to meet your patient demand.

Tyler Comstock
December 12, 2017

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Independent practice scheduling tips to master "the art of scheduling"

Scheduling in an independent practice requires a skillful combination of personal service and efficient technology. Patients’ primary concerns about going to see the doctor are typically about the amount of time they have to wait to see their provider, in the waiting room as well as in the exam room. Proper scheduling can increase the patient flow throughout the day, which makes patients and physicians happier. Practice staff can play a huge part in the “art of scheduling.” Getting to know the patients as individuals can help office staff schedule their next appointment for a day and time that makes sense for both patient and practice. As noted in a recent Physicians Practice article, “by understanding the patient's healthcare needs and schedule of availability, you're better able to get them in the perfect spot on the healthcare staff's schedule.” Finding the perfect time for the patient requires asking questions and truly listening to the answers before, during, and after the visit. If the patient’s work schedule or family obligations conflict with the next available appointment time, then some flexibility and understanding needs to come into play. The patient’s health and well-being are the primary focus for an independent physician and scheduling issues should not be the cause of added stress! Technology can be a significant factor in effective and efficient scheduling. Using electronic health records (EHRs) to track a patient’s medical and appointment history can help the independent physician’s scheduling staff understand what works best for that particular patient in regard to future appointments. Communication tools are also helpful to send reminders, for fewer missed appointments. Elation’s Clinical First EHR enables independent physicians to quickly identify patients who aren’t meeting goals based on custom care management protocols, Meaningful Use objectives, or specific document tags, and easily schedule a follow-up appointment to address any potential gaps in care. Employing a combination of personal attention and EHR technology, the independent physician can manage patient appointments to produce higher quality outcomes for patient and practice.

Parker Nieves
December 11, 2017

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What are the best states for independent physicians to practice in?

For more than 10 years, Physicians Practice has ranked the states based on data “that most affect physicians’ practices.” The result, the Best States to Practice project, lists states in order, according to their performance in each of the categories measured. This year, the project also enables physicians to weight their own priorities and determine the best state for their specific practice. To determine the ranking, Physicians Practice used the “latest data for cost of living, tax climate (state collections per capita), physician density, and Medicare's Geographic Practice Cost Index (which adjusts physician reimbursement based on regional variation in the cost to treat patients).” They also measured the state’s residency retention rate, in partnership with Doximity, and malpractice premium averages, in partnership with the Cunningham Group. The five states that ranked the highest in 2016, based on this data, were Mississippi, Texas, Alaska, California, and Arkansas, in that order. Mississippi is ranked highest because it “finished in the top 10 of all six metrics five times,” the highest number of all the states. Katherine Patterson, MD, of the Indianola Family Medical Group in Indianola, Mississippi, says that “the state’s actions toward tort reform, and helping underserved communities” are just two of the many reasons she has chosen to practice in the state. Carlos Cardenas, MD, on the other hand, says that “Texas is a top place to practice medicine because of its pro-business attitude” and “credits the TMA for helping reduce regulations that make it friendlier for physicians to open up a practice in the state.” Alaska finished in the top five in 2016 for the first time since Physicians Practice began ranking the states, “thanks to its favorable Medicare Geographic Practice Cost Index, its low tax collection and the third highest residency retention rate in the U.S.” Primary care physicians tend to stay and practice in Alaska after completing the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) project at the University of Washington. Independent physicians can determine which is the best state for their practice based on how they weigh the factors that went into the Best States to Practice project. There is also an interactive map that provides additional details on each state’s data.

Greg Miller
December 8, 2017

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What is same-day scheduling?

In an ideal world, patients schedule appointments ahead of time, all the time, so independent physicians know exactly how their day is going to proceed, every day. In reality, things happen. Patients cancel or don’t show up. Patients wake up feeling ill and need to be seen right away. The independent physician’s day may or may not go as planned. Blocking out available time for same-day scheduling can help the practice manage the unexpected, to some extent. When an independent practice allots certain times throughout the day for same-day scheduling, it helps both the patient and the practice. Patients know they can call if they wake up feeling ill, for example, and schedule an appointment to see their provider that same day instead of having to wait until an appointment is available. There is a fine balance, however, between leaving open slots for those same-day appointments and scheduling efficiently. Patients do not appreciate long wait times, either in the office on the day of the visit or when scheduling the appointment itself. Leaving a slot or two open in the schedule to accommodate those patients who need an appointment on the same day may actually help the flow of already booked appointments. The independent practice can also fill no-show appointments with same-day appointments. No-shows are expensive for a provider, costing group practices more than $100 billion each year. No-show rates for primary care can be as high as 18%, particularly if the practice sees patients with chronic conditions or with Medicaid insurance. Allowing patients to schedule same-day appointments can help fill those openings and help the practice recoup some of its lost revenue. A same-day appointment can also provide the patient with more consistent care at a lower cost. Those patients who are not able to schedule an appointment for an illness or injury on the same day that they feel the need to see their independent physician may resort to visiting an emergency room, urgent care, or walk-in clinic. Enabling those patients who need more immediate care to schedule same-day appointments benefits both patient and independent physician in these cases.

Parker Nieves
December 6, 2017

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What does it take to be a successful independent physician in 2018?

As 2017 draws to a close, there is still time for the independent physician to assess practice management strategies and to end the year on a successful note. There have been many changes throughout the year that have affected independent physicians treating Medicare patients as well as those patients with private insurance. There have also been changes in the way patients view their healthcare options. A few steps toward adjusting to those changes will help the independent physician be more successful: Adapting to the Medicare reimbursement shift from “volume to value.” The Centers for Medicare & Medicaid Services (CMS) instituted Medicare Access and CHIP Reauthorization Act (MACRA), which gives the independent physician a choice of payment models -- the Merit-based Incentive Payment System (MIPS) or an Alternative Payment Model (APM) – both of which are based on healthcare value. Financial incentives are involved, particularly with the APM path, that can help the independent physician remain solvent. Adding “new capabilities for population health and care management.” Also part of the shift to value-based care, the independent physician who aligns with the need to improve healthcare outcomes for patients in a more efficient manner will have the tools to succeed in 2018. Reassessing the “patient experience from the patients' perspective.” Patients are becoming less tolerant of long waits, minimal communication with the physician during the visit, and confusing bills. They are increasingly “comparison shopping” to find independent physicians with convenient office hours, multiple communication channels, and the newest technology. In 2018 and beyond, the successful independent physician will give patients what they want and need in value-based care, convenience, and access. Electronic health records (EHRs) play a key part in being able to provide patients with communication tools and access to their own medical information, encouraging those patients to take an active part in their healthcare decisions. All of these strategies will contribute to higher quality care and to improved outcomes for the independent physician and the patient.

Roy Steiner
December 1, 2017

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The role of EHR vendors during the transition to value based care

The transition away from fee-for-service and to value-based care holds promise for improving the level of healthcare quality provided to patients, but it also encompasses a number of challenges for independent physicians. The shifting healthcare environment has presented providers with changes involved in the Affordable Care Act (ACA), its potential replacements, and now the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the requirements around Merit-based Incentive Payments (MIPS). When the independent physician takes advantage of the tools available in an electronic health record (EHR) solution, however, the transition to value-based care is made a little less painful. The choice of an EHR system can make a huge difference in the provider’s journey toward complying with regulations and providing quality care to patients. The EHR vendor should be capable of guiding the independent physician not only through the software setup and usage but, as emphasized in a recent article in Becker’s ASC Review, the vendor also “needs to provide regulatory advice, guidance and training in support of the practice’s success. This is a cost-effective alternative to hiring an outside consultant service and/or relying on internal personnel." Elation Health’s Clinical First EHR gives independent physicians the freedom to focus on their patients by assuming the burden of their practice’s technology needs, helping them stay up-to-date with the latest policy requirements, and supporting their overall business viability. In fact, in March of 2017, Elation’s Clinical First EHR was recognized as a top-three, Best in KLAS EHR in the Small Practices category. Specifically, the Best in KLAS summary states: “Elation delivers a stunningly easy-to-use EMR backed by the guidance and assistance providers need to navigate changing regulations that can sometimes be overwhelming for the smallest practices.” Every year, the health IT industry looks to KLAS, a leading health IT research firm, to recognize the EHR systems that are performing best in serving the needs of their customers. Elation is dedicated to aiding small practices to succeed, strengthening the patient-physician relationship and enabling phenomenal care.

Greg Miller
November 28, 2017

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New survey sheds light on EHR perspectives from patients and medical professionals

Electronic health records (EHRs) are helpful to medical professionals and their patients, although patients would appreciate a little more instruction as to how to access and review their own records. These revelations came about from a survey conducted by SelectHub, which polled more than 1,000 patients and 100 medical professionals about their use of EHRs. Of those surveyed, 86 percent of medical professionals felt an EHR system made their job of caring for patients easier. Among the professionals participating in the survey, 80 percent said that having access to EHRs made it easier to identify potential issues or errors in their patients’ medical records, a significant step toward improving the quality of the healthcare they provide. When asked about collaboration with other medical providers, 85% said that EHRs made it easier to share patient data with other healthcare providers. As to their work as a medical professional in general, 81% said that EHRs made an average workday easier. Patients also recognized the importance of EHR technology to the quality of the healthcare they receive from their providers, with 76% of those surveyed saying that their doctor’s use of EHR has a positive effect on the care they receive. As to their own EHR, 64% of those patients surveyed said it very or moderately important to have that access. However only 58% of the patients said that their providers adequately explained how to access their EHR. Chris Lewis, a creative partner of SelectHub, explained further that “those who received thorough instructions on EHR use and access reported accessing their records more than twice as frequently, suggesting a potential need for more information resources for patients.” Patients and providers participating in the survey viewed EHRs in a positive sentiment for the most part, with 80% of patients and 87% of medical professionals having a positive or very positive sentiment.

Parker Nieves
November 20, 2017

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Using EHRs to improve population health management

Reviewing the data on a group of diabetic patients to assess how quickly they have been able to stabilize their sugar levels since being treated by the independent physician, to determine an optimal plan for that patient population going forward, is one way the information in an electronic health record (EHR) can improve population health management. Douglas B. Fridsma, MD, PhD, FACP, FACMI, president and CEO of the American Medical Informatics Association (AMIA), a professional association dedicated to the development and application of biomedical and health informatics, notes that “Increasingly, as we get more and more information that’s available in electronic health records, that [EHR] becomes a source of how to best take care of the patients in your practice.” Effective population health management, of course, begins with the input of appropriate patient data during the patient visit. Patients that are seen by multiple providers will also have medical records from other physicians, labs, and healthcare facilities that will need to be coordinated within the EHR system, so the primary care physician can have access to the full medical profiles of all the practice’s patients. Furthermore, the office of Health Information Technology (IT) states that “by efficiently collecting data in a form that can be shared across multiple health care organizations and leveraged for quality improvement and prevention activities, EHRs can: Improve public health reporting and surveillance. Better the practice’s ability to prevent disease. Expand communication between health care providers and public health officials. By using the data from specific populations served by the independent physician’s practice, a more meaningful plan for preventative care, including immunization schedules, as well as more appropriate and relevant diagnostic and treatment plans, can be implemented. Elation Health’s EHR solution enables providers to easily find information that supports their decisions with a comprehensive search that will trend relevant data like a patient’s vitals or cholesterol levels, anytime the physician needs it.

Tyler Comstock
November 14, 2017

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How to keep your independent practice sustainable

As an independent physician, you face a lot of challenges. However, the rewards that can come from being independent, rather than joining a hospital group or becoming employed by another healthcare provider, can be tremendous. Those rewards are undoubtedly why you chose to become – and remain – independent. How can you keep your independent practice sustainable, so that you and your patients can continue to enjoy those benefits? Effective practice management is one of the keys to the success of an independent practice. Marni Jameson, Executive Director, Association of Independent Doctors has shared some insights culled from independent physicians’ best practices, in the Medical Group Management Association (MGMA)’s MGMA Plus. The list includes: Keep your community presence strong. Positive exposure in the community helps promote your image as an independent physician while marketing your practice to potential new clients. You can volunteer, sponsor a local team or event, offer to speak to area groups, and get involved in other ways that demonstrate your commitment to your community and to your profession. Use your current connections as a referral base. Word of mouth is hands-down the most effective way to promote your practice. Network with specialty physicians, laboratory reps, and business people in your community to keep your independent practice top-of-mind. Search out practical alternatives to hospital services. You may be able to offer some of those services in your practice, to boost your revenue and better serve your patients. Educate patients and potential patients on the benefits of an independent practice. As an independent physician, you are not tied to higher hospital fees. That fact alone could bring in more patients and increase your revenue. Make referrals easy. Using an electronic health record (EHR) solution increases your ability to immediately access and communicate with other physicians and with your patients. A more efficient and effective referral process has significant potential for increasing your referral rate. Stay positive. As Jameson found, “practice administrators agree, believing you will survive is half the battle.”

Nick Dealtry
November 10, 2017

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5 tips for a successful EHR migration

You’ve determined that an electronic health record (EHR) system is the solution you need to move your independent practice forward. Now what? Of course, it’s time to migrate all of your data to your new system! You may be migrating from another electronic platform or from paper records. Either way, the task seems daunting. It can be done, smoothly and successfully. There are a few steps to take to ensure that your EHR migration is seamless and results in an efficient new system for your practice. Define your parameters. Determine how much data you need to migrate to your new EHR. Parameters may include a timeframe of how far back in your practice’s history you want to go. For current, regular patients, you may want to include their entire patient profile, while you may not need to include lengthy historical data for patients that you have not seen for a number of years. Set a goal for a firm “go live” date. The migration process can become more frustrating if deadlines for implementation are missed because of busy staff schedules or other factors. Work with your vendor to determine a feasible date and then ensure that your staff is onboard with working toward that firm goal. Develop your workflow process. EHR Intelligence recommends developing a workflow for the input of data in the migration and on a regular basis once the EHR is up and running. Check for accuracy and test. During the migration process, particularly if you are uploading information from paper files, you’ll want to be sure all of the information is accurate. Otherwise, your staff will be wasting time making corrections and that becomes frustrating for everyone, including patients. Elation Health will work with you to make sure that your information is uploaded correctly and you’re never without your records. Train your staff as you work through the migration process. Training staff is a vital part of the process. You will need someone designated as a point person who is “technically savvy and trained to a high degree of proficiency with your new software.”

Tyler Comstock
November 10, 2017

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The importance of having an EPCS certified EHR

The ability to actually control drugs that are known as “controlled substances” is becoming more important and more urgent. According to the National Institute on Drug Abuse, “more than 64,000 Americans died from drug overdoses in 2016, including illicit drugs and prescription opioids.” Independent physicians who use electronic health records (EHRs) can take an active part in controlling these substances by ensuring they have an EHR certified for EPCS. Electronic Prescribing for Controlled Substances (EPCS) enables independent physicians to create e-prescriptions that can be received and acted upon by pharmacies. EPCS, a regulation that became effective in June 2010, gives physicians “the ability to use modern technology for controlled substance prescriptions while maintaining the closed system of controls on controlled substances.” An EHR certified for EPCS will add to the security level of prescription drugs. Paper prescriptions can be stolen or misused. EHRs transmit information electronically, so that only a verified recipient, in this case the pharmacist, can access the information. EHRs certified for EPCS use a two-step authentication process to ensure that those using the system have the authority and the appropriate need to do so. The opioid crisis has grown to the point of being officially declared a national emergency in the US. EPCS was introduced as a way to address these high rates of drug abuse across the country. By making prescriptions harder to forge or steal, it reduces the ease with which teens and other citizens can access prescription drugs. More and more EHR systems are becoming certified for EPCS in an effort to help combat the opioid crisis and to stem the growing numbers of deaths occurring because of prescription abuse. Elation Health provides EPCS for a number of customers, including those in New York, which has added a second level of authentication to tighten up regulations even further. An EHR certified for EPCS makes prescriptions safer throughout the process. Independent physicians who take advantage of this technology can take an active part in the movement toward solving the opioid crisis in America.

Tyler Comstock
November 6, 2017

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What is the relationship between EHRs and care coordination?

The primary care provider is usually not the only provider to see a patient. If the patient has a chronic or complex condition, especially, the primary care physician will coordinate with specialty providers, laboratories, healthcare facilities, and others, to ensure the patient is receiving comprehensive, appropriate, and quality care. With the implementation of electronic health records (EHRs), independent physicians are now able to take advantage of the use of EHR for coordinated care. Coordination used to involve a lot of paperwork and waiting. Referral sheets were faxed back and forth between providers’ offices. In the meantime, duplication or omission of certain tests or medical data had serious potential to cause errors in the patient’s care. Using EHR for coordinated care is an efficient method to streamline the process and to ensure the patient is receiving appropriate and timely care. The Office of Health Information Technology (IT), in partnership with the National Learning Consortium, lists a number of areas which “leveraging an EHR across the continuum of care allows for,” including: Better integration among providers by improved information sharing, Viewable and up-to-date medication and allergy lists, Order entry at point of care or off-site, Standardization of data, order sets, and care plans helping to implement common treatment of patients using evidence-based medicine, Access to experts for rural health care providers by sharing best practices and allowing for specialized care through telemedicine, Population management trended data and treatment and outcome studies, More convenient, faster, and simpler disease management. Elation Health offers independent physicians the ability to seamlessly access patient information before, during, and after the visit. Data input by specialty providers and labs is available with the touch of a button rather than through a series of phone calls and traditional faxes. Using EHR for care coordination ensures the patient’s medical information is accurate and current, and provides for higher quality outcomes.

Roy Steiner
November 2, 2017

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How to make the most of your Clinical EHR to combat burnout

Physicians are suffering from burnout in increasing rates. Among the factors contributing to their burnout is a feeling that they lack control over their work, increased pressure to provide higher quality care for less cost, inefficiencies in providing that care, and the need to balance patient care with increased federal and state regulations. According to a report in Mayo Clinic Proceedings, there has been “a significant uptick in physicians reporting at least one sign of burnout over the past several years — from 45 percent in 2011 to 54 percent in 2014.” Another factor in the increase in physician burnout is EHR technology, “despite the benefits of these forms of health IT.” Many physicians understand the benefits of using an EHR system, but have found their EHR systems do not communicate well with each other or are inefficient to use. How can independent physicians leverage a more user-friendly system to reduce burnout? One solution is Elation’s Clinical EHR for independent physicians. While many physicians have complained that using an EHR system actually takes more time out of their busy schedules to manage, Elation is dedicated to producing a provider-centric Clinical EHR solution, focused on enhancing the provider-patient relationship and on the quality of care the independent physician is able to provide that patient. Additionally, the American Medical Association (AMA) has recognized the pressures that befall many physicians. The AMA is working with federal officials as well as EHR vendors to help make sure physicians’ concerns are heard, in regard to future EHR design and use. Elation’s Clinical EHR for independent physicians is designed based on our philosophy of bridging the chasm that results in poorly-conceived IT systems that simply add to the physician’s burdens. We believe EHR systems should be designed to talk to each other, to be used efficiently, and to eventually transform the delivery of healthcare itself. Contact us to learn about our Clinical EHR for independent physicians and to learn how we can help you combat burnout.

Nick Dealtry
November 1, 2017

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What is the impact of EHR vendor readiness?

As healthcare rules and regulations change, so must the independent physician’s practice management. To ensure the independent physician is ready to meet these changing requirements, the information technology that supports that practice must also be ready. When an independent physician uses electronic health records (EHRs), the EHR vendor is expected to be prepared for changes in billing and reimbursement. When the vendor is not ready, it can significantly impact the physician’s practice. The Centers for Medicare & Medicaid Services (CMS) introduced a new payment model last year, Comprehensive Primary Care Plus (CPC+) that “will pay providers a monthly fee for patient care-management services.” Participants in the CPC+ model are required to meet IT requirements “that help them develop patient care plans, including being able to systematically assess patients' psychosocial needs, document and track patient-reported outcomes, and identify and flag patients with complex medical issues.” When the EHR vendor is not able to keep up with changes such as these instituted in the CPC+ model, the independent physician faces a number of challenges in not being prepared to meet the demands of participating in the program. Another similar challenge that independent physicians face is their ability to participate in the Medicare Access and CHIP Reauthorization Act (MACRA) when their EHR vendor is not prepared to implement the changes. Many EHR vendors are generally capable of adjusting to new payment standards; however, “unexpected and sudden CMS rulemakings can introduce many new requirements at once without giving them enough time to implement the changes.” EHR technology is complex and many CMS deadlines for implementing new payment rules can be tight, causing challenges for the EHR vendor as well as for the independent physician. Elation Health is dedicated to working with independent physicians to ensure they have what they need to provide quality care and to receive prompt and appropriate reimbursement. We continually develop intuitive tools that enable providers to be more productive and deliver better care — we focus on them, so they can focus on their patients.

Tyler Comstock
October 30, 2017

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What makes for a winning Independent Practice Association (IPA)?

Independent physicians searching for options that can help relieve their administrative burdens, provide more opportunities for contract negotiations, yet still ensure that they retain their independence may consider forming or joining an independent physician association (IPA). The IPA is a separate business entity that gives its members some of the benefits of a larger organization while they maintain their independent status. A winning IPA has many facets. As Medical Economics points out, an IPA that is “structured as a risk-bearing entity can be especially useful to physicians who may want to participate in risk contracts but don’t have the time or administrative support to hammer out the many details required for such arrangements.” Independent physicians benefit from being part of an IPA that takes on such risk-bearing activities while still allowing the physicians to manage their own practices. The IPA is the legal entity that can negotiate contracts as well as “participate in quality programs that reward improved outcomes that are often not otherwise available to the independent or solo practitioner.” An IPA that is properly structured and managed, often by a separate CEO, encourages communication and coordination among its members. Resource sharing is a major aspect of a winning IPA, which can also “serve as the information technology platform for all automation, often offering the capability of connecting disparate EHR technology.” Successful IPAs, much like any other business entities, are those that control their growth and employ sound management practices. An IPA is a legal structure and participating independent physicians should ensure that they are following all appropriate regulations for their participation as well as for the IPA as a whole. Professional legal counsel is encouraged. A winning IPA provides the benefits that independent physicians need to retain their individual practices, focus on their patients’ healthcare outcomes, and move their practices forward in regard to successful negotiations and administrative functions.

Roy Steiner
October 26, 2017

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How EHRs are driving innovation and creativity in healthcare

Not too long ago, the independent physician would need to complete a file full of paperwork on a patient, reviewing the information prior to a patient visit and potentially waiting for faxes of additional paperwork from specialty providers after the visit. Time was wasted on excessive paper documentation and delays in receiving information from other providers increased the potential for errors and duplication. And then along came the electronic health record (EHR). EHRs enable the physician to easily input patient data and to have immediate access to other providers’ data on that patient. In addition, the EHR, often referred to as an EMR or electronic medical record, improves “patient safety by requiring computer-based physician orders that eliminate illegible handwriting and misinterpreted verbal orders,” according to the Harvard Business Review (HBR). Diagnoses are more accurate, particularly for patients with chronic or complex conditions who require coordinated treatment by multiple physicians. The EHR enables those physicians to collaborate to ensure that duplications or errors are reduced and even eliminated when prescribing medications, ordering lab tests, and developing a detailed healthcare plan. The HBR reports that “there is no question that patients and purchasers can receive benefits in terms of improving safety, ensuring necessary care, and avoiding unnecessary care.” Implementing and optimizing the EHR has been a challenge for some independent physicians, but the results enable providers to use the technology as an innovative tool in their healthcare delivery. HBR cites many of these innovations as “1) detailed prompts and reminders to avoid omissions in care, 2) transparency to engage patients and families in spotting lapses in care, and 3) adding medical intelligence to computer programs.” Elation Health is pleased to offer the latest EHR technology, enabling innovation and creativity in independent physicians’ practices that result in improved healthcare outcomes for both physician and patient.

Nick Dealtry
October 25, 2017

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Survey shows most EHR patients report the technology improves care quality

Independent physicians recognize the benefits of technology in their practice, particularly of using electronic health records (EHRs) to manage their patients’ healthcare information. What do patients think of this new technology? A recent survey conducted for the Physicians Foundation asked 1,747 patients that very question. Participants in the survey were patients who were “between the ages of 27 and 75 and have seen the same doctor at least twice in the past 12 months.” When asked how satisfied they were overall with their primary care physician, 64% of those surveyed said they were “very satisfied” and 31% indicated they were “somewhat satisfied.” Regarding their physician’s use of electronic records and other technology, 77% of the patients surveyed indicated they did have access to their own EHR. That number has increased from 66% in 2016. When asked if they thought the EHRs would improve the quality of healthcare overall, 74% said yes, an increase from 67% in 2016. Patients were then asked if they felt their physician’s use of EHRs would improve the quality of their own healthcare, and 73% said yes. That number was also an increase, from 65% in 2016. Survey participants were also asked if they agreed with the statement: “Technological advances in healthcare will greatly improve the quality of care patients receive.” 85% of the respondents indicated that they either strongly agreed or somewhat agreed with that statement. Many participants also responded that they would like for their primary care physician to listen to them more and spend less time focused on their computer screen during a patient visit. Elation’s EHR solution enables independent physicians to do just that, to spend more time with patients and less time on paperwork or even screen time during the visit. Patients want higher quality healthcare and a more effective relationship with their primary care physician. Elation Health helps make that happen, improving outcomes for patient and physician.

Parker Nieves
October 24, 2017

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Tips for keeping your patients happy at independent practices

As an independent physician, your focus is on providing the quality care your patients need to stay healthy. You also want to keep your patients happy, for their own well-being as well as for the success of your practice. Once patients find a provider that they are comfortable with, they tend to stay with that provider, at least for awhile. Studies have found that “49% of patients stay with their doctor for five years or more,” especially when they have that comfort level. Some tips to help you in your efforts to keep your patients happy include: Communicate: Patients want to have their questions answered, not only during the visit but also afterward. When they have the option to ask questions and to receive additional explanations via an electronic communication tool, they tend to be happier with their provider. Train office staff on customer service skills: Patients who are greeted and welcomed appropriately tend to feel more comfortable with the practice in general. Particularly when the patient has billing questions or needs to schedule additional appointments, a well-trained office staff can make a huge difference. Create and maintain a helpful website: Patients and potential patients often refer to a practice’s website for information regarding the practice staff, operating hours, qualifications, and other relevant data. Making the information accessible and relevant will keep patients happy. Optimize the use of electronic health records (EHRs): An EHR system that provides patient with a portal through which they can access their visit summaries, medications, reports, and more online can help make patients happy with the provider and with the practice. The portal gives patients access to their critical health information – allergies, problems, history, current medications, immunizations, legal and specialists, for sharing with other clinicians who would find it helpful to facilitate care. Focus on the details: As an independent physician focused on providing value-based care, you and your staff can offer patients the highest quality experience, starting with a clean, orderly, and inviting practice office, continuing through to follow-up communication and detailed attention to your patients’ well-being.

Tyler Comstock
October 20, 2017

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The importance of optimizing and enhancing workflows at an independent practice

Independent physicians are concerned primarily, of course, with their patients’ health. They must also be concerned with the health of their practices, as they strive to manage them efficiently. Optimizing and enhancing workflows can help with both goals. A practice that takes advantage of electronic health records (EHRs) has the advantage in using the technology’s workflow process to manage both practice and patient health. The first step in the workflow optimization process is to do a workflow analysis, initially on implementation, and on an ongoing basis. Work with staff to determine their experiences and needs. Review the EHR system to ensure it is providing what the practice needs. Find the inefficiencies in the workflow, as well as potential new opportunities with upgrades or improved EHR functionality. What can an optimized workflow do for an independent practice? EHR Intelligence suggests a number of benefits, including: Improved care coordination: Using an established workflow process, care coordination becomes more efficient and more effective for the independent physician. As EHR Intelligence points out, “EHRs enhance care coordination by automating the communication process.” Streamlined clinical documentation: Optimizing the workflow through EHR enables the independent physician to enhance the quality of care provided to the patient as well as the efficiency of the practice itself. Elation’s Cockpit View surfaces everything the independent physician needs in a unique three-pane console, providing more flexibility. Having immediate access to the patient’s information significantly reduces the amount of time the physician spends looking up records and can increase the amount of time actually spent with the patient. Improved practice efficiency: Understanding how the technology works, gathering feedback from and training staff, as well as reviewing the workflow technology on a regular basis can improve the efficiency of the practice as well. Optimization “is an integral part of leveraging the technology to improve clinical workflow.”

Nick Dealtry
October 17, 2017

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How to prepare staff at your independent practice for value-based care

The shift away from the traditional fee-for-service model and to value-based care entails a number of regulations, deadlines, and reporting requirements. Independent physicians and their staff should prepare now for upcoming participation in the Quality Payment Program (QPP) to be sure there are no “surprises” as the dates for the new requirements approach. As an independent physician, the best first step to start preparing your staff is to do the research and understand the requirements of the Medicare Access and CHIP Reauthorization Act (MACRA) and QPP. There are options for participation and you and your staff will need to be well-versed in the pros and cons of each before beginning. The MACRA Quality Payment Program (QPP) offers two tracks for independent physicians: Advanced Alternative Payment Models (APMs) or The Merit-based Incentive Payment System (MIPS) It might help to assign one staff member to conduct the research, review all the relevant materials, and work with you to determine which path is right for your practice. A number of resources are available to guide you through the seemingly complex administrative responsibilities involved in value-based care. The American Medical Association (AMA) STEPS Forward is one valuable resource that provides information about value-based care and guidance on how to prepare your practice. AMA recommends discussing the upcoming changes and identifying: Staff who will support the new model Roles and responsibilities of each physician and their support team Frequency of patient contact (via phone call, email or portal messaging) Frequency of patient visits to the practice Once you have the information you need to move forward, be sure to share it with staff members and train them on the new requirements, particularly the billing and reporting regulations. An informed staff is a prepared staff! Of course, Elation Health also serves as a valuable resource to you and your staff as you transition to value-based care. We are here to support independent physicians, to help you provide quality care for your patients and grow a successful practice.

Dante Capozzola
October 9, 2017

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What independent physicians need to know about the doctor-patient relationship

A positive, professional relationship with their independent physician is important to patients. In healthcare, that comfort level of being able to trust and confide in their physician is crucial to patients who want to know their physician truly cares about their healthcare outcomes. Patients want to be able to communicate freely with their independent physician and know they will receive clear, thoughtful answers and directions. What about the physician side of that relationship? What do independent physicians need to know? Of course, ethics play a significant part in developing and maintaining professional relationships with patients. The physician must ensure that all communication with and about patients is safe and secure, according to HIPAA guidelines and regulations. Knowing that medical data is secure will add to the patient’s comfort level and increase their confidence in the relationship. The American Academy of Family Physicians (AAFP) offers some very helpful Tips on Building Doctor/Patient Relations, written for the medical resident but that have application for the practicing independent physician as well. AAFP’s tips include: Show empathy to patients. A trusting relationship for the patient is built upon knowing that the independent physician understands and takes into consideration the challenges, emotions, and concerns the patient might have. Minimize distractions and interruptions during a patient visit. Focus on the patient rather than searching for paperwork or responding to calls or messages that may pop up. Patients appreciate the individual attention, particularly as the visit may be stressful for them. Understand the patient’s lifestyle issues. Asking the patients questions - and truly listening to the answers - will give the independent physician insight into the patient as a whole. Understanding other factors that may impact the patient’s health will help in the development of a beneficial relationship.

Dante Capozzola
October 3, 2017

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How are IPAs revolutionizing the healthcare landscape?

Independent physicians associations (IPAs) enable providers to remain independent in their practices while enjoying the benefits of being a part of a larger business entity. Many independent physicians feel overwhelmed by the burden of administrative duties, particularly in regard to healthcare reporting requirements, as well as the need for more influential bargaining power for contracts. An IPA, operating as a separate entity comprised of multiple independent physicians, may be the answer for those physicians and could actually be revolutionizing the healthcare landscape itself. A recent article in Innovaccer pointed out that IPAs have “emerged as coordinated care systems that were slightly larger in scale than small/solo practices, but they have gone beyond being a contracting entity and have come on the frontlines as supportive organizations that bring the required infrastructure to small practices so they can be a part of the changing landscape.” Coordinating care to improve healthcare outcomes is the primary focus of the IPA and of each of the participating independent physicians. Reducing the burdens of individual practice management and increasing the leverage of the independent physician can be significant contributors to improving the healthcare landscape for providers and patients. The Innovaccer article cited a study that was conducted of over 1,164 practices that consisted of 20 or fewer physicians. The study found that “physicians participating in IPAs provided about three times as many care management services for their patients with more than one chronic conditions as compared to non-participating practices: 10.45% over 3.85%.” IPAs can also benefit independent physicians by playing a key role in the implementation and optimization of healthcare technology, such as electronic health records, particularly in regard to interoperability factors. Innovaccer cites the fact that many IPAs have “started deploying healthcare IT to improve their performance, facilitate authorizations, network referrals, utilization management, and care management.”

Dante Capozzola
October 2, 2017

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The EHR switching process

Transitioning from one electronic health record (EHR) system to another can be intimidating. Independent physicians considering a switch may be fearful of the cost and the potential disruption to their practice. However, the EHR switching process can be made smoother and less time consuming. Why would an independent physician need to switch EHRs? The Office of the National Coordinator (ONC) for Health Information Technology (IT) has identified several factors that might lead to that decision. The current EHR contract may have ended, for example. The practice may also consider switching when the current EHR system does not: Enable the independent physician to comply with new regulations, quality reporting initiatives, or payment models Provide an adequate level of support services Provide updates and security features that impact the practice and its patients. Elation works with independent physicians to provide a smooth transition from another EHR system to ours. We can import all of the data from the old EHR, no matter the brand, with exceptional results. Unlike most vendors, we can integrate full patient charts, including old notes, into the practice’s new Elation experience. We have experience with many vendors and can work with whatever system the independent physician may have. Data migration is a critical factor in the EHR switching process. At Elation, we provide implementation guidance and follow-up support to ensure the practice’s patient data is migrated smoothly and efficiently. Our system enables the independent physician to import patient demographics, download clinical data, and reconcile medications into a concise, organized list. We work with the independent physician to make sure that all of the information is uploaded correctly and that the practice is never without patient records. Our migration services are HIPAA-compliant, ensuring the security and integrity of the practice’s data remain intact. The EHR switching process does not have to be intimidating or time-consuming. At Elation, we understand the need for an efficient transition, to help the independent physician continue to provide quality healthcare services throughout the process.

Dante Capozzola
October 2, 2017

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Independent physician associations (IPAs) v. medical groups

Physicians communicate and collaborate with each other in a number of ways. In particular, independent physicians reach out to other independent physicians for support, networking, idea sharing, and other needs that come about as a result of being self-employed and responsible for their own practice management. There are a couple of options for independent physicians who may want to join forces in different aspects and on different levels. The independent physician association (IPA) is a separate business entity that is “organized and owned by a network of independent physician practices.” IPAs provide the benefits of a larger group, while allowing each of the independent physicians in the group to retain their independence. The IPA does not provide or control physicians’ compensation. Physicians often form an IPA to be able to negotiate contracts for their own services or to negotiate with suppliers such as radiology, laboratories, or hospitals. Being part of a larger group enables independent physicians to have more bargaining power. However, because the IPA is a business entity on its own, there are some legal ramifications that must be considered by independent physicians who participate. Medical groups, on the other hand, are practices consisting of multiple providers “characterized by sharing of patient care duties and physical space.” In the group setting, the independent physicians are part of a larger practice, which can benefit them by offering access to other physicians when they are faced with tough diagnoses or other challenges. In a group practice, each of the physicians’ compensation is based on “a method that includes a salary and some type of productivity bonus or incentive” and comes from the managing practice. Potential benefits for the independent physician who chooses to participate in a group practice include the fact that it is “generally viewed as less volatile than solo practice and more likely to afford a controlled lifestyle.”

Dante Capozzola
October 2, 2017

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A brief primer on independent practice associations (IPAs)

Independent physicians who run their own practice have chosen to do so for a reason. They want to remain self-employed rather than report to a larger organization. They want to be able to provide individual, quality care to their patients. Independent physicians tend to be happier, earn more, and find more satisfaction in their work. However, those independent physicians often find they are on their own when it comes to practice management and navigating regulations and policies. An entity called an independent practice association (IPA) is designed to help independent physicians benefit from being part of a larger group while still retaining their independence. Essentially, an IPA has as its main purpose, “reducing overhead or pursuing business ventures such as contracts with employers, accountable care organizations (ACO) and/or managed care organizations (MCOs).” The IPA is considered to be a business entity, separate from each of the members’ practices, that is owned by the participating independent physicians. Joining together as part of a larger group enables independent physicians to combine resources. For example, overseeing and managing issues such as security compliance for EHR for an independent physician association can be much more cost-effective and efficient as a group than as independent practices. Since becoming a part of an IPA does require signing legal documentation, the independent physician should seek legal counsel to review the specific requirements and ramifications. There may be other risks involved, including “underfunded capitation revenue, with risk of significant losses and/or bankruptcy” and “restrictions on collective bargaining by physicians from the Federal Trade Commission and Department of Justice.” The independent physician should weigh the benefits against the risks before deciding to become part of an IPA. For the physician searching for an opportunity to coordinate and collaborate with other independent physicians, the IPA may be the solution. The goal of all independent physicians involved in the IPA must be to optimize healthcare outcomes for their patients, in order for the IPA to be successful in its mission.

Dante Capozzola
September 25, 2017

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What independent physicians need to know about the doctor-patient relationship

A positive, professional relationship with their independent physician is important to patients. In healthcare, that comfort level of being able to trust and confide in their physician is crucial to patients who want to know their physician truly cares about their healthcare outcomes. Patients want to be able to communicate freely with their independent physician and know they will receive clear, thoughtful answers and directions. What about the physician side of that relationship? What do independent physicians need to know? Of course, ethics play a significant part in developing and maintaining professional relationships with patients. The physician must ensure that all communication with and about patients is safe and secure, according to HIPAA guidelines and regulations. Knowing that medical data is secure will add to the patient’s comfort level and increase their confidence in the relationship. The American Academy of Family Physicians (AAFP) offers some very helpful Tips on Building Doctor/Patient Relations, written for the medical resident but that have application for the practicing independent physician as well. AAFP’s tips include: Show empathy to patients. A trusting relationship with the patient is built upon knowing that the independent physician understands and takes into consideration the challenges, emotions, and concerns the patient might have. Minimize distractions and interruptions during a patient visit. Focus on the patient rather than searching for paperwork or responding to calls or messages that may pop up. Patients appreciate the individual attention, particularly as the visit may be stressful for them. Understand the patient’s lifestyle issues. Asking the patients questions - and truly listening to the answers - will give the independent physician insight into the patient as a whole. Understanding other factors that may impact the patient’s health will help in the development of a beneficial relationship.

Dante Capozzola
September 25, 2017

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Recommendations on how to be both a successful business person and physician

As an independent physician, you probably chose your career path because you want to take care of patients. You are focused on providing quality healthcare, on building relationships with your patients, and on making sure they enjoy positive outcomes. You may have chosen to work as an independent provider because you want the autonomy to run your own practice. With that autonomy, however, comes the responsibility to also act as a business person, to ensure the success of your practice. Practice management for an independent physician is often seen as simply another administrative burden. However, with the right strategies and tools, you can manage your practice like a successful business and still focus on providing the highest quality care to your patients. When you simply do not have the time, desire, or skills to do the things that need to be done on the business side of your independent practice, it’s always a good idea to bring in expert help. You might hire staff with the appropriate billing and bookkeeping skills, to keep your financial records healthy. You can also explore the idea of contracting with a professional to provide the accounting expertise your practice needs. Physicians and business people alike should realize that their time has value. Calculate how much time you are spending chasing down visit notes or diagnoses that other providers need to provide regarding your patients. An investment in technology, particularly in an electronic health record (EHR) solution can save you a significant amount of time, making your practice more efficient and enabling you to provide higher quality care to your patients. If you are just starting your independent practice, you will need to make some smart business decisions from the outset, to establish a solid business foundation. An understanding of the rules and regulations around billing and reimbursement, particularly in regard to Medicare and Medicaid, will become an invaluable asset. Again, though, the secret is not necessarily to know everything yourself but to make sure you have qualified staff on your team. Being a successful business person simply means finding the most effective, most efficient way to manage your practice. You do not have to neglect your patients to run your practice as a successful business.

Dante Capozzola
September 22, 2017

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How cloud-based EHR solutions help providers stay independent

Cloud-based EHRs have many advantages over server-based systems. An independent physician can benefit from the many features a cloud-based clinical EHR solution offers, to help maintain that independence. What are these advantages and how can they help independent physicians? With a cloud-based system, patient data is accessible anywhere you have an Internet connection. You do not have to have access to a hard drive on a specific computer and you do not have to be logged in on an office-based server. If you can get on the Internet, you can view and input patient information. More than just accessibility One of the most important advantages to a cloud-based EHR is that all patient information is more secure. The platform itself is vulnerable with a server-based system, as it is susceptible to downtime and hardware issues. As a physician concerned with HIPAA regulations, you can also be assured that your patients’ electronic protected health information (ePHI) is protected with cloud-based EHRs. Cloud-based systems can also be less expensive to implement and maintain. In addition, as the Office of the National Coordinator (ONC) for Health Information Technology (IT)’s points out in their Health IT Playbook, using a cloud-based system  “enables providers to start small and increase their IT allocations as required.” An independent physician can take advantage of this ability to add incrementally to stay on budget and remain independent. With a cloud-based EHR there are no upgrades necessary on your part. Cloud-based systems automatically update to stay current with latest technology. This frees up time and worry over ensuring that you have the most up-to-date version of the software. A provider-centric clinical EHR solution is designed to enhance the provider-patient relationship. As an independent physician who wants to ensure that you stay independent, that is a very important advantage. Cloud-based systems are cost-effective, efficient, and safe, allowing you to focus on patient care instead of paperwork. Check out the Elation difference in cloud-based clinical EHR solutions today!

Dante Capozzola
September 18, 2017

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Practice acquisitions slowdown

A number of factors have contributed to a recent slowdown in the number of practice acquisitions by larger hospital systems. New facility fees and new options for independent physicians who want to remain independent are slowing the acquisition trend seen in recent years. The Centers for Medicare & Medicaid Services (CMS) released a new fee schedule that became effective January 1, 2017, reducing the facility fee for outpatient services at a hospital. The fee had been an incentive of sorts for hospitals to acquire independent practices that would perform these outpatient services. The hospital could then bill for reimbursement for the facility fee in addition to the fee for services rendered by the independent physician. The new ruling reduced the facility fee by 50% for outpatient services not provided on a hospital’s main campus. Given these lowered fees, the idea of acquiring independent practices is no longer quite as attractive to the hospital. In addition, independent physicians who want to be acquired may find it more of a challenge to find a hospital that will take them on. Many independent physicians are choosing to remain independent and that is also slowing the acquisition rate. Another option for independent practices that has grown in popularity is the Independent Physician Association (IPA), which helps physicians to benefit from being part of a larger group, primarily for the purposes of contracting with third parties, for pursuing business ventures, and for reducing overhead costs, while retaining their independence. Elation Health is focused on helping these independent physicians with task such as practice management and patient communication, so they can concentrate more fully on what they do best, providing quality healthcare to their patients. At Elation, we understand the independent physicians’ needs, particularly the need to have the necessary tools that will help them run efficient practices so they can remain independent.

Dante Capozzola
September 18, 2017

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Going from a "solo" practice to a "small" practice

Many physicians at independent practices may consider bringing another physician on-board and expanding their practice. At some point, they may decide that they either need to or want to add to their solo practice, primarily because of increased patient load. What are some considerations they must make to transition from a solo practice to a small practice? The first decision is how to recruit and screen applicants. Outside assistance may be needed with this step. Independent primary care providers who are already strained by limited resources can take advantage of a recruiter’s services to find the perfect candidate. An effective recruiter will be able to “weed through the candidates” so the physician is only reviewing the top three or so. Although the recruiter will conduct the initial screening, it will be up to the independent primary care providers to determine who will be the best fit for the practice. Considerations may include appropriate training and education, the candidate’s familiarity with IT tools such as EHR systems as well as the candidate’s personality and communication skills. Once the candidate is identified and hired, a transition plan will need to be in place to bring the new physician on-board. The new physician may need to be trained on the electronic communication tools or billing system used by the practice. An announcement should be made to patients as well as other providers and healthcare facilities in the independent primary care providers’ network. Post the new physician’s bio on the practice website and send out notices via social media to announce the expansion. The new physician should also be trained on practice management, particularly in regard to the practice’s emphasis on tracking performance and quality measures. With the move toward value-based payments, this step will be particularly important for the success of the practice overall. Expanding from a solo practice to a small practice may seem challenging, but when independent primary care providers take into consideration the steps and the benefits involved, the transition should go smoothly.

Dante Capozzola
September 18, 2017

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5 patient engagement terms independent physicians need to know

Healthcare has its own set of buzzwords and phrases. Some are helpful to use in a hospital or emergency setting, where time is critical and long explanations only slow things down. The independent physician who sees patients every day, and who is now learning how to transition to value-based care, also uses a unique set of terms within the practice. Patient engagement itself is a phrase that has become more popular and more important in today’s healthcare environment. What does patient engagement mean? When the provider encourages patients to become more involved in their own healthcare plan and is open to communication with patients before, during, and after each visit, those patients become more engaged and outcomes are more successful. What are some other important terms, related to patient engagement, that the independent physician needs to know? PatientEngagementHIT.com has identified five terms that are important for the independent physician transitioning to value-based care. Chronic Disease Management. Patients with chronic conditions generally require more extensive care, including coordination with multiple providers, lab tests, and medications. Independent physicians using electronic health records (EHRs) can encourage patients to access their visit summaries and critical health information. Engaging patients in managing their medications, behaviors, and activities can prevent chronic conditions from becoming more serious. Patient Experience. The overall patient experience, including all of the interactions with the physician and staff during a visit, can be assessed to determine the quality of that care experience for the patient. The measure of patient experience “examines whether a provider did things that constitute a quality visit.” Patient-Reported Outcomes Measures (PROMS). Patients who have undergone a procedure can engage with the provider by reporting on the quality of their outcomes. With an understanding, related by the patient, of how the procedure impacted the patient’s well-being, the independent physician can better gauge the quality of the procedure itself. Risk Stratification. Identifying the risk levels of each patient can be used to “determine their care efforts, including patient engagement efforts.” Patients may be considered a higher risk because of a chronic condition or because of an unhealthy home environment. Social Determinants of Health. As Patient Engagement HIT reports, available research “suggests that 80 percent of patient health is influenced by the social determinants of health.” Social determinants include factors such as socioeconomic status, education, employment, and home environment. Independent physicians transitioning to value-based care can “leverage social determinant data to help care for patient social needs and ultimately drive better outcomes at a lower cost.”

Dante Capozzola
September 11, 2017

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What do independent physicians need to know about clinical decision support?

Simply stated, clinical decision support (CDS) is a process that enables independent physicians to have the information they need when they need it, with the goal of improving healthcare delivery. CDS helps the provider make decisions based on patient data that is appropriately filtered and immediately accessible. The office of Health Information Technology (IT) further explains that CDS is “a sophisticated health IT component” that typically operates on an electronic health record (EHR) system or other technology platform. CDS can help the independent physician by “enhancing health-related decisions and actions with pertinent, organized clinical knowledge and patient information.” Health IT has identified CDS interventions that enable the provider and the patient to enjoy these benefits by addressing the CDS Five Rights: the right information (evidence-based guidance, response to clinical need) to the right people (entire care team – including the patient) through the right channels (e.g., EHR, mobile device, patient portal) in the right formats (e.g., order sets, flow-sheets, dashboards, patient lists) at the right times (for key decision or action) Independent physicians who are burdened by paperwork, waiting on faxes or telephone calls from other providers, laboratories, or healthcare facilities, are not able to provide the highest quality healthcare their patients need. When they have immediate access to all of the appropriate data on their patients, including visit notes, medication records, and other providers’ notes, they are able to make more informed decisions about their patients’ healthcare plans. Health IT cites the specific benefits of CDS as being: Increased quality of care and enhanced health outcomes Avoidance of errors and adverse events Improved efficiency, cost-benefit, and provider and patient satisfaction CDS enables independent physicians to focus on the patient, to avoid duplication and potential error, and to have all of the right information at the right time, so they can make the right decisions.

Dante Capozzola
September 11, 2017

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Strategies for getting more patient referrals to your independent practice

Most people do not choose a primary care physician randomly. They do research and they ask other people for advice. When someone is looking for a new doctor, they will usually ask their trusted friends and family members for recommendations. The key word there is “trusted.” Word of mouth, or referral, marketing is the most effective way to grow an independent practice. It is also the least expensive as word of mouth costs you nothing but the effort to make your patients happy and healthy! There are a number of strategies that can help generate those treasured patient referrals. Make sure your patients’ experience is always customer-focused, from start to finish. Train your staff to welcome each patient with a smile and a pleasant greeting, whether in person or on the phone. Patients who are made to feel comfortable and appreciated will tell others about your practice. Communicate with your patients professionally and personally. When you are responsive to your patients’ questions and concerns, they will spread the word about how wonderful your practice is about responding to them quickly and efficiently. Be sure to answer questions promptly and in clear and concise language that ensures the patients understand the explanations and any further instructions you may provide. Testimonials are a “credible and human” way to generate referrals. Capture your patients’ comments on your website or use them in direct mail campaigns. Those testimonials can come from surveys you conduct of your patients or from spontaneous letters or emails they send to you. Ask your patients for permission to use their testimonial and be sure to thank them for their kind words. Maintain an accurate and current website that provides the information new patients will need to learn more about your practice when they are referred to you. Highlight those points that set you apart from other independent physicians, whether it might be extended hours or the use of technology in your practice. Your current patients will tell others about your practice. Be sure they are saying great things and, in doing so, are getting more referrals for you!

Dante Capozzola
September 7, 2017

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Tips for reducing medical billing errors

Patient billing is critical to the financial health of an independent physician practice. When billing errors are made, revenue can be lost and severe consequences can result. Errors in Medicare and Medicaid billing, for example, are not tolerated and can actually result in the practice not being allowed to bill those entities for several years if negligence is discovered in the billing process. Financial ramifications of medical billing errors can be substantial. Access Project, a Boston-based healthcare advocacy group has found that up to 80% of all medical bills have errors in them. In addition, Kaiser Health has reported that medical billing errors account for $68 billion in lost healthcare spending. How can independent physicians reduce their rate of medical billing errors? Fierce Healthcare offers several suggestions, specifically in regard to receiving proper reimbursement for claims: Ensure that patient data is correct. Verify that names, policy numbers, birthdates, and all pertinent information on the bill are accurate and current. Sometimes even the placement of a different middle name can cause a claim to be rejected. Use technology. Billing features in electronic health record (EHR) systems can help the independent physician automatically check for errors in billing before the bill goes out. Maintaining accurate patient data in the EHR can further prevent errors in patient information contained in claims. Data in the patient’s EHR only has to be entered once, so the potential for error is significantly reduced and virtually eliminated. Keep clinical staff informed. Healthcare is changing. Medicare and Medicaid regulations continue to change as well. Independent practices should “conduct regular training about coding and billing updates and other changes.” Stay aware of the trends that may be occurring. The independent physician should review billing errors on a regular basis, as often as weekly, to determine if there is a pattern. Those errors should be addressed with staff so they can be corrected and not repeated.

Dante Capozzola
September 7, 2017

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How does patient engagement work?

For the independent physician, engaging with patients is a very important element in their overall healthcare plan. Taking the time during the visit to listen to the patient and to explain diagnosis and treatment plans is crucial to the quality of that patient’s health outcomes. When patients are engaged and take an active role in their own healthcare, the likelihood of quality outcomes increases, a benefit for both the patient and the physician. After the visit, independent physicians must continue to engage with their patients. More importantly, the patients must be provided the opportunity to engage with their physicians. The Office of the National Coordinator (ONC) of Health Information Technology (IT) states that: The ability of individuals to easily and securely access and use their health information electronically serves as one of the cornerstones of nationwide efforts to increase patient and family engagement and advance person-centered health. Communication is essential to this process. Elation’s electronic health record (EHR) solution for independent physicians provides an effective tool for the independent physician to engage with patients before, during, and after the visit. How does it work? Providers send a letter through Elation to their patient’s Passport, just like an email. The patient gets notified, either by email or text, to check their Passport for the new message. From their Passport, patients can read provider’s letters, view any attached documents – like lab results – and if they have a question, simply reply to the letter right there in Passport. Any message from a patient is immediately sent back to the provider’s Passport queue in the Homepage – just like how providers receive messages from within their practice today. Independent physicians can get started using Elation Passport by inviting patients to sign up for Passport accounts from their charts. Click on the Passport Introduction Guide for more information on how to invite patients to use Elation Patient Passport and how to communicate with them once they have signed up.

Dante Capozzola
September 7, 2017

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Goal-setting for independent practices

Independent physicians who are busy with the day-to-day activities of seeing patients, managing the practice, and coordinating with other healthcare providers may not give much thought to goals for the practice. However, even though an independent practice is certainly not like most other businesses, it does need to determine and work toward those goals to ensure its future growth and success. An independent practice should set goals and determine strategies to reach those goals as part of an overall vision. This can be done in a strategic planning process for the organization as a whole. The first step in that process is to decide, as the independent physician, where the practice needs to or wants to be within certain timeframes. For example, goals can be set based on where the practice wants to be in the next year and then again in the next three to five years. As a recent article in Physicians Practice detailed, the longer term vision “might describe the practice broadly, in terms of its mix of programs, reputation or status inside and outside its primary target community, key accomplishments, and relationships with referring physicians.” Goals might include: Expansion of target geographic market Expansion of target patient makeup Growth of patient numbers Staff expansion plans Implementation of IT tools such as electronic health records (EHRs)  Expansion of provider referral group Improved communications with patients and other providers Other relevant measurements of growth and success for the practice These goals should be shared with the independent practice staff, to ensure all are aware of the vision and strategy for achieving the goals. Uniting the independent practice team to work towards specific goals will help the practice better visualize the possibilities - and then take the necessary steps to make those possibilities realities. The practice, the physician, the staff, and the patients will all benefit from the newly directed focus and strategy.

Dante Capozzola
August 31, 2017

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How to minimize patient no-shows at your independent practice

Patient no-shows create a number of problems for the practice and for other patients. When an appointment slot is reserved for a patient who does not keep that appointment, the practice loses the income from that patient’s visit. At the same time, other patients who may have been able to take that spot had been told it was not available so it usually remains empty. A study conducted by the Medical Group Management Association (MGMA) found that “even well run practices have a daily average of 12 percent no-shows and last-minute cancellations. Some practices actually experience a whopping 50 percent rate.” There are a number of strategies that may help independent physicians minimize their patient no-shows. Overbooking may help resolve the problem of that empty slot that results when a patient no-shows. To avoid creating other problems with overbooking, such as too full a schedule, the independent physician should study the trends in no-shows and appointment demand. Physicians Practice recommends alternating “new and established patient visits, with most of your double-booking being on the established patient front.” Instituting financial repercussions for patients who no-show may be necessary to help with the lost income from patients who fail to show up for their scheduled appointments, particularly if the same patients do so repeatedly. Requiring a deposit when making the appointment or establishing a fee for missed appointments may get the message across to those patients. The independent practice may also want to investigate the option of cloud-based appointment scheduling. Those patients searching for same-day appointments, in particular, will be able to fill those gaps left by no-shows when the appointment schedule is automatically updated and available electronically. Millennial-aged patients, especially, are more likely to want those available same-day appointments. In addition, Elation’s EHR solution offers independent physicians the ability to send their patients automated appointment reminders. These automatic notifications are sent to patients two calendar days prior to their appointments. Our innovative feature will help to free up time for your office staff while also reducing no-show appointments for your practice.

Dante Capozzola
August 29, 2017

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4 branding tips for independent practices

When we think of the term “brand,” we probably think more of the actual “brand name” of a product or company. For example, the brand name of a facial tissue is Kleenex, the brand name of a sports shoe is Reebok, and the brand name of a bottled water is Dasani. The “brand” of those products is actually less definitive. Brand is the image that the company tries to promote around the product, and, more importantly and more prominently, it is the customer’s perception of the product. What does all of this have to do with a medical practice? As an independent physician, why do you need to worry about your brand? The primary answer is because you want your patients and potential patients to perceive your practice a certain way, in the most positive light. You may want your practice to be known as one that uses technology, such as electronic health records (EHRs) to provide efficient, quality care for your patients. You may want your practice’s brand to be centered on your patient focus during each visit. Or, you may want to be known as an independent physician who is flexible with your hours, to accommodate busy patients. Your patients will develop their own sense of your brand based on your actions and on their experience. Physicians Practice has offered four tips to help with developing a brand for your independent practice: Prioritize consistency. Whatever you decide you want your practice to be known for, be sure that message comes across in the actions of your staff, in your communications with patients and other providers, and in your practice’s overall operations. Seek feedback. Ask patients for their opinions about your practice, so you can be sure your message is on point with how you want your brand to be perceived. Surveys are convenient and effective for gathering honest feedback. Don’t try to be and do everything. Even as a primary care physician, you can specialize in the sense of being known for certain things within your practice. Think about what you do best - your niche - and focus on that aspect of your practice. Make time to regroup and refresh. Assess your brand on a regular basis to determine if it is still the image you want to project to patients and potential patients. As your practice grows, your brand will need to grow with it.

Dante Capozzola
August 28, 2017

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What are the first steps toward transitioning to value-based care for independent physicians?

The move toward value-based care, and away from fee-for-service reimbursements, may be a change in thinking and approach for many independent physicians. It may also be a welcome change, as it encourages the provider to spend more time focused on the patient and on delivering quality outcomes, rather than counting the number of patient visits throughout each day. How does the independent physician prepare for this transition? The American Medical Association (AMA) STEPS Forward provides practice improvement strategies, including five steps for the independent physician who is preparing to transition to value-based care. Identify your patient population and opportunity The AMA says that “Knowing your patients is the foundation of value-based care.” When the independent physician sees patients with chronic or complex conditions, those patients will need coordinated care, which has a tendency to increase the cost of their healthcare services. Understanding the patient profile thoroughly will enable the physician to provide higher quality, more cost-effective care. Design the care model Once the patient population and payers are identified, health outcomes for those patients can also be identified. The independent physician can then “design the workflows required to provide the desired care to the selected patient population.” Partner for success Coordinating with other providers and healthcare facilities can enhance the provider’s ability to offer quality care on a number of levels. Resources can be combined, increasing the level of care and reducing redundancies. Drive appropriate utilization The independent physician should review the practice management strategies and determine ways to provide higher quality care at a lower cost to the practice and to the patient. Optimizing the use of tools such as electronic health records (EHRs) enable the physician to spend more quality time with each patient and less time on paperwork. Quantify impact and continuously improve As the independent physician transitions to value-based, the model should be reviewed and assessed for the impact it has in terms of reaching goals for the practice and for patient outcomes.

Dante Capozzola
August 25, 2017

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Should independent physicians extend their hours at their practices?

Given the looming physician shortage and the resulting increase in patient panels for each practice, many patients find themselves waiting for long periods of time to see the physician or unable to even get an appointment that fits their own schedule. Patients who are working may not be able to leave their jobs for a medical appointment or may prefer to not use sick leave for a routine exam. These patients would undoubtedly appreciate earlier or later practice hours. Independent physicians in very small practices can be stretched very thin already and may not be receptive to the idea of further extending practice hours. A number of practices with multiple physicians have found innovative ways to extend hours without overworking the physicians. These practices have arranged for one physician to open the practice as early as 7am and another physician within the practice to work later hours, keeping the practice open until 5:30pm or later. There are many advantages to extending the practice hours: Sending a clear message of compassion and concern for providing quality service to all patients, even those who cannot miss work or school for an appointment. Growing the patient base by offering extended hours that are attractive to a wider range of clients. Retaining patients who might otherwise have to find another practice with hours that better suit their schedules. Providing better care by seeing patients that are already comfortable with the physicians and the practice. Elation Health’s mission is to help independent physicians by strengthening the relationship between patients and physicians, and enabling phenomenal care for everyone. Our electronic health record (EHR) system streamlines the process of entering and maintaining patient medical information, enabling providers to be more efficient. When independent physicians have these tools at their fingertips, they can focus more on their patients throughout the day.

Dante Capozzola
August 25, 2017

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Strategies to improve care quality and access for independent practices

Understanding a patient’s complete medical profile, including social determinants, is a necessary step to truly treating the patient effectively. Chronically ill patients, in particular, need more attention and stress the healthcare system in the process. For independent practices, treating chronically ill patients can be especially taxing. Of course, independent physicians are focused on improving patient outcomes for all of their patients and so may benefit from a few strategies to improve that care quality. Care coordination is an essential strategy for independent practices. Collaborating with a patient’s specialty providers, labs, and healthcare facilities is crucial to the overall patient care plan. Chronically ill patients, especially, may see multiple providers and need to undergo a number of tests or procedures. Kim Ingram, writing in MedCitizens, states that “chronic illnesses now affect more than half of all Americans, and one in four has at least two chronic conditions.” Unless the independent physician is able to easily access information from these other providers, the patient picture is incomplete. That can lead to excessive, expensive, and sometimes unsafe gaps and repetition. Ingram adds that “it is critical that everyone on the healthcare continuum ... should be looking at new ways to promote more effective care coordination and collaboration programs.” In fact, The Centers for Medicare and Medicaid Services (CMS) lists as one of its Quality Strategy goals:  “Promote effective communication and coordination of care.” How can the independent physician move toward coordination and collaboration, to improve patient care quality? Communication - with patients and with other providers - will help ensure that the primary care physician understands the full medical profile. Patients are encouraged to ask questions, to provide input, and to become an active participant in their own care. Optimizing an EHR system for independent practices will also aid the independent physician in gaining easy access to patient data. When using an EHR, the physician need only review the information on the screen to see specific patient information, lab results, and notes from a previous visit. Seamless, cloud-based access to patient records and true collaboration are key strategies for independent practices to improve their patient care quality. It all starts with that very important communication, with the patient and with other providers, to gain a true comprehensive understanding of the patient’s medical profile.

Dante Capozzola
August 24, 2017

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The benefits of creating a budget for independent practices

Caring for patients is an obvious priority for independent physicians. Monitoring the practice’s financial situation should also be among the physician’s priorities, to ensure the practice will continue to be sound and stable as it grows. The financial aspect of a practice may be intimidating or of little interest to independent physicians who prefer to focus on the medicine rather than the balance sheet. However, the practice’s finances can be and should be easily monitored with the proper budget. For many independent physicians, the only numbers they want to read on a daily basis are those associated with blood pressure, heart rate, or test results, numbers that can lives. Budget numbers, when developed realistically and reviewed on a regular basis as part of a solid practice management strategy, may help save the practice. Medical Economics states that when “a budget is done correctly and regularly reviewed, it can offer many beneficial insights into the financial health—present and future—of a practice.” A monthly review of an independent practice’s budget can tell the physician whether money is being spent appropriately and whether new expenditures that may be under consideration make sense. A practice may be considering, for example, bringing a test in-house which would require a significant equipment purchase. Setting a budget for the year, or for several years, can help the independent physician determine whether sending patients to a lab is more or less cost-efficient than purchasing the equipment for in-house services. Creating and monitoring a budget can also help the independent physician who is considering the need to expand the need to expand staff or to market the practice. Understanding the costs involved and whether those expenses are sustainable, based on the budget, will enable the physician to plan the practice’s growth strategy more effectively.

Dante Capozzola
August 21, 2017

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Selecting a practice management system for your independent practice

When it comes to the administrative side of an independent practice, physicians and their staff need a reliable practice management system to ease the burdens of payments, billing, check-ins, patient appointment reminders, and other important tasks. Understanding what’s needed in such a system and then selecting the right system for the practice’s needs can be done by considering some important factors. A recent Physicians Practice article outlines the essential considerations an independent physician must review when selecting a practice management system. Those features include: Integration: The practice management system should be fully integrated with the practice’s electronic health record (EHR) system to streamline the workflow. Elation offers a practice management system that enables the independent practice to easily manage appointments, check-ins, and copays right from the Clinical EHR.  Simplicity, flexibility, and adaptability: It is important for the system to be easy to learn and easy to use, for it to be useful for the practice. Electronic transactions: The independent physician practice must be able to depend on the practice management system for transactions such as billing, prior approval, and other tasks that could become much more time-consuming without the electronic transaction ability. Reporting and inventory management: Understanding the practice’s financial situation at any given time is crucial to the success of an independent physician’s practice. A system that enables the practice to view and track outstanding accounts and other expenses, as well as available resources within the practice, can help the independent physician succeed in this area. Other costs involved: Some practice management systems require training and ongoing support for effective use by the independent practice. Elation Health works with our clients to provide the training they need to ensure they are able to navigate the system efficiently and effectively. With Elation’s practice management system, physicians and their clinical staff are able to automatically send electronic appointment reminders, print appointment reviews, simplify the practice’s to-do list, and improve their practice by understanding their data. Independent practices can begin tracking the practice’s performance, clinical quality measures, and meaningful use criteria measures.

Dante Capozzola
August 17, 2017

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How the patient-physician relationship can help achieve quality outcomes

The shift from fee-for-service to value-based care has resulted in a new emphasis on quality outcomes in healthcare. Independent physicians, of course, have always been focused on providing the best care possible for their patients. One way to do that is to develop a positive and productive patient-physician relationship. When the emphasis is on quantity over quality, the provider feels pressure to spend less time with each patient and to see more patients over the course of the day. Given a renewed emphasis on quality patient outcomes and helpful new technology such as electronic health records (EHRs), independent physicians are now able, once again, to spend more time with each patient. A relationship is developed when the physician is able to focus on the patient rather than the paperwork. Listening to the patient’s concerns and providing clear information about diagnoses, test results, and treatment plans can make a huge difference to that patient. Giving the patient the opportunity to communicate with the provider after the visit also contributes significantly to developing a positive patient-physician relationship. When patients are engaged and the provider takes the time to build a relationship, quality outcomes result. Erin E. Sullivan and Andy Ellner, MD, conducted a study of primary care organizations and found that all of the practices they studied “prioritize relationships with patients over cost and outcome measures …. The leaders of these practices all believe that by promoting relationship building on an individual patient level, favorable costs and outcomes will follow.” A solid patient-physician relationship can build trust, prevent miscommunication, reduce errors, and generally result in better healthcare for the patient. A patient who clearly understands directions provided during and after the visit is more likely to follow those directions. A provider who is able to speak with and, more importantly, listen to the patient will have a better understanding of that patient’s concerns. The provider and patient both will then play an active part in the patient’s quality healthcare outcomes.

Dante Capozzola
August 16, 2017

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What do independent physicians need to know about direct messaging?

When transmitting messages electronically in the healthcare field, security is extremely important. Patient data is protected by HIPAA regulations, which mandate that electronically protected health information (ePHI) be provided only to those authorized to have access to it. As more independent physicians use technology in their offices and maintain patient data on electronic health records (EHRs), the need to safeguard any information sent via electronic communications becomes paramount. Direct secure messaging (DIRECT) is a technology tool used by independent physicians to transmit information electronically in a secure message format. DIRECT works much like an email system, but within an electronically encrypted environment that keeps all patient data secure and accessible only to authorized recipients. DIRECT is a “technical standard for exchanging health information between health care entities (e.g. primary care physicians, specialists, hospitals, clinical labs) in a trusted network.” DIRECT messages are actually more secure than traditional paper notices sent via fax or through the regular mail. These paper records and notes are much more susceptible to compromise than a message sent electronically through a secure system. Sending electronic messages through DIRECT is also a much simpler and quicker process than requesting and waiting for information to arrive via fax or mail. This ease of transmitting information electronically ensures the complete exchange of patient health information and encourages smooth coordination between visits for both patients and physicians. Coordinated care between multiple providers is made more efficient and more effective when independent physicians and the specialty providers are able to communicate electronically. The Centers for Medicare & Medicaid Services (CMS) urges independent physicians and specialty provides to use DIRECT as well, primarily because of the security of the transmitted messages. Secure messaging is an important aspect of the CMS Meaningful Use requirements. Direct secure messaging saves time, reduces potential security issues, and enables independent physicians to reach out efficiently and securely to other providers as well as to their patients with important information regarding those patients’ healthcare.

Dante Capozzola
August 9, 2017

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Tips for managing patient reviews for independent physicians

In times past, someone looking for a new primary care physician probably asked friends, co-workers, or neighbors for recommendations. The conversations were focused on the pros and cons of the physician’s practice and were generally held one-on-one or in small group settings at home or in the workplace. In today’s virtual world, consumers tend to post their experiences online for many more people to see. Unhappy patients may take to the Internet to post reviews that will then be seen by anyone who is looking for a new primary care physician. If you are that physician, you may get some negative online reviews as well as positive ones. The way you handle those reviews could make a difference in the way future patients see your practice and the way your practice is ranked by search engines. Positive reviews are obviously welcomed, but negative reviews need to be acknowledged and handled as well. You may even receive some false reviews and should respond to those appropriately also. A recent article in Physicians Practice advises that patients may “post negative reviews because they wish to be heard and expect a response from your end.” While it is tempting to ignore the complaints or negative information, those are the reviews that need the most attention. Some tips for managing all patient reviews include: Monitor your online presence regularly. You may need to assign a staff member to scan the online review sites as well as your own digital presence on a daily basis. Negative reviews that do not receive a prompt response can only get worse. Respond directly to the negative reviews. Post a warm, acknowledging message for the reviewer and everyone else to see. Note that you’d like to communicate directly with the patient posting the negative review, to resolve the situation privately. Ask for positive reviews from satisfied patients. If a patient has expressed to you in person that he or she is particularly happy about your use of an EHR, for example, ask that patient to post that message online. Patient engagement is particularly important for encouraging positive reviews. Stay proactive with patients to determine any concerns they may have with your practice as well as their healthcare needs. Managing your online reviews well will help maintain your professional reputation among patients and potential patients.

Dante Capozzola
August 8, 2017

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The importance of communication for independent practices

Communication issues in the corporate world can cost a business financially. Communication issues in the healthcare world can lead to much more severe consequences. When a primary care physician does not communicate well with a patient, it can lead to financial costs as well as human costs, including medication errors, medical complications, and even death. The CRICO insurance program assessed 23,658 medical malpractice cases “where patients suffered some form of harm” between 2009 and 2013 and found that over 7,000 of the lawsuits and claims were a direct result of miscommunication. Financially, the errors cost $1.7 billion. The human costs included severe injuries and deaths. There is nothing more important in the patient-physician relationship than clear, concise communication. A patient who sees specialty providers in addition to the primary care physician must understand what each provider is saying verbally, in the exam room, as well as follow-up instructions for care and medications. There are multiple opportunities for miscommunication in such instances, not only in the conversations but also in the documentation of the patient’s records. The time spent in the exam room is crucial for physician-patient communications. The primary care physician must have access to all of the patient’s medical records and then be able to completely and clearly explain diagnoses and care management plans to the patient so there are no misunderstandings. The less time the primary physician has to spend with the patient, the greater the potential for miscommunication. In addition to taking the time to fully explain instructions and follow-up plans, the primary care physician must be sure the patient understands the information that is being relayed. Using medical terminology or speaking too quickly can also increase the opportunity for miscommunication and therefore the opportunity for errors. A good plan is to have the patient repeat the instructions for care or for a new medication, rather than simply asking if the patient has any questions. Elation Health is concerned with the quality of healthcare provided to each patient and with the independent physician’s ability to provide that health care seamlessly and securely. We have developed an EHR solution that gives the primary care provider access to a patient’s complete medical profile with just one click, so the provider can spend more time communicating with the patient and less time searching through paperwork. At Elation, we are focused on improving physician-patient communications and helping to reduce the often devastating errors that can result from miscommunication.

Dante Capozzola
August 8, 2017

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What should you include on your practice website?

Independent practices are very much like other small businesses that need websites. Having a website can be helpful for attracting new patients, providing information for existing patients, and for patient management. As an independent physician, what should you include on your website? Some essential elements of a website for an independent physician include: About Us. In this section you will provide information about your practice, about yourself as the primary physician, and about the office staff. Describe your experience, including how long you’ve been practicing, your education, and any areas of expertise you and your staff may have. Include any volunteer activities you and your staff participate in, to further connect with your patients and to show your engagement in your community. Services.  Are you a primary care physician? Do you have a lab or x-ray facilities onsite? Do you offer online billing and appointments? In this section, describe the services you and your office provide to your patients. The types of services you provide could make a difference when attracting new patients. Contact Us. Make sure your phone number and location are displayed prominently. Include a map link with your location, so new patients will know how to get to your office. Many patients might prefer to send an email or a secure online message, so it will be helpful to have those options available on your contact page as well. Patient Portal. A secure patient portal enables you to communicate directly with your patients and helps with patient management. While many of your patients may still prefer to pick up the phone and call, many will appreciate the ability to communicate, schedule, and review visit notes on a secure portal. Testimonials. You have happy patients - ask them to share their thoughts about the care they receive at your practice, on your website! New patients will be reassured by reading your current patients’ stories. People tend to go where other people have had good experiences. Blogs and News. Share helpful information with your patients, such as recommending how often they should have their physical exam done, what kinds of questions they should ask when they come to see you, and other tips and tricks that will position you as an expert in your field. You can also post industry news, particularly on current topics such as the Affordable Care Act (ACA) and healthcare coverage in general. Be sure to update your content regularly, so your patients have something to look forward to and so search engines can find fresh content! As an independent physician, you are focused on your patient’s’ care. An informational website, with all the right elements, will help with your patient management and with attracting new patients! Contact Elation to learn more about patient communication tools for your practice.

Dante Capozzola
August 4, 2017

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How independent physicians can protect their practices against malware, hacking, and data breaches

Cyber attacks have hit a number of computer networks lately. Technology is a helpful tool but it can also be a vulnerable target when it is not protected. In light of the most recent major worldwide ransomware attack, what can small and solo practices do to protect themselves and their patients against such attacks and boost their cyber security in this digital age? Steps to security The first step to protect yourself and your patients is to secure your computer. Set up passwords for all computers and make sure they are complicated enough (and obscure enough) that someone else cannot easily figure them out. Encrypt your computer’s hard drive to protect it against attacks and to protect yourself against HIPAA violations if an unauthorized individual gains access to the information on the computer. Creating a data security plan for your independent practice, conducting security audits, and training your staff on security measures will further help ensure that your practice remains safe against malware, hacking, and data breaches. You can also install anti-virus software on each machine. Another step to take is to ensure that your patient communication remains secure and safe. Your patients need the reassurance that their information is protected and you need to know that you are not accidentally allowing their data to be seen by intruders. Data kept on hard drives can be particularly vulnerable to such unauthorized intruders. A cloud-based Clinical EHR solution keeps your patient information out of individual hard drives. All information is stored on highly secure external servers. Many have actually described the security of cloud-based servers as “achieving HIPAA compliance with bank-level security and high-level encryption methods.” For independent physicians, you have many additional concerns beyond the fear of having your office’s computer system hacked. You have a responsibility to keep your patient’s’ information safe. Elation understands your concerns and your challenges; that’s why we’ve developed a secure, cloud-based Clinical EHR solution that will give you - and your patients - the reassurance of a safe environment. Contact us today to learn more about protecting your practice and your patients!

Dante Capozzola
August 4, 2017

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How does EPCS affect independent physicians?

The US Department of Health and Human Services (HHS) reports that, on an average day in the US, more than 650,000 opioid prescriptions are dispensed. Most of those prescriptions are written on paper and handed to the patient, which then makes them susceptible to misuse or fraud. Unfortunately, 78 people die every day from an opioid-related overdose. Prescription opioids account for more than half of those opioid-related deaths. An effective way to help prevent the high rates of prescription abuse is through Electronic Prescribing for Controlled Substances (EPCS). Electronic transmission of prescription orders sent directly from the independent physician to the pharmacist help make prescriptions harder to steal or forge. There are many safeguards involved in the independent physician’s use of EPCS, to further ensure the safety and security of the prescriptions being transmitted. The Drug Enforcement Administration (DEA) made electronic prescriptions legal in all fifty states and Washington, DC, in 2010. To date, only two states, New York and Minnesota, have mandated the use of EPCS. A third, Maine, is expected to mandate its use this year. The DEA has emphasized that independent physicians who use electronic health records (EHRs) “will be able to issue electronic controlled substance prescriptions only when the electronic prescription or electronic health record (EHR) application the practitioner is using complies with the requirements in the interim final rule.” Otherwise, the prescriptions will have to be printed out for manual signature. Elation’s EHR solution is certified for EPCS and is compatible with the required security updates. Elation provides EPCS for our customers in New York and is rolling it out to other states, such as Maine, soon as well. At Elation, we are concerned about independent physicians’ ability to provide quality healthcare to their patients. We are also concerned about their ability to prevent prescription fraud and misuse, particularly when it leads to the often severe consequences of opioid abuse.

Dante Capozzola
August 4, 2017

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Simple ways to reduce patient wait times for independent physicians

Long patient wait times are an issue for the patient, for the physician, and for the independent practice staff. The potential for health concerns increases with extended wait times, particularly among chronically ill patients. The patient’s overall visit quality may be impacted by a longer wait time. In addition, as reimbursement moves to a value-based system, the patient’s satisfaction level and quality of care may have an impact on the independent physician’s financial situation as well. Reducing patient wait times can be a simple matter of making some adjustments within the independent practice. Optimize the use of technology tools. Take advantage of advanced options such as scheduling software, electronic health records (EHR), and online patient communication. When the independent physician is able to seamlessly and effortlessly access patient records, including any concerns the patient may have communicated, and use EHRs for completing chart information, appointments run more efficiently. Dedicate the front desk staff to checking in and answering questions from patients in the independent practice office. Lines to check in are often held up by front desk staff answering phone calls. When those phone calls are redirected to another dedicated team member, the front desk can more efficiently serve those patients who are in the office, ready to see their physician. Study and analyze wait times during late morning and afternoons to develop a realistic picture of wait times in the independent practice. Early morning appointments are usually not delayed and do not provide an accurate assessment of how long patients have to wait to see their physician. Make the independent physician’s schedule more efficient. Review the schedule for open and overbooked times. Determine how the schedule can be more efficient, to help reduce wait times, especially for those late afternoon appointments. Elation’s tools can help make an independent practice more efficient, so the physician is able to spend more time focusing on patient care and less time on paperwork. Patients are happier and healthier, as their wait time is reduced and the quality of the time they spend with their physician is increased.

Dante Capozzola
August 3, 2017

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Important HIPAA reminders for independent physicians

The Health Insurance Portability and Accountability Act (HIPAA) was signed into law in 1996, to provide a uniform protection of patient medical records. HIPAA is a United States legislation that provides data privacy and security provisions for safeguarding medical information. As an independent physician, how can you protect yourself against HIPAA violations? HIPAA protects individually identifiable information, including medical conditions, treatment plans, and personal information such as name, address, Social Security number, and birthdate. This protected health information (PHI) should only be made available to those medical professionals and others who have permission to access it. Covered entities include all health plans, healthcare clearinghouses, and healthcare providers. When working with paper files, including a patient’s medical records, you must be particularly careful not to expose PHI to others, including other patients. When a paper record is visible to anyone other than the medical professionals who have permission to use it (with few exceptions), that is a HIPAA violation. Benefits of using an EHR The benefits of electronic health records (EHR), particularly in regard to HIPAA regulations, are that all patient information is maintained electronically and there is no paper record left exposed. Electronic health records are protected as e-PHI under the HIPAA Security Rule, which protects “all individually identifiable health information a covered entity creates, receives, maintains or transmits in electronic form.” Further, the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 promotes “the adoption and meaningful use of health information technology.” In part, the HITECH Act requires healthcare organizations to implement secure electronic systems to protect electronic protected health information (ePHI). As an independent physician taking advantage of the many benefits of electronic health records, you are better able to protect yourself against HIPAA violations that can often result from mishandled paper records. HIPAA compliance for independent physicians is a crucial part of your practice management. For additional guidance on HIPAA and other topics, check out our Resource Center.

Dante Capozzola
August 3, 2017

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Frequently asked questions about independent practice associations

An independent practice association (IPA) is a separate business entity owned by a group of physicians. The number of IPAs, which have varying purposes and goals, is increasing across the country. As an independent physician, you may have a number of questions about IPAs and how they might be able to benefit you. Q: What are the benefits of joining an IPA? A: An IPA can provide the benefits of a larger group, while allowing you to retain your independence. For example, as an article by the Wyoming Medical Society points out, one significant benefit is the IPA’s ability to negotiate “on better pricing on everything from common supplies and services, to systems which aggregate health records and drive improvement, to reimbursement for the services the IPA provides.” In addition, overseeing and managing issues such as security compliance for EHR for an independent physician association is much more cost effective and efficient as well. The IPA, as a separate, larger entity, is able to reduce or virtually eliminate some redundant expenses for its members. Q: Will I lose my independence if I join an IPA? A: You will absolutely retain your independence as a practice when you join an IPA. The organization does not own any part of your practice. In fact, when you are part of an IPA, you are better able to focus on the core business of your practice - providing quality care to your patients - and on your practice management. Q: Does an IPA help alleviate the isolation I sometimes feel as an independent physician? A: As an independent physician, you need to connect and communicate with other providers, while retaining your independent practice. An IPA does provide that opportunity to share common experiences and to leverage shared data to improve patient care, especially when taking advantage of the benefits of EHR for an independent physician association. Q: Should I be concerned about anything in regard to an IPA? A: Before signing any contract, you should always have your legal counsel review the information. Physicians Practice stresses that a healthcare attorney can help ensure that “Stark Law and Anti-Kickback Statute issues have been addressed in the contracts.”

Tyler Comstock
July 31, 2017

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First steps for opening up an independent practice

Are you considering an independent practice for yourself? Although it may seem an intimidating prospect, you will probably find that independent and solo practitioners are better able to provide quality care for their patients. In fact, Linda Girgis, MD, FAAFP , writing in Medical Practice Insider states that “patients receive the best care when their physicians maintain control of the way they practice.” What are some of the first and most important things you will need to do when planning your independent practice? The list may seem long and daunting, but there are a few items that are crucial and will help independent and solo practitioners move toward success. Hire quality staff. When you have skilled team members who are patient-focused, you can be more confident in your practice management. Your patients will be happier, knowing that everyone in your office truly cares about their well-being and that the practice is well run. Launch a marketing strategy. Create a professional website that provides your patients with information about your practice. List your location and contact information as well as an overview of your background and education. Make the website interactive, so patients can communicate with you and your staff, make appointments online, and pay their bills online. Set up an EHR system. Take advantage of technological advances by maintaining your patients’ health records electronically. With an EHR solution, you will spend less time on paperwork and more time being able to provide quality care to your new patients. Hire professionals. You will need to enlist help to stay on top of legal issues and accounting matters, particularly taxes. In addition, as an independent physician it will be your responsibility to credential with insurance companies, so you may need professional assistance to be sure that task is completed appropriately and in a timely manner. Communicate with the medical community. You know that communication is important once you are seeing patients as an independent physician, but it is just as important to reach out to specialty providers, labs, and healthcare facilities before you open your practice. Let them know what you have to offer, particularly when you have the ability to collaborate electronically. Independent and solo practitioners have an advantage in being able to focus more fully on patient care. Follow these guidelines to open and succeed in your independent practice!

Dante Capozzola
July 26, 2017

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Patient engagement at independent practices

Patient engagement is an important part of an independent physician's role in providing high-quality care to patients. Patient engagement means more than having a conversation during a visit. It means following up with that patient, communicating test results, and checking in on the progress of the patient’s medical plan. It also means the difference in having that patient return for follow-up visits and quite possibly even the difference in the future health and welfare of that patient. What are some patient engagement strategies for independent physicians? Key steps to take in engaging patients include: Continuing patient communication beyond the office visit Optimizing the features of a clinical EHR for independent primary care physicians Encouraging patient interactions at critical touch points. According to a playbook published by Health IT, “patient access to information and communication with providers can increase the quality of life,” particularly for those patients with chronic illnesses. A clinical EHR for independent primary care physicians offers you much more than the ability to maintain a patient’s health records electronically. You can also quickly identify patients who aren’t meeting goals based on custom care management protocols, reaching out to them to schedule follow-up appointments to address any potential gaps in care. Knowing that the patient’s time is as valuable as the independent physician’s time, patient engagement can be much more easily and efficiently accomplished through tools such as electronic messaging, to include appointment reminders and answering a patient’s follow-up questions. Quite often the patient - as well as the independent physician - thinks of information that needs to be shared long after the appointment is done. Communication with the patient enables everyone to share that information in a convenient manner, ensuring that follow-up care is appropriate and effective. Patient engagement helps both the patient and the independent primary care physician work toward happier, healthier patient results. Employing engagement tools at critical touch points, particularly as part of a follow-up plan, will improve your patient engagement success as an independent physician.

Tyler Comstock
July 26, 2017

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The importance of office staff at an independent practice

  As an independent physician, you have been trained and educated to treat patients. You probably did not prepare yourself to run an office. That’s why you hire office staff, to help you with the daily tasks that have to be done - and done well - to keep your practice running smoothly. The office staff at independent practices play a key role in ensuring that patients are happy and that you are able to give your attention to their medical care. Some of the tasks performed by office staff at independent practices include: Greeting and checking in patients Managing co-pays Accompanying patients to the exam room Answering phone calls Helping patients navigate their portal login Scheduling appointments Billing and other administrative tasks The role of the office staff is important for independent practices especially. With a capable team in your office, you can spend less time worrying about administrative details and more time focusing on patient care. When determining the number of office staff at independent practices, it is helpful to check industry benchmarks. It is also important to know how you work - and how you prefer to work. For example, if you are well organized, tend to stay on schedule, and are generally able to complete your paperwork in a timely fashion, you will need less help in the office. If your independent practice uses an EHR system that virtually eliminates the abundance of paperwork found in a typical medical office, you will also need fewer staff members in your office. Hiring staff members will add to your expenses, of course, but when you think of all the tasks they perform each day, allowing you to focus on what you do best, the expense is certainly justified. Gauge carefully the number of staff members you will need, be sure they know their specific responsibilities, and train them in medical office and customer service skills. Your patients will appreciate the treatment they receive from your dedicated staff, before and after they receive treatment from you as their primary care physician.

Roy Steiner
July 26, 2017

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What is an Independent Physician Association (IPA)?

Independent physicians who want to focus more on the care of their patients sometimes feel challenged with the need to keep up with compliance regulations, administrative contracts, and other overhead issues related to their practice management. An independent physician association (IPA) may be able to help by reducing or eliminating some of those headaches. Independent physician associations (IPAs) are on the rise. Essentially, an IPA is a business entity, owned by a network of independent physicians. IPAs vary in their purpose and activities, depending on the area of the country in which they are located. What do small and solo practice physicians need to know about them? Joining an IPA does not mean you are losing your independence. An IPA does, however, offer you the benefit of being part of a larger group, primarily for the purposes of contracting with third parties, for pursuing business ventures, and for reducing overhead costs. The American Academy of Family Physicians (AAFP), recognizing that there are benefits as well as risks involved with participating in an IPA, has established a list of Guiding Principles for IPAs. In part, the principles state that the IPA should “promote efficiency and effectiveness in the delivery of health care to patients that produces value.” This guideline aligns with your focus as an independent physician and with Elation’s philosophy to improve the quality of patient care while being more productive and more effective. An IPA can be a useful tool for practice management for an independent physician. As the AAFP warns, though, there are some risks involved. When you are considering an IPA, be sure to have your attorney review all documents related to the organization. AAFP advises, in particular, that risks might involve “conflicts of interest for the physician between financial gain and optimal care for the patient.” Another guiding principle for IPAs, according to the AAFP, is that “effective management of relationships between primary care physicians, limited specialists, and hospitals is critical to the optimal care of patients….” Elation is also focused on helping you, as an independent physician, to optimize those relationships with patients and with other physicians. Check out our solutions that can help you provide the highest quality care possible!

Dante Capozzola
July 21, 2017

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Medicare's impact on independent practices

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its associated Merit-based Incentive Payment System (MIPS) have proved quite challenging to many independent practices. In addition, the Medicare-qualifying patient population is expected to increase from 55 million to 80 million by 2030. How does all of this impact independent practices? A recent BlackBook Research survey of 1300 very small independent practices found that “67% of such physician practices believe their independence will end with MACRA.” In addition, 89% of the solo practices that participated in the survey “plan to minimize Medicare volume to avoid filing quality and clinical practice improvement reports or cost performance reports to CMS.” There is much confusion among independent physician practices as well. Of the very small practices surveyed, “63% remain unsure which health information technology and products meet their needs for meaningful use, clinician usability, interoperability and coordinated claims and billing.” Fortunately for these independent practices, the Centers for Medicare & Medicaid Services (CMS) has released a new proposed rule for 2018 that would simplify requirements going forward. Recognizing that small practices may not have the resources needed to comply, CMS has increased the thresholds for required participation in MIPS in the proposed rule. The new proposal increases the threshold from $30,000 or less in Medicare Part B allowed charges or less than 100 Medicare patients to $90,000 in Part B allowed charges or less than 200 Medicare patients. Other proposed changes for 2018 include allowing the use of the 2014 Edition CEHRT (Certified Electronic Health Record Technology) and adding bonus points in the scoring methodology for caring for complex patients and for using 2015 Edition CEHRT exclusively. Moving from a fee-for-service structure to a value-based payment plan is an important strategy for independent physicians who are primarily focused on their patients’ healthcare outcomes. However, the future of these independent practices as it relates to their willingness and ability to continue in the Medicare program may depend on the outcome of the proposed 2018 rule.

Tyler Comstock
July 20, 2017

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Working in an independent practice vs a large clinic setting

Entrepreneurship is a life’s dream for many people. A person who is able to launch a business and report only to clients, rather than to a management structure or supervisor, may find happiness and fulfillment in his or her newfound independence. The same may be true for primary care providers who decide they want to practice independently rather than be employed by a larger health care facility. There are advantages and disadvantages both to remaining independent and to working in a large clinic setting. Challenges and benefits for the independent physician, according to Philip Masters, MD, FACP, writing for the American College of Physicians, include: -Practice management. An independent physician is ultimately responsible for all of the administrative tasks involved in operating and maintaining the practice. -Hiring staff. Such tasks cannot be handled alone, so the independent physician will have to recruit, hire, and retain quality staff members who can assist with patients and with administrative duties. -Billing, keeping up with regulations. The shift to value-based payments and the continuing debate over health care coverage will impact the independent physician’s practice in regard to billing and maintaining compliance. -Ensuring the integrity of protected data. HIPAA regulations apply to all protected health information, including electronically maintained data (ePHI). Independent physicians who take advantage of electronic health records (EHRs) must adhere to HIPAA regulations as well. -Developing closer relationships with patients. The independent physician has the opportunity to get to know patients more fully in a smaller practice. Likewise, there are challenges and benefits for the physician working in a larger clinic: -Reduced administrative burden. Most clinics are fully staffed with personnel assigned to patient services and administrative duties. -More resources for coverage. Clinics generally employ more than one primary care physician, so backup is available. -Lack of control. Dr. Masters points out that “scheduling and productivity expectations may be beyond your control, and policies and procedures may be developed by others without your input” in a clinic setting. -Other expectations, beyond providing for patient care. A clinic may expect its physicians to participate in committees or other activities within (and outside) the organization. -Business-like structure. Larger clinics are often focused on making money. The independent physician who is more focused on patient outcomes may find this a challenging adjustment.

Dante Capozzola
July 17, 2017

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Marketing trends for independent physicians

Marketing can be effective for independent physicians. As an independent primary care physician, you certainly want to focus on patient care without being concerned about promoting your practice. However, marketing done well can ensure that you actually have those patients in your practice that need your care! Marketing is not hard-pitch selling. Rather it is communicating and promoting the services you have to offer your patients. If you were a patient looking for a new independent physician, what would want to read or hear about that practice? A good marketing strategy to keep in mind, regardless of current trends, is to make sure your message is addressed to your specific clients’ needs. What are the trending marketing tactics that are most relevant to the independent primary care physician community? In 2017, healthcare marketing is all about the digital options. You should have a solid, useful website for your potential patients to learn more about your practice and for your current patients to use to communicate with you, set appointments, and pay bills. Optimize your web content and your social media posts to reach your specific target market. As an article in Healthcare Success, 10 Healthcare Marketing Trends to Watch in 2017, points out, the trend is to have “content that is authoritative, interesting and share-worthy.” You know that, of course, as an independent primary care physician, you may be competing with larger practices. Use that to your advantage in your marketing strategies. Believe it or not, patients consider their time to be just as valuable as you do yours. A very effective tactic for you is to emphasize that you are a small, independent practice so you also understand how important your patients’ time is to them. In addition, point out that by using your EHR solution for maintaining and viewing their patient information, you are able to provide the individual care they need at each visit, rather than being bogged down with their paperwork! Patients do tend to do their research before choosing an independent primary care physician. They want to see that you are able to provide coordinated care with specialty providers and labs. When you take advantage of digital marketing options, you can send that information and more, out to potential patients through your website and social media posts, straight to their mobile device. Promoting your practice does not have to be intimidating or time-consuming. Marketing can actually benefit both you and your patients!

Roy Steiner
July 13, 2017

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Reasons why independent physicians can stay independent

Even as the healthcare landscape changes, there are a number of solid reasons why independent physicians can and will stay independent. New healthcare regulations, insurance rules, and pressures to consolidate are challenges for independent physicians. However, most prefer to maintain their independence to better serve their patients with personalized care and advances in technology, including an EHR system for independent physicians. As healthcare payments shift to value-based care, independent physicians are actually better positioned to not only maintain their autonomy but to grow their practice. In fact, a 2015 Independent Physician Outlook Survey, as reported in Becker’s ASC Review, revealed that many independent physicians “envision a future where the employed physicians at larger healthcare institutions migrate back into a private practice or independent practice setting.” Almost half of the survey respondents agreed that innovation in business models, designed to focus on cost savings and efficiency, would help them maintain their autonomy. Incorporating an EHR system for independent physicians can be a crucial piece of such business model. Elation offers a provider-centric Clinical EHR that exists at the nexus of the clinical workflow, supports the physician-patient relationship, and drives outstanding patient outcomes, enabling independent physicians to provide the highest quality care and remain independent. Joining an Independent Physician Association (IPA) is another step toward maintaining independence. An IPA enables independent physicians with more leverage in certain types of contract and payment negotiations. About 49 percent of the survey respondents felt that an IPA would also help them by providing a forum for aligning with other, like-minded physicians. The survey report noted that “nearly half of independent specialists expect to sell their practices in the coming years, but not because they want to.” Independent physicians have a number of available reasons to stay independent. Employing the right tools for secure and effective patient communication as well as practice management is a key aspect of staying independent as a physician. Using advanced technology to more efficiently record and maintain patient health records enables the independent physician to focus on the core goal of the practice - quality patient care.

Tyler Comstock
July 11, 2017

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Independent physicians can stay independent during transition to value-based care

There is uncertainty surrounding how independent physicians will adapt to the transition from fee-for-service to value-based care. In reality, independent providers are already uniquely situated to succeed within this new landscape. Farzad Mostashari, MD, writing in the Annals of Family Medicine, cites research suggesting “that small, physician-owned practices …have lower average cost per patient, fewer preventable hospital admissions, and lower readmission rates than larger, independent- and hospital-owned practices.” Independent practices realize all of these benefits, while also providing personal attention and responsiveness to their patients. Since value-based care is focused on patients and the quality of care provided to those patients, independent physicians are poised to deliver on the type of care required to succeed in the value-based world.  Independent physicians have provided this kind of care for generations - but with the right technology, that advantage grows. Optimizing the value of care An effective EHR for independent primary care should be cloud-based and easy to use in the clinic, eliminating the need for redundancy and additional work. With the right technology tools, providers can focus more on the patient’s needs and less on the paperwork involved in a patient’s care.  Using a Clinical EHR helps to drive quality patient outcomes that are especially important in a value-based system. In addition, primary care physicians will take an increasingly important role as the quarterback in patient care within the value-based environment. Understanding a patient’s complete medical care profile, including having access to the network of providers a patient has seen for specialty medical services, will enable independent physicians to optimize the “value” in their transition to value-based care. Communications between providers can be a crucial element of making more efficient and more accurate medical decisions, which is the key to providing personalized high-quality care. To learn more about Elation Health’s cloud-based Clinical EHR solutions and how we can help you succeed in the new value-based care landscape, contact us today.

Roy Steiner
July 10, 2017

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How many office staff members do independent practices need?

The independent physician has to balance the need to keep overhead manageable with the need to adequately staff the practice. Too few staff members and patients are not well served. Too many staff members and the practice faces excess expenses. There is no magic formula for how many staff members an independent practice needs, but there are guidelines and suggestions that can help in the calculation. The first step, according to guidelines provided in an article published by the American Academy of Family Physicians (AAFP), is to compare their independent practice with industry benchmarks. Sources for available benchmarks include “the Medical Group Management Association (MGMA), Practice Support Resources (PSR), the American Medical Association (AMA) and the American Medical Group Association (AMGA), as well as local medical societies.” Benchmarks should address: The number of support staff per full-time-equivalent (FTE) physician The percentage of gross revenue spent on support staff salaries. Another consideration when determining how many staff members an independent practice needs is to review the overall practice management style and structure. If an independent physician is organized and completes paperwork efficiently - fewer staff members might be sufficient to maintain patient records and update charts. If the practice employs advanced technology tools, such as an EHR, enabling the independent physician to access and update patient information electronically, that should also be included in the considerations. Adequate staff members will be needed to support communication with patients, including checking in patients, answering patient questions on-site, and responding to patient telephone calls. If the independent practice collaborates with other providers or has satellite offices that require coordination of scheduling, additional staff members may be needed to ensure those services operate smoothly. Factors that may also affect the numbers include the qualifications and ability level of each staff member. For example, a staff person who checks in patients may have the capabilities to perform other duties in the office. If the patient level is high, however, individual staff members may need to perform separate tasks. There is no one answer to the question of how many staff members an independent practice may need. However, guidelines are available to ensure that staffing makes sense given the particular situation of each practice.

Dante Capozzola
July 7, 2017

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The importance of empathetic communication for independent physicians

Patients want to know their primary care physicians care about their well-being. Physicians want to be able to provide the highest quality care to their patients, especially with the current transition to value-based reimbursement. One method that has been proven effective in achieving all of these goals is empathetic communication. What is empathetic communication? As Kasley Killam explains in Greater Good Magazine, “empathy in a clinical context is the physician’s ability to understand patients’ emotions, which can facilitate more accurate diagnoses and more caring treatment.” Empathy builds trust, which further strengthens the patient-physician relationship that is so important to quality healthcare. When a physician takes the time to listen to the patient’s concerns, it can make a difference in the level of patient outcomes. An article in the Georgetown University Journal of Health Sciences notes interesting gender differences in physicians’ ability and practice when communicating empathetically. Published evidence shows that “female doctors are generally more empathic than male doctors when relating to their patients.” The journal article further explains that the “average duration of a female physician’s interview is ten minutes and forty-five seconds, compared to the seven minute and thirty-eight second average interview conducted by her male colleague.” Communication is extremely important for the patient and the physician both during the visit and after the visit. When the physician has to spend excessive time on paperwork, there is less time for face-to-face conversation during the patient’s office visit. A tool such as EHR can provide increased patient data access so the physician can spend more time focused on listening to the patient, displaying empathetic communication skills, and less time searching through files for information. After the visit, a patient may have questions or a physician may need to relay additional information to the patient. A communication tool that offers seamless, secure messaging for both patient and physician can also increase the empathy shown by the physician toward the patient’s concerns, thereby improving the quality of follow-up care.

Dante Capozzola
July 6, 2017

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How independent practices can succeed with MACRA, MIPS and APMs in 2017

The Centers for Medicare & Medicaid Services (CMS) has deemed 2017 as the transitional year for independent physicians to comply with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). During 2017, there are a number of ways that independent practices can choose to participate in the program and remain compliant. Reporting for the MACRA was officially kickstarted in January. The results of the reporting that begins in 2017 will be reflected in the payments that are issued beginning in 2019. This allows for the tracking of a composite performance score under which all physicians will be graded under MACRA. The CMS Quality Payment Program, enacted by MACRA, enables independent providers to focus more on providing high quality care for their patients. The program offers two tracks for independent practices to choose from: Advanced Alternative Payment Models (APMs) or The Merit-based Incentive Payment System (MIPS) The MIPS track consolidates current fee-for-service Medicare programs (Meaningful Use, Physician Quality Reporting System, and Value-Based Payment Modifier) into a single program. When you choose the MIPS track, you also have the option to “Pick Your Pace” which, in the words of CMS, provides “an on-ramp to participating.” Participating in MACRA in 2017 What are the options for independent practices to be able to participate in MACRA in 2017? You can test the Quality Payment Program. As an independent provider, you simply have to submit some data from after January 1, 2017 to avoid the negative payment adjustment. This option exists to ease providers into greater participation in 2018 and 2019. You can participate for part of the calendar year, for a reduced number of days. You will still qualify for a small payment if you submit data on how your practice is using technology and what you are doing to improve your quality of care. As a Clinical EHR participant, you can demonstrate that you are taking steps to improve your patient care while streamlining and optimizing your clinical workflow. You can participate for the full calendar year. To take advantage of this option, you would have been ready to fully participate in the Quality Payment Program for a full calendar year as of January 1, 2017. You can participate in an Advanced Alternative Payment Model in 2017. With this option, you are excluded from the MIPS reporting required in the other options and you are given the opportunity to qualify for a 5 percent annual bonus. We want to help ensure that you are MACRA compliant in 2017. Contact us to learn more about your options!

Tyler Comstock
June 21, 2017

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New state policy aims to level the playing field for independent physicians

Independent physicians often receive lower reimbursements than their hospital-employed counterparts. The state of Vermont recognizes the situation and is working toward alleviating the issue with new legislation. The Vermont State Senate passed a bill in May 2017 that would level the playing field for independent physicians. The independent private practice physician has long received smaller reimbursements from insurance companies than the physician employed by a hospital. For the past four years, the Vermont legislature has been trying to rectify the situation. In fact, in 2015 they ordered two of the state’s insurers to restructure their billing method to be more equitable. However, that resulted in very little change, over a long period of time. The new bill, designed in part to keep independent private practice physicians from leaving the state, puts into place plans to “reduce pay disparities between independent physicians and academic medical center physicians by the ‘maximum achievable’ amount in the next three years.” The pay parity verbiage was added to the original bill, known as H.29, which was originally written to address Medicare supplemental insurance issues. Hospitals and insurance companies, along with two Senate committee chairs, opposed the bill. Why independent physicians should care At Elation, we work to help every independent private practice physician succeed, both in terms of quality patient care and practice management. Particularly, as the healthcare industry shifts the focus to value-based care, being able to provide quality, coordinated care for each patient and have it be efficient and cost effective will become more important. We realize that costs are high and inconsistent for an independent physician. We focus our efforts on small and solo practices, helping you optimize your practice through streamlined electronic records, interoperability, and collaborative health records. Explore a sample chart to see how Elation’s EHR solutions can benefit your independent private practice.

Dante Capozzola
June 15, 2017

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