Guest Spot: Transparency, Consumerism, and the Patient
By: Travis Gentry, Financial Healthcare Systems (FHS Corp.)
Over the past couple of years, numerous heavy-hitting organizations have chimed in on the topic of price transparency within the healthcare industry, advocating patient consumerism. Those organizations include the HFMA (Patient Friendly Billing Project®), various state hospital associations, the American Hospital Association, and even the U. S. government, all trying to answer some difficult questions:
Do patients understand the concept of price transparency in the healthcare industry and the benefits they can gain from it? And how can providers prepare themselves for a movement toward patient consumerism? In the search for solutions, what are the different roles offered by technology and changes in process?
The concepts of price transparency and patient empowerment are both noble and basic to American culture. However, the transition from concept to reality contains significant challenge. Today, transparency means simply the publication of provider charges. For self-pay patients, such a display of charges can be meaningful; however, self-pay patients represent only about 5 percent of the average payer mix. Growth of the self-pay population does not justify this weak solution to the issue of price transparency. True transparency occurs only when patients understand their out-of-pocket expenses...not just provider charges.
Patients view healthcare as any other transaction...with a buyer and a seller. Patients are the buyer and the providers are the seller. In the mind of the patient, the payer is just a third party to whom they or their employer has paid a health insurance premium in order to gain access to the provider. Patients are typically unaware of the complexities of the relationship between the provider and the payer, and they are specifically unaware of the way the payer-provider relationship affects the patient's out-of-pocket expenses.
If patients want to understand consumerism, they need to understand the unique relationships between the entities (contracts, charges, and benefits). To achieve transparency and empower providers and patients to work together, payers need to provide better access to patient eligibility information via Internet and 270/271 EDI transactions. Providers need tools that allow ready access to their contracts and charges to determine how a procedure will be paid. Integration of contracts, charges, and benefits provides all the necessary information for patients to evolve into educated consumers.
The solution involves two elements: technology and process. Typically, payers and providers store critical data from contracts, charges, and benefits in separate computer systems, even though integration of those systems could create meaningful information for patients. Today, several companies leverage technology to offer the healthcare industry a variety of pro-price transparency/patient consumerism tools. These robust tools include such features as demographic and address validation/correction, charity advisors, patient liability estimators, credit scoring, e-cashiering, and A/R segmentation. The tools are offered to providers on various levels, formatted for use by an individual organization or combined with others, and with integrated solutions. The needs and personality of the organization and its tendency to champion and adopt change will determine the best approach.
Technology should always be used to enable process – the second element of the price transparency and patient consumerism solution. Providers who expect tools to solve their problems in isolation are doomed to failure. Providers must engage in process evaluation with an understanding of what technology and tools can offer, while keeping in mind that work flow and business processes must drive the change. Technology and tools support the effort. Whether the process evaluation is driven internally or externally from consultants, it is the critical factor for long-term viability and success.
Providers must embrace process and technology to be prepared to meet tomorrow’s demands for price transparency and patient consumerism. Process creates change; technology supports change. The end result is an empowered healthcare industry prepared to educate and care for patients.
Catholic Health Initiatives (CHI), a multi-facility health system which uses MEDITECH at nearly all of their hospitals, is one of the nation’s leaders in price transparency. CHI embarked on their solution back in the Summer of 2006. Pete Savini, VP of Revenue Cycle, was tasked with finding a solution that could be rolled out in a MEDITECH environment where the historical data and payer contracts could be easily compiled and leveraged in a solution. Today, two years later, CHI has selected and implemented the FHS Corp. solution, ClearQuote, in most facilities across the country, with implementation in all of their facilities scheduled to be completed by the Spring 2009.
Travis Gentry is Chief Operating Officer and President of Financial Healthcare Systems (FHS Corp.), based in Denver, Colorado. For more information, go to www.fhscorp.net.
Tricks of the Trade: Writing Readable MEDITECH NPR Macros (Part 2 of 3)
Contributed by: John Sharpe, President, Comstock Software, Inc.
In Part 1 of this series, we put the standard DO Loop under the microscope and found a way without changing the function of the code, to make it readable at first glance. Restructuring the standard DO Loop into a Reverse DO Loop, improved our ability to see all the code at once in the NPR Macro Editor. In Part 2, the macro in question has been implemented with a Reverse DO Loop; but in spite of our initial effort, the code still runs off the screen. Let’s see what can be done to improve the readability of the code at first glance.
As you can see, our visibility is limited to 92 characters in the NPR Macro Editor.
Let’s see if we can regain real estate on the screen, by replacing the conditions in the Reverse DO Loop with new subroutines.
Let’s call the subroutines: URN.PRV & DT.PRV.
Next...we’ll make the following changes to the conditions in the DO Loop.
In review, we’ve implemented new subroutines to regain valuable real estate. Now that the code is readable in a single glance, the next programmer will be able to step in quickly and make the required changes in a timely manner.
By writing readable code, you and your team will be more productive and your MEDITECH users will love you for your responsiveness to their needs. Keep learning. Your new level of productivity is the new standard that will be expected from now on.
John Sharpe is President / NPR Consultant at Comstock Software, Inc. Learn more about NPR Report Writing at the MEDITECH NPRReport Writing Blog.
Featured Employer: Sponsored by MeditechCareers.com
Every month, we feature one employer who has advertised their job posting on our affiliate web site: MeditechCareers.com. In addition to the basic job posting, we provide some information about the employer, their location and environment, and highlight them as a "Featured Employer" in this newsletter. MeditechCareers.com provides MEDITECH professionals a place to explore career opportunities. Having a separate web site for this purpose will allow us to maintain the original focus of The MEDITECH Community Bulletin for our loyal readers who are seeking news and information.
To advertise your MEDITECH-related opportunity on MeditechCareers.com and become a "Featured Employer", contact Donna Carroll at 413-569-1111.
Recent News: Natividad Medical Center Adopts NeoIntegrate as Their Integration Engine Platform
PLANO, TX--October 21, 2008. Natividad Medical Center chooses NeoIntegrate as their integration engine platform to leverage ADT feeds from their MEDITECH system. Prior to selecting NeoIntegrate, Natividad relied upon point-to-point interfaces to exchange critical patient data via a single data feed (ADT) to multiple applications. Although a logical approach to exchange patient data, point-to-point became impractical with vendor fees for new interfaces and increased time for deployment.
"Our mission is to build a hub-and-spoke approach to connecting our applications. This is an economical, practical approach to interfacing in a MEDITECH environment, and utilizes our limited resources more effectively," said Michael Jobin, CIO, Natividad Medical Center.
Jobin continued, "Selecting an integration engine platform and partner centered on three primary evaluation criteria – customer support, product reputation, and ease of use in building, testing, and deploying interfaces. NeoTool exceeded in all three."
Implementing an integration engine platform was a critical part of Natividad’s IT strategic plan – Vision2010. The selection of NeoIntegrate will enable Natividad Medical Center to reduce cost and elevate their level of technological competitiveness within the California healthcare system.
"Before NeoIntegrate, Natividad lacked the flexibility that an integration engine would provide in meeting our goal of upgrading and adding new systems that increase the quality of care," stated Jobin. "We want to be the most technologically advanced safety net hospital within the state of California, which we believe will translate to enhanced quality of care."
Jobin added, "NeoTool has the reputation of working productively with hospitals that have numerous interface connections in large, connected, extended healthcare communities. With NeoIntegrate, our approach to integration is more effective because of the leverage gained in utilizing our interfaces more practically and deploying our resources more productively."
"The NeoTool team demonstrated their commitment to customer service throughout the process. From sales to technical support, NeoTool delivered on everything they promised."
"We are pleased Natividad selected NeoTool to assist them in leveraging their MEDITECH environment and extending connectivity to other applications and providers. The Natividad team’s consistent focus on improving patient care through a more effectively integrated network provided clear direction to NeoTool from our first visit through deployment of their initial interfaces," said Phil Guy, CEO of NeoTool.
"Natividad Medical Center joins a growing customer base of MEDITECH hospitals that realize the leverage and innovation that can be gained by implementing NeoIntegrate. At NeoTool, we are committed to delivering the best integration platform and customer service to the healthcare community in support of their efforts to provide the highest quality of patient care," stated Guy.
About Natividad Medical Center
Natividad Medical Center is an acute care medical center emphasizing the care of women, children and families. Fully Accredited by the Joint Commission on Accreditation of Hospitals and Healthcare Organizations, Natividad Medical Center is a modern medical center campus offering comprehensive inpatient, outpatient, diagnostic and specialty care.
About NeoTool
NeoTool’s healthcare integration solutions empower organizations to develop, test, deploy, and manage data exchanges between healthcare applications and providers. Through software, HL7 training, and consulting, NeoTool is dedicated solely to healthcare application interfacing. NeoTool customers include healthcare providers (e.g., hospitals, imaging centers, labs, and clinics), healthcare software application providers, and medical device manufacturers.
More info: http://www.neotool.com/about/pressreleases/Natividad-Medical-Center-Adopts-NeoIntegrate
Recent News: AHIMA Issues Statement on ICD-10 Controversy
Date: October 15, 2008.
AHIMA CEO Linda Kloss issued a statement in response to the findings from a study conducted by the Nachimson Advisors for a group of provider organizations. The group is petitioning HHS to extend the deadline for implementation of the ICD-10 codes.
More info: Read article
Recent News: Beacon Partners is Named One of the 100 Best Places To Work in Healthcare
WEYMOUTH, MA--September 23, 2008. Healthcare management consulting firm Beacon Partners, Inc. was recently named as one of "Modern Healthcare's 100 Best Places to Work in Healthcare."
Modern Healthcare conducted this program to recognize outstanding employers in the healthcare industry on a national level, especially in the following areas: leadership and planning, culture and communications, role satisfaction, working environment, relationship with supervisor, training and development, pay and benefits and overall satisfaction.
"It's truly an honor to be recognized by Modern Healthcare in this capacity and it is indicative of our commitment to attract and maintain top talent that allows us to provide our clients with exceptional service and unparalleled satisfaction," says Ralph P. Fargnoli, President and CEO of Beacon Partners.
"The healthcare environment today and in the future is characterized not just by shrinking margins; increasing regulations; new technologies; increasing consumerism; patient empowerment; autonomy and competition; but also by staffing shortage challenges and a heightened appreciation for the quality of the workplace," said Fawn Lopez, Publisher of Modern Healthcare. "'Modern Healthcare's Best Places to Work in Healthcare' program identifies and recognizes healthcare organizations that have successfully built workplace excellence and enabled employees to perform at their optimal level."
About Beacon Partners
Beacon Partners coaches organizations in the Healthcare Community on the development of strategies that maximize Enterprise Yield™ - the alignment of people, processes and technologies. To achieve top levels of performance, a healthcare provider must factor strategic direction, physician alignment, economic incentives and overall market impact. Beacon Partners has proven that focusing on these critical success factors will strengthen an organization from its core outward and improve patient experience. Beacon Partners, the only firm in the industry that provides a satisfaction guarantee, has offices in Boston, San Francisco, and Toronto, and is one of the fastest growing privately-held firms in healthcare management consulting.
More info: http://www.beaconpartners.com/press_room/pressreleases/08/092308.html
Recent News: maxIT Healthcare and E-Hospital Consulting Announce Merger
INDIANAPOLIS, IN--September 5, 2008. maxITHealthcare and E-Hospital Consulting (Bangs, TX) announced today that they have entered into a definitive agreement, under which the companies will be combined as maxIT Healthcare.
The combined company with distinguished complementary capabilities is now in a position to extend its reach throughout the healthcare IT professional staffing solutions market.
The Meditech subject matter expertise throughout the two entities has expanded to support a broader portfolio of healthcare IT consulting services. maxIT Healthcare will continue to focus on its full range of healthcare enterprise software support to hospitals and healthcare providers, and aggressively grow its Meditech practice.
"maxIT Healthcare is one of the most recognized healthcare IT service delivery partners, with over 277 consultants, consisting of diverse skill sets, a leading enterprise integration practice, and well entrenched sales organization throughout the United States. These two distinct brands are now one, providing us the ability to accelerate our rapid growth plans," said Parker Hinshaw, CEO and Founding Partner, maxIT Healthcare." This combination is the next logical step for both organizations to provide value to maxIT Healthcare’s joint customer base," said Mr. Hinshaw.
"We are excited for the many opportunities that an E-Hospital Consulting and maxIT Healthcare combination will provide our clients; the combined company will be better positioned to compete effectively within the continually expanding healthcare IT market. We look forward to sharing the benefits of the exciting new growth opportunities this combination will provide for all of our stakeholders," said Jack Walker, CEO of e-Hospital Consulting.
About maxIT Healthcare
maxIT Healthcare established in 2001, headquartered in Westfield, IN , has various sales offices throughout the United States, has grown and built a significant business of over 277 consultants providing critical IT support for clinical and financial applications to maximize the efficiency of information technology. Supporting healtcare industry applications from leading providers including McKeson,Epic, Cerner, Eclipsys, Siemens, Meditech, PeopleSoft, Lawson, Misys, NextGen, Allscripts, SoftMed and other software providers.
About E-Hospital Consulting
E-Hospital Consulting, headquartered in Bangs, TX, has built a focused Meditech practice serving hospitals and healthcare providers implementing Meditech system installations in the Western and Southwestern United States, as well as several Eastern U.S. based healthcare facilities.
More info: http://www.maxithealthcare.com/PDFS/maxITEhospital.pdf
