For regularly-updated/published content, please follow me on Twitter at “Lisa_Eramo” or view my Facebook page at “Lisa Eramo, freelance writer & editor.” Following are several samples that have been published in the last few months:
Go Practice blog (Kareo), July 2017
Population health: What providers need to know about risk-adjustment documentation
By Lisa A. Eramo
When it comes to accurate population health-based payments, three factors go hand-in-hand: Risk adjustment, documentation, and quality, says Marian J. Wymore, MD, CPC, CRC. Wymore, a California-based physician documentation improvement consultant, spoke recently at HEALTHCON 2017 about how physician documentation directly affects capitated payments. Thorough and specific documentation not only makes good clinical sense, but it also tends to support quality measures and risk-adjusted payments, she adds …
Medical Economics, July 2017
How to improve patient engagement through technology
By Lisa A. Eramo
Primary care physician Frank Maselli, MD, is somewhat of an anomaly. That’s because his New York City-based practice has continued to gain in efficiency since implementing an electronic health record (EHR) system in 2001 and switching to a new vendor in 2009.
What’s his secret? Patient engagement.
By engaging patients with the EHR-based portal since 2010, Maselli’s practice has reduced patient phone calls, streamlined in-house workflows and decreased postal costs. The portal allows patients to view clinical information, schedule appointments, pay bills and ask for prescription refills or referrals. Patients can also download a mobile app to easily access the portal on their cell phones …
For The Record, June 2017
By Lisa A. Eramo
In the post-ICD-10 era, more organizations are eschewing external vendors in favor of pulling auditors from their in-house coding ranks …
Go Practice blog (Kareo), May 2017
Can medical coders save the healthcare industry?
The scoop from HEALTHCON 2017
By Lisa A. Eramo
Medicare reform, risk adjustment, and the expanded role of medical coders in today’s physician practices were among the many topics discussed during HEALTHCON 2017 sponsored by the American Academy of Professional Coders (AAPC). More than 2,500 billing and coding professionals attended the event that took place in Las Vegas earlier this month.
This year’s agenda included a wide variety of sessions covering denial management, evaluation and management (E/M) challenges, auditing, HIPAA, practice management, and various specialty coding topics that went beyond coding basics to include anatomy, pathophysiology, and an in-depth discussion of procedures and treatments. An overarching theme throughout many of these sessions? The value that credentialed coders bring to physician practices—especially during the transition from fee-for-service to value-based reimbursement …
Medical Economics, May 2017
How to improve diabetes outcomes under value-based care
By Lisa A. Eramo
Visitors to the office of Sandra Adamson Fryhofer, MD, might notice it contains a few surprising features.
First are the two yoga mats—one for her and one for her patients—that she uses to demonstrate stretches. Second are the brochures listing local gyms and community health programs. Sometimes she even downloads and prints upcoming gym class schedules during appointments—all with the goal of empowering patients to control their diabetes.
“When you give people specifics, I really feel that this makes a difference,” she says. “I try to use the office visit as an opportunity to not only talk about what they need to do, but also how they can do it.”
Working diligently to motivate patients—especially those with diabetes—is something that primary care physicians must do if they want to be successful under Medicare payment reform. In particular, physicians must help patients achieve and maintain a healthy hemoglobin A1C level and focus on care coordination with specialists. Doing so helps boost a physician’s Merit-based Incentive Payment System (MIPS) composite performance score, which translates directly to additional reimbursement …
For The Record, February 2017
By Lisa A. Eramo
Over the last decade, Minnesota-based Allina Health has migrated patient and provider data from several EHR systems into a single EHR. During each of these transitions, the organization made a concerted effort to clean up patient duplicates. Over the last year, HIM professionals and others have begun to turn their attention to a similar but different problem: resolving provider duplicates …
Medical Economics, February 2017
Wearables and EHRs: 5 essential questions
By Lisa A. Eramo
Wearable fitness devices such as smartwatches, activity trackers and other biometric sensors continue to grow in popularity. Physicians must determine whether and how to incorporate device-generated data into their practice’s electronic health record (EHR) …
Medical Economics, January 2017
7 ways physicians can take control of uncompensated time
By Lisa A. Eramo
The workday for internist Jeffrey Kagan, MD, doesn’t end when he leaves his Newington, Connecticut, office. He still has two to three hours of unpaid work ahead of him reviewing lab reports, X-rays and MRIs, as well as returning phone calls.
Kagan says he spends 12 to 17 hours weekly on tasks for which he receives no compensation. This includes the work he performs each evening at home, plus unpaid tasks throughout the day, such as prior authorizations for insurance companies and research to identify the latest clinical treatments and closest centers of medical excellence that could potentially benefit his patients.
“It’s not unusual for me to leave the office around 7 p.m. because I’ve had enough, come home and eat dinner with my wife, and by 8 p.m. I’m on the computer,” he says. “I’m there through the 11 o’clock news.”
Like many physicians, Kagan uses personal time to complete tasks necessary to keep his practice running efficiently. To some degree, physicians have always done this. However, anecdotal data suggests that physicians are spending even more of their time on uncompensated tasks than they ever had in the past …
For The Record Magazine, December 2016
Medicare Bundled Payments: Are AMI and CABG next?
By Lisa A. Eramo
Bundled payments have been growing in popularity over the past several years—particularly with the Centers for Medicare & Medicaid Services (CMS). In the beginning, these payment models were voluntary; forward-thinking organizations made the deliberate choice to participate. Now, the agency is taking additional steps to implement and grow mandatory bundled payments that continue to reward hospitals for working with physicians and other providers to avoid unnecessary complications, improve quality outcomes, prevent hospital readmissions, enhance the patient experience, and enable a faster recovery in the appropriate care setting …
Journal of AHIMA, November 2016
Standardizing interoperability is a team effort
By Lisa A. Eramo
AHIMA and other key stakeholders continue to drive national and global progress to achieve information systems interoperability in healthcare.
Like a complex puzzle, health information data and system interoperability takes time, effort, and collaboration to solve. And solving this puzzle is critical. Without immediate access to health information during a patient’s time of need, healthcare providers can’t offer effective—or perhaps even life-saving—treatment …
For The Record Magazine, September 2016
Many providers feel under the thumb of Medicare Advantage plans
By Lisa A. Eramo
If you’re on a budget—and who isn’t these days?—you probably tighten your purse strings once in a while to ensure your bills are paid on time. Now imagine that you’re the Centers for Medicare & Medicaid Services (CMS). According to the latest data from paymentaccuracy.gov, the agency has made $14.1 billion in improper payments to its Medicare Advantage (Part C) supplemental plans, representing a 9.5% improper payment rate.
During a time when every penny counts, it’s not surprising that CMS has begun to take a closer look at its expenditures in this growing market.
Through its risk adjustment data validation audits of Medicare Advantage plans, CMS examines whether its risk-adjusted payments to these plans are appropriate based on actual provider documentation. Medicare Advantage plans are paid according to CMS’ hierarchical condition category (HCC) model that takes each beneficiary’s specific health risks and certain demographic characteristics into consideration. In essence, CMS pays Medicare Advantage plans a monthly capitated rate to cover expenses for patients with greater risk, meaning those who have multiple HCCs.
However, experts say that CMS’ scrutiny of Part C payments has led some Medicare Advantage plans to become particularly aggressive with providers in terms of denying payment …
Journal of AHIMA, September 2016
Five tips to develop and share your HIM ‘elevator speech’
By Lisa A. Eramo
As a health information management (HIM) professional, you know just how difficult it is to explain your profession to others. So many acronyms, so little time. How can you capture all of the nuances of HIM in a way that others will understand while also keeping their attention?
As an HIM freelance writer, I know the struggle. Friends and family members don’t quite get it. They know I write about healthcare, but they probably couldn’t articulate the types of topics I cover on a daily basis—medical coding, release of information, electronic health records, etc. Could your friends and family members describe the important work you perform within your organization? I’m guessing the answer is no.
In many ways, HIM seems to be the best kept secret in healthcare. That’s because very few professionals know how—and when—to educate others about HIM’s role within the healthcare ecosystem …
Medical Economics, September 2016
The next ICD-10 hurdle: Prepare for payer scrutiny
By Lisa A. Eramo
When the clock struck midnight on October 1, 2015, the healthcare industry shifted from the antiquated ICD-9 disease classification system to the more refined ICD-10. One milestone achieved. Can physicians assume it will be smooth sailing now that one major hurdle has been crossed?
Not quite. There is yet another hurdle to cross in the coming months—navigating the conclusion of the ICD-10 grace period—a year-long moratorium on retrospective denials of unspecified claims …
Go Practice blog (Kareo), August 2016
Can an EHR help save time? Yes … with these 7 savvy tips
By Lisa A. Eramo
There are few things more frustrating than wasted time—especially in the workplace. Most of us want to be productive—to feel as though we’ve accomplished something or made a difference. We certainly don’t want to be slowed down by technology. Neither do physicians, many of whom are afraid to make the transition to an electronic health record (EHR) system for this very reason.
Anticipated loss of productivity continues to concern physicians considering a transition to an EHR system. In fact, 59% of office-based physicians who haven’t yet adopted an EHR say loss of productivity is one of the biggest barriers, according to a 2014 report published by the Office of the National Coordinator (ONC) …
Journal of AHIMA, August 2016
Stopping thieves in their tracks: What HIM professionals can do to mitigate medical identity theft
By Lisa A. Eramo
The clues are subtle but critical: Perhaps you get a bill for urgent care services you never received. Or upon reviewing your medical record through a patient portal, you see a diagnosis of back pain and multiple prescriptions for narcotic pain relievers.
Though not definitive, chances are probable that you’ve been an unfortunate victim of medical identity theft due to a breach of your healthcare data. In the last two years, nearly 90 percent of HIPAA-covered healthcare entities have had a data breach, according to the Ponemon Institute’s “Sixth Annual Benchmark Study on Privacy and Security of Healthcare Data,” published in May 2016.1 Forty-five percent of healthcare entities had more than five data breaches during the same time period.
Although not every breach leads to medical identity theft, many of them do. Medical identity fraud has nearly doubled since 2010, according to the Medical Identity Fraud Alliance (MIFA). Thirty-eight percent of covered entities said they’ve experienced at least one case of medical identity theft that affected patients or customers during the past 24 months, according to the 2016 Ponemon study …
MedCityNews, July 2016
5 tips to prepare for CMS’ new cardiac bundled payment model
By Lisa A. Eramo
High-quality care at a low cost is the goal of the Centers for Medicare and Medicaid Services’ newly proposed bundled payment model targeting cardiac care. If finalized, this mandatory model would take effect July 1, 2017 and affect hospitals in 98 randomly selected metropolitan statistical areas.
Why should hospital leaders care about this new bundle? …
Go Practice blog (Kareo), July 2016
A frugal EHR implementation: Is there such a thing?
By Lisa A. Eramo
The average up-front cost for an in-office EHR is $33,000, according to HealthIT.gov. Up-front costs for a web-based EHR are reported as slightly less at $26,000. However, these estimates don’t indicate what is included, and there can be a wide variation in expenses related to training, implementation, staffing, and patient load. Even with reduced patient load and some added staff costs, there are some EHR vendors that provide solutions at a far lower cost.
Still, there are both upfront and ongoing expenses when implementing an EHR. And many physicians are concerned about that impact and whether or not there is enough return to warrant the investment.
The good news is that with a little strategizing, physicians can make frugal decisions that won’t make or break their EHR implementation …
MedCityNews, July 2016
4 questions every healthcare provider should ask about fitness wearables
By Lisa A. Eramo
By 2018, 81.7 million users will own a wearable fitness device, according to eMarketer. And while consumers dabble in the cool features and sleek user interface of their wearables, healthcare providers continue to ask one important question: Does this tsunami of patient-generated data ultimately belong in the medical record?
The answer will be largely dictated by patients themselves, many of whom have already begun to express a strong desire to share wearable data with their healthcare providers …
Medical Economics, July 2016
How to utilize care coordination to boost practice income
By Lisa A. Eramo
With the proliferation of accountable care organizations and other alternative payment models, the trend toward value-based reimbursement is already well underway. Primary care physicians who weather this storm of payment reform successfully will be those who prioritize care coordination to keep patients healthy. Unfortunately, this often requires three of the most limited commodities in today’s practices: time, operational resources and money.
The good news is that in 2013, the Centers for Medicare & Medicaid Services (CMS) began paying for transitional care management (TCM). TCM includes services rendered for certain patients during their transition from an inpatient hospital setting to a community setting, such as their home. In 2015, CMS continued to recognize the importance of care coordination by starting to pay for chronic care management (CCM). CCM includes non-face-to-face services provided to Medicare beneficiaries who have two or more significant chronic conditions.
But many physicians feel that the financial payoff isn’t worth the extra effort required to fulfill documentation and other requirements …
