Chasing EHR Incentives? Don’t Lose More Meaningful Money to RCM

Ever since the HITECH Act was signed into law, physician mind share has been almost exclusively directed toward electronic health record (EHR) adoption. The attainability of Meaningful Use incentive funds has caused a nearly singular focus on EHRs across the healthcare industry.

As a result, the most permanent, overarching business concern of every medical practice, revenue cycle management (RCM), has fallen off of many physicians’ radars. To put it simply, providers cannot afford to forget about RCM amid the EHR hubbub.

The Centers for Medicare and Medicaid Services found that medical practices fail to collect on a full 18% of submitted claims. The main reason that percentage is so high is that so many providers are relying on outmoded RCM systems that lack the most useful features that ensure proper payments.

And the financial impact that 18% loss can reap on a private practice makes the Meaningful Use money look like pocket change.

Consider this: If a busy one-doctor practice adopts an EHR system and qualifies for the full amount of Medicare EHR incentive payments, it will receive $44,000 over a five-year span. That amounts to $8,800 each year.

But if that same practice is failing to collect on 18% of its claims, it could easily be losing up to $62,000 annually – that’s $310,000 over the same 5-year period. How important does the Meaningful Use money seem in comparison?

An Expensive EHR Obsession
In pursuit of those relatively minor MU incentives, providers are allowing EHR vendor selection to consume their attention for the better part of a year – usually nine months or more.

Then comes the lengthy period of set-up and training, which rarely goes easily. In a recent report in the Journal of the American Medical Informatics Association, 89% of physicians surveyed said EHR implementation was difficult.

EHR onboarding is a time-suck that costs money and hurts practice productivity levels. And throughout that long, expensive EHR process, physicians are relying on inadequate, outdated billing systems and paying no mind to the financial losses they’re suffering as a result.

Since no government entity has incentivized the use of advanced revenue cycle management technology, it seems there’s no reason for practices to upgrade to newer, better RCM systems.

Giving such unprecedented priority to the digitization of medical records solely because of the Meaningful Use incentives is not only unwise – it’s illogical.

Meaningfully Flawed Logic
After all, electronic medical records have been around for over half a century, having first been introduced by Dr. Lawrence Weed in the 1960s. One of the few major reasons they’ve recently been widely marketed to and purchased by providers is the availability of a monetary reward.

Which begs the question: If electronic records were really such useful tools for the practice of medicine, would their adoption have to be financially incentivized?

The inadequacy of early EHRs was a factor in incentivizing their use. The HITECH Act expanded the EHR market – which research shows will reach $6.5 billion by 2012 – and boosted competition among technology vendors for all of that increased business.

Today, the best electronic health records are enabling physicians to connect with other doctors to improve the patient experience. It’s critical to the continuity of care for EHRs to integrate seamlessly with practice management, billing and patient management systems and enable secure transmission of patient data between providers.

Though it’s taken too long for EHR solutions with those capabilities to enter the market, they’ve finally emerged. Thankfully today, incentives or no incentives, effective EHR use can enhance patient care. And what’s good for patients is good for business.

But the bottom line of that business still depends on RCM. The outdated technologies being used in most medical practices – sometimes side-by-side with advanced EHRs – are allowing far too many claims to go unpaid.

Effective RCM is Its Own Incentive
Neglecting RCM can cost you more money than the Meaningful Use incentives could ever cover. If you’ve been too busy focusing on the EHR transition at your practice to assess the rest of your systems, now is the time to fix your aim on RCM.

If your billing and collections software doesn’t check every claim for common errors prior to submittal, manage your payer contracts, or automate collection incidents based on the age of your receivables, you need upgrade your technology. A good system can increase first-pass resolution rates by 20% or more and keep your claims denial rate under 4% – earning you back tens of thousands of missing dollars.

Electronic health record adoption is important, but effective management of claims, payments and collections is what keeps a medical practice in business. CareCloud has understood this from the beginning, which is why we developed our state-of-the art RCM technology long before entering the EHR market. By building out our product suite after perfecting our revenue cycle management software, CareCloud created a fully integrated set of medical practice technology systems with effective RCM at its core.

Before you deploy an EHR in your practice, figure out how to best optimize your management of the revenue cycle.

You can’t afford not to.

How does your RCM process work to maximize your collections?

Richard Lopez del Rincon is Executive Vice President of CareCloud, responsible for the management, growth and leadership of the Sales and Marketing functions of the company. He is an experienced sales, marketing and revenue cycle management executive and entrepreneur.

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