Jun 21, 2016

Healthcare Solutions: How to Resolve Unintended Industry Consequences

Alanna Diffendal  |  Updated June 28

RXNT Logo and name displayed on a building outside

Why should your medical practice suffer the unintended consequences of government laws and regulations, curtailing coveted time that should be spent with patients? As the healthcare industry continues to evolve, physicians face an abundance of changing circumstances. Navigant Center for Healthcare Research and Policy Analysis highlights the eight “pressure points” that matter the most to physicians in 2016. Fortunately, there are existing software platforms, such as RXNT’s fully integrated solutions, that alleviate some of the tiring administrative duties that distract physicians from providing clinical care.

  1. Medicare Reimbursements and Value Based Care
  2. Medicare Policy Changes
  3. Business Relationships
  4. Meaningful Use
  5. ICD-10
  6. Mega-Mergers
  7. Patient Engagement
  8. Supreme Court and Federal Court Cases

Pressure from the government has resulted in a transition from the traditional fee-for service payment model to a more robust, value-based payment model. The intention is to focus more on the quality of care with an individual patient rather than the quantity of patient visits. As of March, 2016, the U.S. Department of Health & Human Services (HHS) released that “an estimated 30 percent of Medicare payments are now tied to alternative payment models.” Although the Affordable Care Act aims to improve the quality of patient care, it also presents a learning curve for physicians to adapt a new payment model. Similarly, the ICD-10 coding structure was implemented to decrease fraud and abuse through over-coding; however, this transition is reported to increase the amount of denied claims.

Additionally, there have been many reforms to Medicare as well as more stringent HIPAA regulations. Eligible professionals, eligible hospitals, and critical access hospitals only have until July 1st, 2016, to apply for a hardship exception from Medicare’s Electronic Health Records (EHR) Incentive Program for 2017’s payment adjustment. Nevertheless, Meaningful Use is designed as gradual, incentive program for physicians to adopt EHRs. By using the RXNT|EHR solution, physicians will not only streamline their workflow, but also receive regular updates through cloud-based technology – ultimately allowing physicians to stay ahead of government regulations.

In medical practices, physicians strive to provide the highest quality of care in the most effective and efficient manner. However, the previous decade has seen a exponential increase in deductibles with the introduction of the Affordable Care Act. In fact, The Henry J. Kaiser Family Foundation states that the average deductible for all covered workers in 2015 is up 67% from 2010 and 255% from 2006, leaving many household are unable to pay for healthcare expenses. Consequently, patient engagement and financial responsibility will become increasingly important for physicians. While these factors escalate the pressure on a physician’s revenue cycle, RXNT’s Practice Management Solution along with outsourcing revenue cycle management will alleviate some of these concerns.

In today’s complex healthcare industry, providers should be aware of solutions that minimize the unintended consequences of government mandates. RXNT offers fully integrated EHR, PM and E-Prescribing solutions that enable physicians to streamline their workflow. To learn more about the benefits of RXNT’s solutions for your practice, contact us at 800-943-7968 option 3 or email us at [email protected].

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