Portfolio of bylined articles

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AHIMA, October 2023

Federal cybersecurity efforts seek to improve protection of healthcare data

By Lisa A. Eramo, MA, freelance healthcare writer

Healthcare data breaches affect millions of people every year, and it’s a growing problem. Medical records include financial and personal information that hackers can sell on the dark web and use for various other nefarious purposes. In 2022, healthcare organizations in the United States suffered an average of 1,410 weekly cyberattacks per organization—an 86 percent increase compared to 2021. As an industry, healthcare consistently has the highest number of data compromises, and the number of healthcare data breaches continues to increase each year. …

HFMA, October 2023

Applying AI to RCM

By Lisa A. Eramo, MA, freelance healthcare writer

Auburn Community Hospital, an independent 99-bed rural access hospital, uses robotic process automation, natural language processing and machine learning in revenue cycle management (RCM). The hospital started on this path nearly 10 years ago with the transition from the coding standard to ICD-10-CM from ICD-9-CM. …

AHIMA, August 2023

Four social media stars of medical coding and health information

By Lisa A. Eramo, MA, freelance healthcare writer

You’ve probably seen their posts on LinkedIn, heard their voice on a podcast, or watched their videos on YouTube.

They’re the coding and health information (HI) gurus leveraging social media to provide coding education, build brand awareness, or expand their professional networks. Here are four of them to know …

HFMA, June 2023

Health vs. care (Healthcare 2030 series)

By Lisa A. Eramo, MA, freelance healthcare writer

Laura Kaiser is on a mission to help people live healthy lives. As president and CEO of SSM Health, Kaiser is moving the St. Louis-based Catholic health system toward an approach that promotes health instead of healthcare, and prevention instead of treatment. …

Medical Economics, June 2023

Ace potential Medicare audits of advance care planning in 2023 with these tips

By Lisa A. Eramo, MA, freelance healthcare writer

Family physician Karen Smith, M.D., says end-of-life conversations are among the most important ones she has with patients. They’re also among the most emotionally charged. Whom would you want to make medical decisions on your behalf if you can’t? What would you want that person to do? What else would you want your loved ones to know? Collectively, this back-and-forth dialogue about advance directives is what’s known as advance care planning (ACP), a Medicare-billable service that pays approximately $85 for the first 30 minutes and $74 for every 30 minutes thereafter. …

Journal of AHIMA, June 2023

Stamp out payer denials

By Lisa A. Eramo, MA, freelance healthcare writer

Nick van Terheyden, M.D., was very familiar with claim denials and rejections.
As a former emergency department physician from the U.K., he knew payers frequently withheld or reduced payments. However, it wasn’t until his own insurance company, Cigna, denied his personal medical claim for a vitamin D test that he decided to explore the issue more deeply. …

Journal of AHIMA, May 2023

How health information management professionals can help their organization leverage SDOH data

By Lisa A. Eramo, MA, freelance healthcare writer

Nearly eight in 10 healthcare organizations currently collect social determinants of health (SDOH) data. However, challenges persist in leveraging this data to improve outcomes, a recent AHIMA survey found.

The Cleveland, OH-based MetroHealth Population Health Innovation Institute created the Institute of H.O.P.E. to address SDOH using evidence-based strategies. The acronym H.O.P.E. stands for Health, Opportunity, Partnership, and Empowerment as the institute’s goal is to help people live their healthiest lives.

The institute partners with numerous community-based organizations (CBOs), hospital associations, and healthcare systems to help patients get the services they need. AHIMA spoke with Susan M. Fuehrer, MBA, president of the Institute for H.O.P.E. about how her organization collects and uses SDOH data to benefit patients. …

Medical Economics, April 2023

Providing culturally competent care

By Lisa A. Eramo, MA, freelance healthcare writer

Ashley Bose, M.D., a family physician in Edinburg, Texas, has lived in the Rio Grande Valley nearly her entire life. She says cultural immersion helps her better understand and address the unique health needs of Spanish-speaking patients, who make up about 93% of her patient population. For example, Bose knows that mental health carries a big stigma in many cultures. Sometimes even saying the word “depression” can be taboo. Spanish-speaking patients may instead focus on their physical symptoms, in which case Bose mirrors that language to make them feel more comfortable. “It’s a big issue in Hispanic cultures and certain Asian cultures as well,” she says. “Mental health doesn’t exist. It’s the whole concept of, ‘Keep going and you’ll be fine.’” …

HFMA, April 2023

Hospital operational changes underway as health equity becomes one of The Joint Commission’s National Patient Safety goals

By Lisa A. Eramo, MA, freelance healthcare writer

Reducing healthcare disparities became a Joint Commission accreditation standard (LD.04.03.08) on Jan. 1, a little more than a year after the organization issued a Sentinel Event Alert warning of impacts on patient safety. However, on July 1, the standard will become a National Patient Safety Goal (NPSG), which experts say points to one thing: Healthcare organizations must have a plan in place to promote health equity. …

For The Record Magazine, February 2023

Race in CDS tools

By Lisa A. Eramo, MA, freelance healthcare writer

Health care organizations have collected data about race for decades—since the dawn of EHRs and even before that. However, what do organizations do with that data? More specifically, should they use it for clinical decision support (CDS) to address health care disparities? Experts agree that the answer is anything but straightforward, and in some cases, data about race can actually exacerbate disparities rather than help solve them. …

HFM Magazine, February 2023

How community partnerships can play a central role in reducing cost of care and improving health outcomes

By Lisa A. Eramo, MA, freelance healthcare writer

As average rent for a one-bedroom apartment in Chicago soared to nearly $2,000 a month, Illinois-based Cook County Health saw another unfortunate upward trend in housing insecurity and homelessness. That’s when the health system decided to partner with the Center for Housing and Health. The goal? To reduce healthcare costs and improve individual healthcare outcomes by connecting people to stable housing and supportive services. …

Medical Economics, February 2023

Are you leaving money on the table? The answer is probably ‘yes.’

By Lisa A. Eramo, MA, freelance healthcare writer

These days, physicians are terrified about overcoding — that is, billing for services they did not render or for more labor-intensive services than they provided. This is not surprising considering the rise in payer audits, fines and recoupments.

However, a recent study published in the Annals of Internal Medicine found that primary care physicians may forgo considerable revenue — $210,000 annually — because they do not bill for preventive and coordination services even despite providing appropriate services to eligible Medicare patients. Experts say physicians may also leave money on the table when they underestimate medical decision-making (MDM) that affects evaluation and management (E/M) levels, or they fail to leverage code specificity that affects payment. …

Medical Economics, December 2022

Seven ways to ease patient collections in your medical practice

By Lisa A. Eramo, MA, freelance healthcare writer

Collecting money from patients is an ongoing challenge that has only worsened with high-deductible health plans. Traditionally, physicians have accepted this challenge as the status quo, instead choosing to overlook unpaid balances and provide the care that patients need. However, experts say the COVID-19 pandemic has prompted them to rethink this strategy and take a more proactive, business-savvy approach. …

Medical Economics, November 2022

How physician documentation can combat the opioid crisis

By Lisa A. Eramo, MA, freelance healthcare writer

More than 10 million people misuse opioids every year, according to the National Center for Drug Abuse Statistics. Overdose deaths involving opioids increased 519.38% from 1999 to 2019. These and similarly alarming statistics are why the U.S. Department of Health and Human Services (HHS) officially declared the opioid crisis a public health emergency in 2017.

More recently, HHS announced it will provide nearly $1.5 billion to states and territories to help address the opioid epidemic. The grant funding opportunity will be available through the Substance Abuse and Mental Health Services Administration (SAMHSA). Meanwhile, the Centers for Disease Control and Prevention (CDC) has finalized voluntary guidelines in November on when to initiate opioid prescribing, selection and dosage, duration and follow-up, and assessing risks and addressing harm.

It’s all part of an effort to support physicians in the quest to help patients struggling with opioid use disorder. At the heart of these efforts? Coded data. …

HFM Magazine, September 2022

Revenue cycle automation helps health systems regain financial footing during COVID-19 and beyond

By Lisa A. Eramo, MA, freelance healthcare writer

Healthcare organizations are learning to embrace revenue cycle automation in order to better navigate staffing challenges and try to reduce administrative costs.

“There’s a clear case for why you should be automating,” said Jamie Davis, executive director of revenue cycle management at Banner Health in Phoenix, Arizona. “The more you react to change with human resources, the more you’re going to be hamstrung when you experience volatility in your volume and other disruptions.” …

Medical Economics, July 2022

The 2022 coding guide

By Lisa A. Eramo, MA, freelance healthcare writer

Despite your best efforts to follow billing guidelines, payers still deny your claims.
Or in some cases, they pay you and then take the money back. Experts say you can’t ever eliminate denials and post-payment recoupments entirely, but you can reduce them by focusing on coding and documentation compliance. Listed below are eight of the most common reasons for denials and how to avoid them. …

Medical Economics, June 2022

How to avoid medical necessity denials

By Lisa A. Eramo, MA, freelance healthcare writer

Medical necessity denials are a source of frustration for many practices nationwide. “It feels like the game of whack-a-mole,” says Holly Ridge, B.S.N., RN, CPC, CPMA, manager of medical necessity and authorization denials at Duke University Health System in North Carolina. “We have an increase in denials in one service, determine the root cause, improve our processes and [then] appeal — and then something else comes up.” …

Medical Economics, June 2022

Cybersecurity: How medical practices can protect patient data from hackers

By Lisa A. Eramo, MA, freelance healthcare writer

Picture this: You come into the office and all your electronic patient files are encrypted. When you try to access them, this is what you see: “You can’t access information unless you pay a ransom.” If you’re lucky, it might only be a few thousand dollars. Experts say “bad actors” have been known to demand hundreds of thousands of dollars or more. Without a system backup, you could face significant operational disruptions. …

Medical Economics, March 2022

New principal care management codes: What physicians need to know

By Lisa A. Eramo, MA, freelance healthcare writer

Effective in 2022, Medicare began accepting four new current procedural terminology (CPT) codes for principal care management (PCM) and discontinued two Healthcare Common Procedure Coding System G codes. Experts say the new codes, which are paid at a higher rate than the G codes, afford physicians the opportunity to improve outcomes while simultaneously generating additional revenue. …

HFM Magazine, March 2022

Revenue cycle staff shortages push leaders to adapt quickly

By Lisa A. Eramo, MA, freelance healthcare writer

Spectrum Health, based in Grand Rapids, Michigan, is finding that it’s taking longer to fill all revenue cycle management (RCM) positions.

“We’re not getting the volume of candidates we used to, either because of the ‘Great Resignation’ or because there are a lot of other options” for job candidates, said Amy N. Assenmacher, FHFMA, MSN, MBA, Spectrum’s senior vice president of revenue cycle. “There are so many virtual positions out there. You have a lot more choices now than you did before the pandemic hit.” …

For The Record Magazine, February 2022

Hit a CDI roadblock? Maybe your success metrics need a tune-up

By Lisa A. Eramo, MA, freelance healthcare writer

Consider this scenario: On paper, a hospital’s clinical documentation improvement (CDI) program looks fantastic. CDI specialists review dozens of charts every day and send countless queries to which physicians respond in a timely manner. The only problem? The hospital’s volume of denials and recoupments continues to skyrocket.

Such a scenario begs the question, “How does a hospital with a successful CDI program actually lose money?” …

Medical Economics, January 2022

How virtual scribes can reduce EHR headaches

By Lisa A. Eramo, MA, freelance healthcare writer

Ellen Hight, M.D., a family medicine physician in East Greenwich, Rhode Island, says the electronic health record (EHR) completely changed her practice, and not necessarily in a good way. “When our practice started using an EHR, I began to feel a distance between myself and my patients because I was constantly staring at the computer,” she says. Her work-life balance also took a hit as she began to spend Saturday mornings finishing her notes from the previous week.

When the Rhode Island Primary Care Physicians Corporation (RIPCPC), an independent practice association to which her practice belongs, approached her about piloting a virtual scribe program — and said it would pay for the first two months of participation — she jumped at the opportunity. “When I heard about virtual scribes, I thought, ‘Well that’s a good idea,’ ” she recalls. …

HFM Magazine, November 2021

The future of consumer expectations (Healthcare 2030, part 3 of 4)

By Lisa A. Eramo, MA, freelance healthcare writer

Treating a simple sore throat doesn’t have to be the complicated affair it often is, and in the future it won’t be.

Traditionally, the patient takes on most of the work, searching for an open slot at a primary care clinic, getting there on time and then waiting after filling out a repetitive and lengthy intake form, all the time holding out hope that the provider is in-network.

But in the future, managing healthcare may be more like shopping on Amazon, or it literally will be shopping on Amazon, depending on how things play out. …

Medical Economics, August 2021

Get paid what you’re owed

By Lisa A. Eramo, MA, freelance healthcare writer

The reimbursement side of medicine is filled with the potential for denials on every claim you submit. Each payer has its own policy, and rules change frequently. Then, of course, there are post-payment audits. Just when you think you are in the clear, a payer decides to recoup that money. It all depends on the codes you assign and whether your documentation supports them …

For The Record Magazine, July 2021

How to build an in-house coding department

By Lisa A. Eramo, MA, freelance healthcare writer

When patient volumes decreased temporarily during the COVID-19 pandemic, coders at Georgia Cancer Specialists in Atlanta forged ahead with whatever noncoding tasks could be done. They ran reports, pulled data, and educated providers as needed. Leonta Williams, MBA, RHIA, CCDS, CCS, CPC, CHONC, CEMC, CPCO, CRC, director of medical coding operations, attributes her team’s flexibility to two factors: an in-house coding team that’s in place and Williams’ willingness to hire and train credentialed coders with minimal coding experience.

“Everyone wants experienced coders, but there are so many benefits to developing your own coders,” Williams says. “When crisis hits, the person who is less experienced but willing to do other things is incredibly beneficial.” …

HFM Magazine, June 2021

CFO of the future: The new and improved healthcare finance leader of tomorrow (Healthcare 2030: Part 1 of 4)

By Lisa A. Eramo, MA, freelance healthcare writer

There’s a sign next to Bashar Naser’s computer monitor that says, “Dream Big,” and this is exactly what he has done during the past seven years as CFO and COO of Gerald Champion Regional Medical Center (GCRMC) in Alamogordo, New Mexico. The once-struggling stand-alone rural hospital now boasts more than $200 million in net revenue as Naser continues to identify and pursue innovative strategies to increase profits in a community that has had a static population …

Kareo, April 2021

Improving the patient experience: Five things every patient wishes their physician knew

By Lisa A. Eramo, MA, freelance healthcare writer

Although the number of COVID-19 cases has lessened in recent months since the start of 2021, the pandemic continues to be on the minds of healthcare providers across the nation. As a result, it’s easy for a provider to lose sight of one simple truth: the quality of the patient experience can make or break a practice, says Stacy Hurt, patient experience consultant and accomplished healthcare executive.

“If there’s one thing that COVID-19 has shown us, it’s that anyone can become a patient overnight,” says Hurt. “Practices really need to differentiate themselves and leave a lasting impression.” …

HFM Magazine, November 2020

5 tips to safeguard 20% payment increase for treating patients with COVID-19

By Lisa A. Eramo, MA, freelance healthcare writer

Medicare, commercial payers and the Office of Inspector General (OIG) are starting to audit COVID-19 cases to make sure payments reflecting a 20% increase for inpatients were warranted. If they weren’t, hospitals could face significant recoupments during a time when many are struggling to rebuild …

Medical Economics, October 2020

E/M changes take effect January 1, 2021

By Lisa A. Eramo, MA, freelance healthcare writer

Good news for physicians tired of counting bullet points to assign an evaluation and management (E/M) level for an outpatient office visit: Per new AMA guidelines, it’s going to be a whole lot simpler. As of January 1, 2021, physicians will select an E/M code based on total time spent on the date of the encounter or medical decision making (MDM)—whichever is most financially advantageous …

For The Record Magazine, October 2020

HIM Homebodies — Ignited by COVID-19, More Operations Go Remote

By Lisa A. Eramo, MA, freelance healthcare writer

When COVID-19 hit, Joe Naretto, MHA, RHIA, senior director of HIM at Novant Health in Charlotte, North Carolina, was faced with the task of transitioning 80 full-time employees anchored onsite at various corporate locations across the state to remote work arrangements.

“Our direction from leadership was: ‘Stay-at-home orders or not, we’ve got to get as many people home as quickly as possible,’” Naretto says. “In a week, it went from ‘let’s think about it’ to ‘we’ve got to make this happen.’” …

Medical Economics, September 2020

Digitize admin tasks to reduce staff burdens

By Lisa A. Eramo, MA, freelance healthcare writer

Physicians enter the medical profession because they want to take care of patients, not focus on administrative tasks. Yet these tasks continue to dominate their time and attention, leading to frustration and burnout. Administrative tasks also overwhelm staff, fueling job dissatisfaction and turnover …

HFM Magazine, August 2020

8 security tips for remote revenue cycle staff

By Lisa A. Eramo, MA, freelance healthcare writer

Poorly secured home networks. Highly accessible workstations. Use of personal laptops that don’t adhere to security standards. Each of these (and more) is a vulnerability for revenue cycle staff working at home during COVID-19. Unfortunately, with vulnerability comes opportunity for hackers to target this newly remote workforce and access protected health information (PHI) …

Kareo’s Go Practice blog, July 2020

Six lessons practices learned to boost patient satisfaction in a COVID-19 era

By Lisa A. Eramo, MA, freelance healthcare writer

How can practices engage patients to improve their health? It’s a question practice managers and clinicians ask daily, and it’s one that continues to surface during COVID-19. Patients may be afraid to come in for in-person appointments because they do not want to expose themselves to the virus. Others may delay or forgo care due to financial difficulties. Consider these six lessons learned during the pandemic that practices can apply going forward to improve the way in which they engage with patients—all with the ultimate goal of keeping individuals safe and healthy …

HFM Magazine, July 2020

Implement these six safeguards against fraud accusations in telehealth

By Lisa A. Eramo, MA, freelance healthcare writer

During times of social distancing, telehealth has been essential for continuity of care. However, in the rush to implement the technology, providers may have overlooked one important detail: If they don’t follow coding, documentation and other requirements, they could be at risk for a post-payment recoupment or even payer accusations of fraud in the months ahead …

For The Record Magazine, July 2020

Patient-generated health data under the microscope

By Lisa A. Eramo, MA, freelance healthcare writer

It’s a question on every physician’s mind: What actually happens outside of the exam room? Do patients follow treatment recommendations? Are they getting enough exercise? What are their daily glucose levels? What about their daily blood pressure readings?

All of this (and more) is patient-generated health data (PGHD), information that could potentially improve patient outcomes while also helping providers take advantage of new reimbursement models focused on episodic care …

Medical Economics, July 2020

Strategies to rebuild patient volumes in the wake of COVID-19

By Lisa A. Eramo, MA, freelance healthcare writer

Like many physicians nationwide, Kansas-based primary care physician Jennifer Bacani McKenney saw a dramatic drop in patient volume when COVID-19 hit. A few weeks into the pandemic, McKenney knew she had to take action to keep the practice afloat.

“We decided to go back six months in our schedule to see if there were people we would normally see for regular visits like a monthly weight-loss check or a three-month diabetic check,” she says. “We called them and scheduled appointments either in the clinic, in the parking lot, through telehealth or by phone.”

Soon after, they began calling patients from lists their Accountable Care Organization sends throughout the year, including patients due for well visits and patients with chronic medical conditions who hadn’t yet been seen this calendar year. McKenney’s hope was to get them back on track for visits and let them know it was safe to come in.

Although patient volumes started to increase in early May when Kansas reopened its economy, McKenney says volumes are still down 50% …

RxVantage, July 2020

5 tips to help patients with medication adherence during COVID-19

By Lisa A. Eramo, MA, freelance healthcare writer

As of June 2020, more than 14 million Americans are unemployed due to COVID-19. With this devastation comes a myriad of challenges, including for many a loss of health insurance. Coupled with financial insecurity and increased anxiety, people are forced to make difficult choices. Paying for medication may, unfortunately, fall behind other necessities for some patients. …

Medical Economics, June 2020

Tap the power of patient stories to augment clinical care

By Lisa A. Eramo, MA, freelance healthcare writer

When Boston-based internist Annie Brewster was diagnosed with multiple sclerosis (MS) in 2001, she was in denial. “Coming to terms with a diagnosis takes a long time,” she says. “For me, it took five years.”

Initially, she wasn’t ready to attend a support group, but she did want to read about other patients with MS. “I didn’t want to hear media sound bites,” she says. “I wanted true stories with the full arc – stories of how people are moving forward despite the hardships that are put in front of them.” …

Anthem BCBS, June 2020

How team-based care supports value-based reimbursement

By Lisa A. Eramo, MA, freelance healthcare writer

Team-based care isn’t a new concept — providers have always collaborated to achieve the best outcomes for their patients. However, the lower costs and improved outcomes associated with outcome-based models are driving this teamwork to new levels of popularity.

Provider teamwork is becoming more formalized through shared care plans that team members develop together to address each patient’s unique goals, needs, preferences and challenges. The concept of this “team” is also expanding beyond health care providers to include community organizations and employers, among others …

Anthem BCBS, June 2020

How geography and health affect outcomes and access to care

By Lisa A. Eramo, MA, freelance healthcare writer

It may seem like a weak association, but your ZIP code is actually a pretty good predictor of your health status. In other words, geography and health go hand-in-hand: Where you live and work dictates the air you breathe, the food you eat, the viruses to which you’re exposed and, to some degree, the health care services you’re able to access …

Kareo’s Go Practice blog, May 2020

Patient collections 2.0: A novel approach during COVID-19 and beyond

By Lisa A. Eramo, MA, freelance healthcare writer

Collecting copayments and co-insurance amounts has always been a challenge, and during COVID-19, some would say it has become nearly impossible. Patients are not coming to the office as frequently, so there are fewer opportunities to collect unpaid balances. Telehealth also adds a layer of complexity. When patients owe a copayment or co-insurance, they must often pay it after the service has been rendered, making up-front collections difficult to say the least.

If practices want to keep their doors open, they need to rethink their collection strategy, and there is no time like the present to do so, says Tammy Tipton, owner of Appeal Solutions, Inc. in Oklahoma City, Oklahoma. …

Medscape, April 2020

COVID-19: New programs can provide money to keep your practice running

By Lisa A. Eramo, MA, freelance healthcare writer

Family physician Frank Maselli, MD, saw approximately 30 patients a day in his office in the Bronx before COVID-19. But New York City has become a hot spot for the virus that has claimed the lives of the lives of more than 40,000 people nationwide.

Now Maselli and the other 10 physicians in the practice each treat only eight or nine patients a day via telemedicine. He spends most of his time on the phone answering patients’ questions about COVID-19 symptoms and potential exposure. Although he tries to bill for telemedicine and phone calls, he says many commercial payers reject the claims because their processing systems aren’t updated to reflect new coverage policies. He has enough cash in reserve to cover two payrolls, but he knows he needs a backup plan if patient volumes continue to decrease indefinitely …

Anthem BCBS, April 2020

Employment and health outcomes: What’s the connection?

By Lisa A. Eramo, MA, freelance healthcare writer

Americans spend about half of their waking hours at work, so it’s no surprise that your workplace affects your health. Of course, there are other social determinants of health — economic stability, education, neighborhood, education, access to health care and health literacy all play a role.

But given the time employees dedicate to work, there’s a particularly strong link between employment and health. Employers provide and maintain the physical environment in which their staffs spend their days. Here’s how to cultivate a safe and healthy environment that improves outcomes, reduces injuries and ultimately lowers costs …

For The Record Magazine, April 2020

Big companies cast large shadow in health care

By Lisa A. Eramo, MA, freelance healthcare writer

The speech recognition industry has a new player, and it’s an unlikely one: Amazon. In December 2019, Amazon Web Services (AWS)—a subsidiary of Amazon that provides on-demand cloud computing platforms and application programming interfaces—launched Amazon Transcribe Medical, a machine learning–powered speech recognition service that automatically converts speech to text.

Artificial intelligence–driven speech recognition certainly isn’t a novel concept. However, experts agree it’s too soon to tell exactly where the technology is headed next …

Journal of AHIMA, April 2020

New eyes on HIM

By Lisa A. Eramo, MA, freelance healthcare writer

It isn’t always easy to say goodbye, and for skilled nursing facilities (SNFs), parting with therapy minutes as the primary driver of payment has been easier for some facilities than others. Prior to October 1, 2019, SNFs received a per-diem payment rate along with additional reimbursement based on the number of therapy minutes and/or nursing services provided to each patient. However, under the new patient-driven payment model (PDPM), ICD-10-CM diagnosis codes take center stage, driving everything from admission to care planning to payment. This radical departure from how SNFs were paid previously is why many owners and operators are starting to lean on health information management (HIM) professionals for guidance …

Anthem BCBS, March 2020

Addressing social and community context to improve health outcomes

By Lisa A. Eramo, MA, freelance healthcare writer

For our health and well-being, where we live geographically is just as important as our social and community context — that is, the social circles in which we interact and the relationships we form with family, friends and beyond. This context is one of several social determinants that affect our health risks and outcomes, and it’s one that employers can influence for the better …

For The Record, March 2020

The untold MPI story: How ‘dirty data’ affect a value-based revenue cycle

By Lisa A. Eramo, MA, freelance healthcare writer

When most of us think about master patient index (MPI) errors, our minds immediately go to the worst-case scenarios: A patient prescribed a medication to which they’re allergic experiences a negative outcome. A patient undergoes the wrong procedure. There are delays in a patient’s cancer diagnosis and treatment all because of a duplicate record or overlay.

In fact, the ECRI Institute identified diagnostic errors and the improper management of test results in the EHR as the top patient safety challenge in 2019. It isn’t a stretch to assume these errors and data mismanagement are largely due to an inability to match records accurately.

But experts say negative patient safety–related outcomes don’t tell the entire story of what can happen when MPI errors occur. In fact, there are other important implications that actually affect an organization’s bottom line and perhaps its ability to remain profitable …

Journal of AHIMA, January 2020

Getting to know the many sides of HIM

By Lisa A. Eramo, MA, freelance healthcare writer

Regardless of whether they’re with a hospital, physician practice, health IT vendor, governmental agency, consulting company, or payer, there is no shortage of job opportunities in health information management (HIM). In fact, few professions offer this level of diversity and job security. Becoming pigeonholed is no longer a reality as the need for data stewards persists throughout the industry. Shannan Swafford, DHA, MBA, RHIT, CHDA, CCS, knows this firsthand. An HIM professional who gained an early appreciation for the power of coded data, Swafford has since applied her knowledge in a variety of settings throughout her career …

Medical Economics, December 2019

Behavioral health: How to generate revenue, improve patient care

By Lisa A. Eramo, MA, freelance healthcare writer

Physicians understand the connection between mental and physical health, yet many don’t feel equipped to address patients’ behavioral health problems. They also don’t have the time, says Bonnie T. Jortberg, Ph.D., RD, associate professor of the department of family medicine at the University of Colorado School of Medicine. “Severe depression and anxiety isn’t something you can address effectively during a 15-minute visit,” she adds …

Journal of AHIMA, October 2019

Close doesn’t count: Patient matching challenges in HIEs

By Lisa A. Eramo, MA, freelance healthcare writer

The more we know about patients, the easier it is to match them. Or at least that’s the theory. Clinical data, patient-generated data, biometrics, social determinants of health: all of this should make patient matching in health information exchanges (HIE) a breeze, right?

Not exactly.

“As the volume of data grows, the matching burden grows as well,” says Shaun Grannis, MD, MS, FAAFP, director of the Center for Biomedical Informatics at the Regenstrief Institute, a collaborative research and learning organization that develops and evaluates innovative solutions for improving patient care. HIEs are caught in the crossfire, trying to make sense of the data and ultimately provide accurate information to its participating providers, according to Grannis …

For The Record Magazine, September 2019

Eight ROI missteps to avoid

By Lisa A. Eramo, MA, freelance healthcare writer

The story is the same—only the characters change. Someone wants a copy of a medical record, and they want it as soon as possible. That “someone” could be a patient using the information to improve their health, a payer using it to measure quality, an attorney using it to support an argument for litigation, or a whole host of other entities using it to glean insights or even drive profits.

As HIPAA regulations continue to evolve, the release of information (ROI) process is more complex than ever before. ROI staff must retrieve records from multiple systems within specified timeframes all while keeping track of what information they disclose and to whom they disclose it …

Medical Economics, September 2019

Coding for revenue

By Lisa A. Eramo, MA, freelance healthcare writer

Physicians work hard to generate revenue, and with slim operating margins, they don’t want to contend with costly recoupments. Compliant coding and billing helps them avoid the focus of a pre- or post-payment audit. This article discusses four services that physicians say pose payment challenges along with general tips for coding compliance …

Go Practice blog (Kareo), September 2019

Addressing physician burnout one step at a time

By Lisa A. Eramo, MA, freelance healthcare writer

While most American workers are thinking about relaxing this upcoming Labor Day weekend – the sad truth is many physicians of small independent practices will not have that luxury. Instead, they will continue thinking about what they always think about – reducing medical costs, improving patient outcomes, reporting quality metrics, documenting notes in the EHR for proper billing…and more. It’s a tall order for any physician, and it’s why physician burnout has reached epidemic proportions with some experts even dubbing the problem a public health crisis …

Anthem BCBS, August 2019

How employers can address poverty to improve health outcomes

By Lisa A. Eramo, MA, freelance healthcare writer

It’s a striking statistic: According to the United States Census Bureau, nearly 40 million U.S. residents live in poverty. Defined by the Centers for Disease Control and Prevention as a condition in which “a person or group of people lack human needs because they cannot afford them,” poverty is one of many social determinants linked to adverse functioning and poor quality of life, leading to negative health outcomes.

When employers take proactive steps to address poverty and health, they not only improve employee satisfaction and retention, but they also enhance health outcomes, in turn reducing costly turnover and absenteeism …

Medical Economics, July 2019

Boost revenue by getting coding right

By Lisa A. Eramo, MA, freelance healthcare writer

It’s every physician’s worst nightmare: Receive payment for services rendered, but then a payer identifies an aberrant pattern in claims data, audits the records, decides it has overpaid the practice, and recoups those funds. That money you already allocated for overhead, staff salaries, bonuses, or new medical equipment? Gone. With one post-payment audit, you now owe thousands of dollars or more. The good news is, physicians can take steps to focus on accurate billing and avoid costly recoupments. This article explores five billing vulnerabilities and provides tips to maintain compliance …

Journal of AHIMA, July 2019

Revolutionary payment changes prompt skilled nursing facilities to eye CDI programs

By Lisa A. Eramo, MA, freelance healthcare writer

While clinical documentation hasn’t exactly been a strength in many of today’s financially strapped skilled nursing facilities, this may soon change as SNFs shift to a new payment methodology–the Patient-Driven Payment Model (PDPM)–in which these facilities are paid based primarily on each patient’s unique medical complexity …

Medical Economics, June 2019

How to build a practice for younger patients: Millennial and Generation Z patients demand convenience and quicker access, experts say

By Lisa A. Eramo, MA, freelance healthcare writer

Millennials (born 1981 to 1996) and Generation Zers (born 1997 to 2012) represent 7 percent of patients in the practice of James Legan, MD, and they also tend to come in for an appointment only once every couple of years. However, this hasn’t deterred the Montana-based internist from devising a strategy to attract and retain these individuals that he hopes will, over time, comprise more of his patient base …

Medical Economics, May 2019

Level of care coding tips to boost revenue, mitigate risk

By Lisa A. Eramo, freelance healthcare writer

The clock is ticking, and you’re trying to select the right E/M level from a drop-down menu in the EHR. Choose a level that’s too high, and you run the risk of post-payment audits and recoupments. Choose one that’s too low, and you may lose revenue to which you’re entitled. You decide just to trust your instincts and go with a code that feels right so you can move on to the next patient.

Choosing an E/M code based on a gut feeling is one of the biggest mistakes a physician can make, says Sonal Patel, CPMA, CPC, a healthcare coder and compliance consultant with Nexsen Pruet LLC, a business law firm in Charleston, S.C. Payers and auditors use a quantitative scoring process that requires specific elements (i.e., history, exam, and medical decision-making [MDM]—or time spent counseling and coordinating care) for each E/M level …

Journal of AHIMA, May 2019

Investing in apprentices pays dividends for employers

By Lisa A. Eramo, freelance healthcare writer

When Mary B. Parks, JD, RHIA, CCS, director of health information at St. Joseph’s/Candler in Savannah, GA was charged with replacing inpatient contract coders with in-house staff, she did what most directors do. She dove into a candidate search in the hope of finding coders with that coveted combination of credentials and experience. When the search didn’t yield results, she contemplated hiring individuals without coding experience and training them herself. However, she knew she probably didn’t have the time, and she didn’t want to put minimally-trained staff into a production environment that could cause compliance risk.

“That’s when I saw that the AHIMA Foundation had an apprenticeship program, and it caught my eye,” Parks says …

HFM Magazine, April 2019

Engaging physicians in value-based compensation models

By Lisa A. Eramo, freelance healthcare writer

As the number of value-based programs in which the University of Maryland St. Joseph Medical Center participated grew, hospital leaders knew they needed to revamp their physician compensation model to incentivize physician cooperation. A purely work relative value unit (RVU) model no longer seemed fair, considering physicians spent more and more of their time on documentation required for quality metrics …

Medical Economics, April 2019

How to integrate health apps at the point of care

By Lisa A. Eramo, freelance healthcare writer

They track caloric intake, sleep, and daily steps. They educate patients about their conditions and medications. They coach patients to self-manage their anxiety, depression, diabetes, and pain … and so much more. We’re talking about the thousands of consumer health apps available on app stores today.

Experts agree that these apps foster consumer empowerment that may even translate to better outcomes and lower costs, both of which can help physicians gain points under the Merit-based Incentive Payment System (MIPS). Some apps—those that capture physiologic data—may also help physicians generate revenue for reviewing the data that’s captured …

HFMA’s Leadership Forum, January 2019

Streamlining efficiency to improve care quality

By Lisa A. Eramo, freelance healthcare writer

Leaders at UT Physicians, the clinical practice at McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), knew they needed a strategy to ensure operational efficiency and consistency across all care locations. The ultimate goal? To increase the quality of care for the 1,800 patients served by the practice’s 103 clinics.

The idea was that by gaining administrative efficiencies, providers could focus more directly on rendering high-quality care. In addition to improving the patient experience, such care would boost payment under eight different value-based payment programs in which the practice participated …

Medical Economics, November 2018

6 tips for getting paid to administer vaccines to Medicare patients

By Lisa A. Eramo, freelance healthcare writer

Vaccines are a high-volume service in most primary care practices, but are physicians capturing all of the Medicare revenue they’re entitled to?

Not always, says Yvonne Dailey, CPC, CPC-I, CEO of Dailey Billing Services Inc. in Toms River, N.J. Physicians often don’t report the correct codes, or they forget to report certain codes. During peak flu and pneumonia season, these mistakes can definitely add up, she adds. Dailey provides five tips to help practices bill Medicare Part B correctly …

Go Practice blog (Kareo), November 2018

4 ways to embrace healthcare consumerism

By Lisa A. Eramo, freelance healthcare writer

“24/7 access, improved productivity, and fewer human errors are three examples of how technology has completely disrupted major industries,” said Brent Bowman, vice president of strategy and expansion markets at Kaiser Foundation Health Plan in Denver, Colorado. Unfortunately, healthcare isn’t one of them, he added. “We are striking out at meeting consumers’ needs,” said Bowman, who spoke at Medical Group Management Association’s (MGMA) annual conference, held in Boston Sept 30 – Oct 3 about how providers can become more consumer-centric …

Go Practice blog (Kareo), October 2018

Using data analytics and the EHR to improve population health

By Lisa A. Eramo, freelance healthcare writer

Managing population health is impossible without two things: good data and good analytics. Novant Health has both of these. As a result, the not-for-profit, integrated system that spans communities in the Carolinas, Virginia, and Georgia is making significant strides in an era of value-based payments and population health management.

Keith Griffin, MD, chief medical information officer, and Ryan Neaves, MHA, director of IT applications, shared their data-driven strategy at Medical Group Management Association’s (MGMA) annual conference held in Boston Sept. 30-Oct 3. In particular, they provided these five tips …

For The Record Magazine, October 2018

A targeted approach to EHR training improves success rates

By Lisa A. Eramo, freelance healthcare writer

Imagine a physician walking into an exam room where a volunteer patient awaits while an EHR trainer silently watches them navigate the entire visit using a new record-keeping system. This hands-on simulated learning environment is exactly what more than 1,850 clinical providers at MD Anderson Cancer Center in Houston experienced as the organization transitioned from a best-of-breed EHR to an integrated system in March 2016 …

For The Record, August 2018

Choose your words carefully

By Lisa A. Eramo, freelance healthcare writer

Words matter. It’s not only what you write but also how you write it that affects others. Words shape our perception of reality. They stir emotions both good and bad, and they invite action as well as inaction. This is true in a variety of settings, and health care is certainly no exception. In fact, a recent study conducted by researchers at Johns Hopkins University School of Medicine found that the words providers document in patients’ medical records affect how other clinicians perceive and ultimately care for those patients—and not necessarily for the better …

Go Practice blog (Kareo), June 2018

5 steps to ensure revenue integrity after implementing a new EHR

By Lisa A. Eramo, freelance healthcare writer

In the rush to implement EHRs for Meaningful Use incentives, many practices lost sight of what matters most for continued success—revenue integrity, says Joette Derricks, healthcare compliance and revenue integrity consultant in Baltimore, MD. Revenue integrity—the idea that practices must take proactive steps to capture and retain revenue—isn’t a novel concept. However, it’s becoming increasingly important for physician practices operating in a regulatory-driven environment, she adds …

Journal of AHIMA, May 2018

Leading HIM reimagined by example

By Lisa A. Eramo, freelance healthcare writer

TECHNOLOGY HAS TRANSFORMED almost every industry, and health information management (HIM) is no exception. Data used to be handwritten words on a page. Now, with the rise of electronic health records (EHR), data is becoming an organization’s most important financial asset. Human coders used to comb through medical records to assign codes. Now, computer-assisted coding is increasingly assuming that role, while coding professionals begin to serve as code auditors and validators. Underlying these changes is a growing risk of cybercrime that magnifies the need for data integrity, privacy, and security—all tenets of HIM’s expertise. Some HIM professionals have been able to expand their skillsets to keep up with these changes, while others have struggled to stay relevant. Experts agree that the industry must address the widening skills gap that could render some professionals unable to move into new and emerging HIM roles as older traditional HIM jobs eventually fade away …

Futurehealthindex.com, April 2018

Three ways asthma treatment is getting connected

By Lisa A. Eramo, freelance healthcare writer

We have grown accustomed to smartphones, smartwatches and a variety of other intelligent technology that collects and analyzes all kinds of data to help us understand how we interact with the world around us. Now there are smart healthcare devices, too. But these innovations aren’t mere gimmicks – they’re having a real impact on the way medical conditions can be treated and managed. Take asthma, for example, where smart technologies are helping those with the illness live healthier and more satisfying lives …

Go Practice blog (Kareo), April 2018

Combatting the opioid epidemic with improved documentation

By Lisa A. Eramo, freelance healthcare writer

On average, 115 Americans die every day from an opioid overdose. Since 1999, deaths from prescription opioids such as oxycodone, hydrocodone, and methadone have more than quadrupled.

Coded data is what drives these and many other statistics that help healthcare providers, researchers, and others understand the opioid epidemic and how to address it, says Jaci Kipreos, CPC, CPMA, CPC-H, CPC-I, president of Practice Integrity, LLC. “The easiest way to obtain global information is through claims and coded data,” she says. “That’s what codes have always been about—a way to capture information very easily. So, the emphasis becomes coding it correctly.” …

Medical Economics, March 2018

Psychiatric collaborative care management may improve outcomes, boost revenue

By Lisa A. Eramo, freelance healthcare writer

Although Kristine McVea, MD is an internist at OneWorld Community Health Centers Inc. in Omaha, Neb., she’s also often a “surrogate psychiatrist,” titrating and prescribing psychiatric medications for patients with anxiety, depression, and other mental health problems daily. These patients need access to psychiatric services. However, it’s not uncommon for them to wait months or longer to see a psychiatrist. 

The good news is that, as of Jan. 1, 2018, financial incentives exist for physicians and psychiatrists to collaborate when caring for patients with behavioral health disorders. In its 2018 Medicare Physician Fee Schedule, CMS created a new Psychiatric Collaborative Care Model that enables physicians to generate revenue when they co-manage patients with a psychiatrist or some other professionals trained in behavioral health and provide ongoing care management support …

Journal of AHIMA, November 2017

Health IT time out: Where is the U.S. healthcare system on interoperability and a quality strategy?

By Lisa A. Eramo, freelance healthcare writer

Think about what life would be like if we could occasionally hit pause, taking a “time out” of sorts to process information before acting. Unfortunately, we don’t have that luxury—but that doesn’t mean we shouldn’t reflect on the past before moving forward. This article brings together several leading healthcare, health IT, and standards experts to discuss and provide a status check on health IT adoption and standardization efforts, and their impact (if any) on healthcare delivery …

Medical Economics, July 2017

How to improve patient engagement through technology

By Lisa A. Eramo, freelance healthcare writer

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

Discover the auditor within

By Lisa A. Eramo, freelance healthcare writer

When it came time to bring the auditing function in-house, Renee Petron, RHIA, hit a seemingly impassable roadblock. “We did not have a robust pipeline. The candidates we saw had little to no auditing experience. And those who did have the experience just didn’t align with our compensation package,” says Petron, director of coding quality review at Parallon Business Performance Group, a subsidiary of Hospital Corporation of America …

Medical Economics, January 2017

7 ways physicians can take control of uncompensated time

By Lisa A. Eramo, freelance healthcare writer

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 …

Journal of AHIMA, November 2016

Standardizing interoperability is a team effort

By Lisa A. Eramo, freelance healthcare writer

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 …

Journal of AHIMA, September 2016

Five tips to develop and share your HIM ‘elevator speech’

By Lisa A. Eramo, freelance healthcare writer

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 …

Journal of AHIMA, August 2016

Stopping thieves in their tracks: What HIM professionals can do to mitigate medical identity theft

By Lisa A. Eramo, freelance healthcare writer

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 …