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


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


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


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


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


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:

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


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


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


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


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