Skip to main content
MJH Life Sciences
  • Login
  • Register
  • Login
  • Register
Home
  • Topics
  • Health IT
  • Careers
  • Law/Malpractice
  • Compensation
  • Pearls
  • Staffing
  • Contribute to Site
MJH Life Sciences

SUBSCRIBE: eNewsletter

3 ways a community HIE can help boost your practice’s revenue

community HIE, data, EHR, TCM, coding, physician practices, revenue, health IT

James Thew/Adobe Stock

  • Scott Fowler, MD, JD, FACOG
July 8, 2019
  • Health IT, Billing and Collections, EHR, Medical Billing & Collections, Medicare, Medicare Reimbursement, Patients, Payers, Population Health, Reimbursement, Technology, Value-Based Care

Recent research points to how community health information exchanges (HIEs) help reduce the cost of care, improve patient safety and decrease utilization and duplication. However, one potential benefit of community HIEs is just starting to be explored: increased revenue.

In an era of value-based care, community HIEs present an attractive opportunity to protect and increase revenue for physician practices.

When it comes to improving value, community HIEs have an advantage over a proprietary HIE, including fewer duplicated procedures, reduced imaging, lower costs and improved patient safety, according to research from Indiana University. Community HIEs enable physicians and other providers to share information about any patient whose data is captured within the HIE, while proprietary HIEs limit access to patient data to certain providers.

Here are three ways physician practices can leverage community HIEs to drive increased revenue.

 

Community HIEs can support compliance with transitional care management billing requirements.

The Centers for Medicare & Medicaid Services (CMS) estimated primary care physicians could increase collections up to 4 percent by offering transitional care management (TCM) services, while internists could see a 3 percent boost in collections.

However, complying with TCM billing requirements isn’t easy, in part because physician practices have a limited window in which to contact patients after discharge (within two business days) to receive TCM reimbursement. If practices are not aware that a qualifying patient was hospitalized, this makes TCM compliance extraordinarily difficult.

Related: Transitional care management: Coding and documentation in brief

When practices are part of a community HIE, they can establish an electronic admission/discharge/transfer (ADT) feed with area hospitals. This feed alerts practices when Medicare patients are discharged from the hospital to their home or an assisted living center. Such alerts help to ensure staff are aware of patients who require follow up and are able to contact patients within 48 hours of discharge, per TCM billing requirements.

 

Community HIEs support strong performance under value-based payment contracts.

Community HIEs give providers a critical line of sight into the care needs of complex patients, thereby boosting practices’ ability to enhance health outcomes at a reduced cost. For example, patients often neglect to share information that could be important to determining next steps in care, such as a visit to the emergency department (ED) with complaints of chest pain.

However, when practices have access to a community HIE, they can build automatic notifications into their electronic health record (EHR) that alert physicians to patients’ recent care interactions. So, in a few clicks, a physician could be alerted to a recent visit by the patient to an ED or urgent care facility and could then drill deeper to view details about the encounter. With this information in hand, the physician can explore the reasons for the visit, such as complications related to a patient’s chronic condition. These ensuing one-on-one conversations could lead to adjustments in the patient’s chronic care plan, effectively improving health outcomes and patient satisfaction while reducing costs.

Pages

  • 1
  • 2
  • next ›
  • last »

Related Articles

Resource Topics rightRail

  • Resource Topics
  • Partner Content
  • Medical Billing & Collections
  • Coding
  • Patient Relations
  • EHR
  • Law & Malpractice
Why Patient-Centered RCM: 6 RCM Trends Affecting Medical Offices & Patients [eBook]
Across Generations: Millennials & Baby Boomers Advance Healthcare Communications
A buyer’s guide to alternative payment models
How adopting a virtual business office delivers new efficiencies to one medical group
Unpredictable pairings: A new approach to community health
Connect with Us
  • Column 1
    • Home
    • About Us
    • Contact Us
  • Column 2
    • Editorial Info
    • Editorial Board
  • Column 3
    • Advertising Info
    • Reprints
    • Advertising Terms
  • Column 4
    • Terms of Use
    • Privacy Policy
Modern Medicine Network
© UBM 2019, All rights reserved.
Reproduction in whole or in part is prohibited.

We've noticed that you're using an ad blocker

Our content is brought to you free of charge because of the support of our advertisers. To continue enjoying our content, please turn off your ad blocker.

It's off now Dismiss How do I disable my ad blocker?
❌

How to disable your ad blocker for our site:

Adblock / Adblock Plus
  • Click on the AdBlock / AdBlock Plus icon on the top right of your browser.
  • Click “Don’t run on pages on this domain.” OR “Enabled on this site.”
  • Close this help box and click "It's off now".
Firefox Tracking Prevention
  • If you are Private Browsing in Firefox, "Tracking Protection" may casue the adblock notice to show. It can be temporarily disabled by clicking the "shield" icon in the address bar.
  • Close this help box and click "It's off now".
Ghostery
  • Click the Ghostery icon on your browser.
  • In Ghostery versions < 6.0 click “Whitelist site.” in version 6.0 click “Trust site.”
  • Close this help box and click "It's off now".
uBlock / uBlock Origin
  • Click the uBlock / uBlock Origin icon on your browser.
  • Click the “power” button in the menu that appears to whitelist the current website
  • Close this help box and click "It's off now".