Five Ways Doctors Can Use EMRs to Boost ProfitabilityNovember 8, 2012 by David Fried
With the rapid growth of the electronic medical records (EMR) market and the technological advances that have occurred since their introduction, we thought it was time to revisit the topic of how EMR software can improve the profitability of your practice. Here are five ways.
1. Stop Paying Staff to Manage Paper
How much time does your staff spend shuffling paper, searching for charts and translating illegible text? Among the benefits for a typical practice, an EMR:
- Minimizes physical file storage requirements, to the point of allowing many practices to open up another exam room where they once stored their files.
- Cuts thousands of dollars per year in office supply expenses, particularly printer paper and toner.
- Eliminates all transcription costs.
- Allows the potential elimination of a front office assistant.
Of course, to maximize cost savings from using an EMR, your entire practice needs to go paperless. For every office process, ask yourself, “What would I do in this instance if I didn’t have a printer?” and then make that your habit. For instance, scan (not photocopy) patients’ insurance cards. Put new patient information directly into your EMR, not document it on paper and transfer it later. And having patients fill out their information with paper and clipboard is a huge waste that costs you far more every year than any tablet that could replace it.
2. Increase Claim Revenues
Many doctors bill government payers for less than the work they actually performed. One reason: documenting all the routine medical checks payers require is too time-consuming to perform at every patient visit. Since Medicare requires documentation for every item billed, doctors only bill for those items for which they have written evidence. This practice deprives doctors of up to 15 percent of their legitimate reimbursements each year.
Then there’s the matter of downcoding–when an insurer changes a medical code to a “less complex” (and therefore less expensive) one because they deem certain claims unnecessary or unsupported. This is usually because the doctor lacks the proper documentation to justify the claim.
EMRs give you the opportunity to document every part of the patient visit with just a couple of mouse clicks. Known as “documentation by exception,” this feature alone can increase revenue for every patient you see.
3. Increase Efficiency
An EMR can have a significant impact on the efficiency of your practice. Some features that support this include:
- Pre-filled templates let you document common patient complaints more quickly than writing everything from scratch.
- Patient histories can be brought forward for easy viewing, whether it’s copying the last visit with a few minor edits or monitoring trends over time.
- Prescriptions go straight to the pharmacy before you’ve even left the patient.
- Billing becomes a matter of clicking a few buttons, with little to no data entry required.
All of this reduces the amount of time you spend documenting visits and managing your practice. And since time is money, you should quickly recoup your investment in an EMR. If the time spent with each patient drops from 20 minutes to 18, you can probably get two more patients per day, which at just $100 in revenue per patient would increase revenue $50,000 per year. If you have ten office staff and you’re able to reduce their workload by 10 percent, you’ll end up saving an entire employee’s salary, or perhaps using your employees for more revenue-generating activities.
4. Get the Government to Pay You for It
The Medicare EHR Incentive Program provides up to $44,000 in reimbursements over five years. The equivalent Medicaid program provides almost $64,000 over six years. You have to pick one or the other, and the total collectible amount starts to drop at the end of 2012, but either way, that’s a significant chunk–if not all–of the initial investment.
In addition, there are dozens of pay-for-performance/incentive-based medicine programs across the country. Though the “meaningful use” Medicare bonuses through 2014 have gotten the most attention in the last few years, there are also programs from NCQA, AHRQ, the Leapfrog Group and lots of private insurers, too. Participation in all of these programs requires or is made easier by an EMR, which automatically collates and reports all your patient data for you.
5. Reduce Liability Premiums
In 2008, the Midwest Medical Insurance Company (MMIC) began offering a two to five percent credit to physician groups using an EMR, believing that “EMR software improves the quality of care through better patient safety.”
The reality has proven a bit more complicated, as liability premiums have held steady over the last few years due to the growing pains associated with EMR adoption. Nevertheless, there’s still some strong evidence for the benefits of EMR adoption from a liability standpoint.
A recent observational study suggests a strong association between EMR adoption and fewer malpractice claims. In the study, out of 51 malpractice claims filed during the observation period, 49 occurred before EMR implementation and only two occurred after. Furthermore, many malpractice insurers like MMIC, Texas Medical Liability Trust and five companies collaborating with Blue Cross Blue Shield of New Jersey continue to offer discounts for physicians adopting EMRs.
In the long run, “failure to adopt and use electronic technology may itself constitute a deviation from the standard of care.” Once this is the case, the laggards will be branded as dinosaurs; they’ll be more open to scrutiny and will lose patients and reimbursements, all for failure to adopt what everyone else, by then, will consider to be an essential business tool.
EMR implementation can present some challenges, but doing it properly can help you realize significant cost savings and increased revenue. As technology improves and incentives proliferate, the initial investment is becoming more affordable and the longer-term return increasingly compelling.
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