NAHAM Webinar: Introducing NAHAM AccesKeys

Join NAHAM for a Webinar January 14th, 2:00-3:00pm EST, to discover NAHAM's exciting new tool for members: 

AccessKeys

NAHAM is excited to announce the unveiling of a project more than two years in the making, created from the minds of a dedicated group of your NAHAM member peers. Unprecedented in the field of Patient Access, this new tool will fill a gap in the front-end of the revenue cycle, helping define the complex and ever-changing registration processes, oftentimes little understood by revenue cycle managers. Furthermore, this new offering will reshape your understanding of how your facility’s Patient Access department’s performance compares to other, similar healthcare organizations across the United States.

Never before have Patient Access managers been able to use standardized, simple equations to measure, for example, Point of Service Collections to Revenue, and then compare that score against industry benchmarks, thus measuring outcomes, not merely activities.

The AccessKeys^® are set up as a series of equations created by NAHAM’s Industry Standards Committee (ISC), which was formed as a new standing committee of NAHAM tasked with continually updating these Access Keys and develop other industry standards and best practices. The 23 different KPIs measure how well front-end departments and staff are doing across six Patient Access domains:

• Collections
• Conversions
• Patient Experience
• Process Failures
• Productivity
• Quality

For each KPI, the committee has provided a simple equation, using easy-to-find data, and each equation comes with some helpful “tips and tricks” provided by the committee. Upon plugging in the corresponding numbers for your organization, you can see if your score falls into the “Good,” “Better,” or “Best” benchmark.

Members-Only Benefit

The NAHAM AccessKeys^® are a members-only benefit. To access them when they are released in mid-January, renew your membership today!  

Register Today for the AccessKeys^® Webinar

Wednesday, January 14, 2015
2:00 pm Eastern 

Paul Shorrosh, NAHAM Industry Standards Committee chair and key contributor to the AccessKeys^® will present a webinar to describe how to implement the tool in your facility. 

Register today!

Negative Consequences Abound When Nonprofits Hospitals Sue Poorest Patients

Nonprofit hospitals receive a tax-exempt status based on their work to serve the poor by addressing their medical needs. However, the medical billing practices of hospitals was recently called into question by a Consumer Financial Protection Bureau report. The report examined medical debt in this country and found that 1 in 5 consumers, or 43 million individuals, have a negative mark on their credit report from a medical debt. The debt collections practices employed by hospitals raise several concerns including releasing private medical information covered by HIPAA to outside parties not involved in treatment, unfair billing practices that disproportionately impact low-income patients, a failure to provide and educate patients on available aid, the need for aid to retroactively cover eligible medical costs, and the legality of nonprofit hospitals suing their poorest patients. 

A recent NPR story highlighted the issues that arise for low-income patients when nonprofit hospitals sue for unpaid medical bills. In addition to the aribtrarily higher prices many low-income patients are charged for medical treatment, the debts associated with their medical care negatively impact nearly every area of their lives. Medical debts reported to credit agencies lower credit scores which in turn, raises the prices for many basic needs such as car insurance, mortgages, credit cards, and loans. Additionally, some employers examine the credit report in the hiring process and a low credit score or history of medical debt may negatively impact an individual's chance to get a job because they are viewed as irresponsible or the employer feels they will not be reliable due to the medical issues insinuated in the report. 

Hospitals are turning to the courts to recover these inflated debts from their low-income patients. When the hospitals are successful they may be able to recover the debt, in addition to court costs, debt collection administration fees, and interest by garnishing the low-income individual's wages. This practice creates a cycle of poverty that is nearly impossible to escape and discourages individuals from receiving medical care. It particularly provides a disincentive for low-income individuals to receive preventative care, which would be beneficial to all parties involved. 

Reform is imperative. Hospitals and health access managers must be diligent in educating patients about aid, prudently billing, and limiting the debts that move to collection agencies. 

Resources to help those with medical debt may be found at the following websites:

• Legal Aid
• Families USA
• National Consumer Law Center
• USA.Gov

Patient Identification and Matching Report Released by ONC

The Office of the National Coordinator for Health Information Technology (ONC) released the final version of the Patient Identification and Matching Report. The report evaluated best practices and current trends in using electronic health record systems to accurately identify patients and exchange information between providers, patients, and caregivers. Mistakes in properly identifying patient health records put patient safety at risk and has resulted in too many patient deaths. 

The drafting process for the report included an industry environmental scan with input from stakeholders at meetings, on calls, and requests for submitted comments and recommendations. NAHAM was an active participant throughout the drafting process and provided recommendations focused on improving patient safety that are featured in the report. NAHAM's recommendations can be found on page 76 of the report. 

The report resulted in 10 findings that ONC will use as they move forward with the process of improving electronic health record systems and patient matching to improve patient safety.The findings are below.

Findings

1. Standardized patient identifying attributes should be required in the relevant exchange transactions. 

2. Any changes to patient data attributes in exchange transactions should be coordinated with organizations working on parallel efforts to standardize healthcare transactions. 

3. Certification criteria should be introduced that require certified EHR technology (CEHRT) to capture the data attributes that would be required in the standardized patient identifying attributes.

4. The ability of additional, non-traditional data attributes to improve patient matching should be studied. 

5. Certification criteria should not be created for patient matching algorithms or require organizations to utilize a specific type of algorithm. 

6. Certification criteria that requires CEHRT that performs patient matching to demonstrate the ability to generate and provide to end users reports that detail potential duplicate patient records should be considered. 

7. Build on the initial best practices that emerged during the environmental scan by convening industry stakeholders to consider a more formal structure for establishing best practices for the matching process and data governance. 

8. Work with the industry to develop best practices and policies to encourage consumers to keep their information current and accurate. 

9. Work with healthcare professional associations and the Safety Assurance Factors for EHR Resilience (SAFER) Guide initiative to develop and disseminate education and training materials detail best practices for accurately capturing and consistently verifying patient data attributes. 

10. Continue collaborating with federal agencies and the industry on improving patient identification and matching processes. 

Study Finds Copy-Paste Function in Electronic Health Records Leads to Medicare Fraud

A report released by the Department of Health and Human Services (HHS) Wednesday outlined more flaws in the government oversight of adopting electronic health records. This is the second report issued by the HHS that specifically criticizes the CMS oversight of the federal program created to convert paper patient records to an electronic format. 

The report specifically points to the lack of clear "program integrity practices" to provide guidelines on the proper use of copy-paste, or cloning function, in updating electronic health records and recording new office visits and treatments. Doctors and hospitals use the feature to reduce the time it takes to input patient data. Many say that without this function the health practitioners would drown in the patient input process, to the detriment of the treatment quality for their patients. 

However, the report finds that widespread indiscriminate use of the cloning function may lead to the input of more extensive treatment and tests than actually occurred. This, in turn, leads to doctors overcharging Medicare for care that was not actually provided. There is also concern that without proper oversight this type of fraud may grow exponentially in the coming years with the implementation of electronic health records nationwide. 

The report issued by the Office of the Inspector General for the Health and Human Services Depart is available here.

Media coverage of the report is available at:

• New York Times, "Report Finds More Flaws in Digitizing Patient Files."