MEDITECH Director of Marketing Support Melissa
Swanfeldt recently participated in the North Carolina
Healthcare Financial Management Association's (HFMA) Annual
Meeting, as part of a panel discussion on "Next
Generation Revenue Cycle Solutions." Swanfeldt's
presentation focused on the financial benefits health care
organizations realize as byproducts of using automated
clinical information systems, and how these benefits will
continue to evolve as financial incentives become even more
tied to organizational performance.
According to Swanfeldt, one of the most evident ways
integrated clinical systems contribute to financial benefits
is through the real-time capture, exchange, and processing of
critical data. "We are now seeing a convergence of
clinical and financial systems, as it is no longer feasible
to have information silos," she explains. "Charge
capture needs to be a byproduct of clinicians documenting
safe, effective care. For example, the point-of-care
documentation functionality embedded in MEDITECH's Advanced
Clinical products immediately captures charges and
automatically calculates E&M codes."
Reducing
Cost of Care by Improving Outcomes
Beyond simply capturing charges, Swandfelt also presents
evidence demonstrating how automated clinical information
systems help to cut costs and maximize reimbursement by
improving the quality of care. For example, a recent study
from the Archives of Internal Medicine indicates how urban
hospitals in Texas with automated clinical information
systems experienced fewer complications, lower mortality
rates, and lower costs. On average, hospitals with clinical
decision support systems saved over $500 per patient
hospitalization. "This is just one of many studies
indicating the cost and outcome benefits to hospitals using
clinical decision support," states Swanfeldt. "I
even read a study showing how patients on a clinical pathway
had a 10 percent reduction in costs compared to patients not
on a clinical pathway."
Swanfeldt described the many ways Advanced Clinical Systems
contribute to quality patient care, and ultimately improved
financial performance. For example, providing caregivers with
instant access to evidence-based medicine helps guide their
clinical decision-making and establish best practices.
Clinical decision support as well as closed loop medication
management flag potential medical errors before they occur,
reducing patient complications which might otherwise result
in increased lengths of stay. Furthermore, patient trackers
and status boards improve interprovider communication,
resulting in better outcomes, timelier treatment, and more
efficient workflows.
Pay
for Performance Leads to Incentives-Based Reimbursement
Another driving force Swanfeldt described behind the adoption
of Advanced Clinical Systems is the national trend toward pay
for performance, which has placed increased demands on
organizations to substantiate payments. Health care
organizations are reaping increased incentives based on their
quality of reporting; adoption of technologies like e-Prescribing,
CPOE, and EHRs; and the quality of their patient outcomes.
Because pay for performance systems link compensation
directly to quality measures, providers are rewarded for
meeting pre-defined targets in the delivery of health care.
"While
most pay for performance is currently voluntary, we are
starting to move from the carrot to the stick where financial
penalties will begin for non-use," states Swanfelt.
"A prime example of this is in the Commonwealth of
Massachusetts, where hospitals and community health centers
are required to adopt CPOE by 2012 or face financial
penalties."
Similarly, with organizations like The Centers for Medicare
and Medicaid Services (CMS) no longer reimbursing for some
conditions not present on admission, such as hospital
acquired infections, health care organizations are forced to
bear the brunt of the cost for treating such conditions.
"An
undocumented, pre-existing decubitis ulcer can add anywhere
from $6,000 to $40,000 in costs," explains Swanfeldt.
"Clinicians using Advanced Clinical Systems like
MEDITECH can flag users to document those conditions present
on admission, which would not be covered under the pay for
performance system if contracted while under the hospital's
care. Furthermore, by establishing standard care protocols
for all care providers to follow, health care organizations
can help curb the threat of patients acquiring such
conditions by simply enforcing quality practices."
By combining data from clinical and financial systems, health
care organizations can also use MEDITECH's quality reporting
capabilities to evaluate clinical and financial data for pay
against performance measures. They can then use this data to
establish and measure benchmarks and target areas of
improvement.
Securing
Funds through Adoption of EHRs and Advanced Clinical
Solutions
Finally, Swanfeldt demonstrated how hospitals with cutting-edge
clinical technologies stand to benefit financially from
Medicare incentives, government grants, economic stimulus
funds, accelerated depreciation costs, etc. "With 19
billion dollars in the American Recovery and Reinvestment Act
tied to EHR adoption, health care organizations will also see
an additional $17 billion in Medicare and Medicaid incentive
payments beginning in 2011. Hospitals can reap great rewards
from simply using Information Technology to provide safe,
quality care," she states.
"At one point financial constraints may have deterred
health care organizations from investing in I.T. These days,
however, with so much financial incentive tied to the use of
Advanced Clinical Systems, health care organizations may find
themselves facing even greater costs by not adopting them.
When you can save both money and patient lives by investing
in these technologies, it really becomes a win-win for
everyone!"
MEDITECH
Medical
Information Technology, Inc.
MEDITECH Circle
Westwood, MA 02090
781-821-3000
www.meditech.com