Stay on top of changing governmental regulations and don't leave money on the table. Value based reimbursements can be tricky to navigate while managing a medical practice but not with athenahealth.
Patient-Centered Medical Home: Navigating through Recognition and Rewardsathenahealth
Join athenahealth as we delve into Patient-Centered Medical Homes and the complications that come with navigating through the regulations to achieve level three recognition status.
Population Health in 2016: Know How to Move Forwardathenahealth
Accountable care organizations (ACOs) present a significant opportunity to reduce health care expenditures and ensure quality care. Successfully managing the transition to an ACO is one of the most difficult challenges facing health organizations today. The key is to focus on the risk contract and approach population health management in a staged, incremental way.
The Latest Regulations, Simplified: MU, PQRS & MIPSathenahealth
Changing governmental regulations for the advancement of healthcare is more than difficult and we have simplified these changes to keep you up to date.
The Latest Self-Pay Trends: New Burdens and Opportunitiesathenahealth
Let athenahealth guide you through the burdens of navigating through revenue collections from your patients to make sure your practice has access to all monetary opportunities to ensure financial success.
Patient-Centered Medical Home: Navigating through Recognition and Rewardsathenahealth
Join athenahealth as we delve into Patient-Centered Medical Homes and the complications that come with navigating through the regulations to achieve level three recognition status.
Population Health in 2016: Know How to Move Forwardathenahealth
Accountable care organizations (ACOs) present a significant opportunity to reduce health care expenditures and ensure quality care. Successfully managing the transition to an ACO is one of the most difficult challenges facing health organizations today. The key is to focus on the risk contract and approach population health management in a staged, incremental way.
The Latest Regulations, Simplified: MU, PQRS & MIPSathenahealth
Changing governmental regulations for the advancement of healthcare is more than difficult and we have simplified these changes to keep you up to date.
The Latest Self-Pay Trends: New Burdens and Opportunitiesathenahealth
Let athenahealth guide you through the burdens of navigating through revenue collections from your patients to make sure your practice has access to all monetary opportunities to ensure financial success.
It's no secret that any EHR takes away essential time with the patient and doctoring in general. See what athenahealth is doing to help remedy these frustrations and to make the best out of a bad situation.
Go deeper with athenahealth specialists to discover all that you need to know and some things you may not know about Meaningful Use Stage 2 and the newest government updates.
Learn about 2016 trends in government and private healthcare spending, employer costs, and the patient-as-consumer movement that's spurring new provider models.
Physician Payment Reforms: The Future of MIPS and APMs – Value-Based Payments...Epstein Becker Green
Epstein Becker Green Webinar with Attorney Lesley Yeung - Value-Based Payments Crash Course Webinar Series - May 16, 2016.
Topics include:
* An overview of the physician payment reforms included in the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”)
* A summary of the Merit-Based Incentive Payment System (“MIPS”) and Alternative Payment Models (“APMs”) Proposed Rule (publication is expected in the spring of 2016)
* Opportunities for provider engagement with the Centers for Medicare & Medicaid Services to shape physician payment reform efforts
http://www.ebglaw.com/events/physician-payment-reforms-the-future-of-mips-and-apms-value-based-payments-crash-course-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Physician-Hospital Integration Strategies to Maximize the Bottom Line for Ort...Wellbe
Economic pressures on physicians and hospitals have increased attention on integration and collaboration between providers. The passage of the Patient Protection and Affordable Care Act (ACA) has propelled physician-hospital integration onto the national stage, forcing physicians and hospitals to change and accelerate their alignment structures with each other to meet the ACA’s mandates: quality excellence, population health management, efficiency, and cost savings. This presentation provides a detailed overview of strategies for the orthopedic service line that have been successfully implemented in order to achieve the Triple Aim while enhancing alignment with the service line’s physicians.
About the Speaker:
DanielleDanielle L. Sreenivasan, MHA is a senior manager with The Camden Group with more than ten years of healthcare experience. She specializes in strategic and service line business planning, facility planning, financial feasibility analyses, and medical staff planning and alignment on behalf of community hospitals, healthcare systems, academic medical centers, and physician medical groups. Ms. Sreenivasan has worked with clients analyzing current and potential markets and developing population-based healthcare strategies.
Prior to joining The Camden Group, Ms. Sreenivasan directed the Virginia Cardiac Network, LLC for Inova Fairfax Hospital located in Falls Church, Virginia. Her responsibilities included the development of strategic business plans and scorecards for clinical quality and budgeting processes, as well as oversight for the implementation of operational performance improvement plans. Ms. Sreenivasan’s experience also includes departmental and operational audits, and reimbursement analysis.
Ms. Sreenivasan received her master’s degree in health administration from Medical University of South Carolina with Honors, and her bachelor’s degree in accounting, business administration, and finance from the College of Charleston. She is a member of the American College of Healthcare Executives.
White Paper - eCQMs: It's Time to Make Data Quality the No. 1 Priority Q-Centrix
This white paper will examine eCQM data quality issues and their implications. It will raise questions hospitals should consider when developing strategies to improve their eCQM capabilities. Lastly, it will outline how they can benefit from implementing better data quality control practices and present new developments in eCQM data collection and reporting.
3 Perspectives to Better Apply Predictive & Prescriptive Models in HealthcareHealth Catalyst
In healthcare we tend to think of predictive or prescriptive model building and deployment as technical challenges. We do not put enough emphasis on the importance of change management. This disorientation leads to uneven adoption and results. In this webinar Jason Jones discusses and demonstrates three perspectives, accompanied by tools, to help you drive action and deliver better outcomes.
We develop predictive and prescriptive models in healthcare to improve Quadruple Aim outcomes—population health, patient experience, reduced cost, and positive provider work life. Successful adoption of predictive and prescriptive models heavily depends upon behavior change. This requires more than technical accuracy. While prediction algorithms abound, tools to facilitate change management remain scarce. During this webinar, we will discuss how to achieve model understanding using three perspectives: functional, contextual, and operational.
View the webinar to learn:
- Why a predictive or prescriptive model endeavor is more a change management challenge than a technical one
- How to apply three types of model understanding to a use case in your own organization
In this webinar, Jason Jones, PhD, Chief Data Scientist at Health Catalyst discusses and provides examples of our work using three perspectives of understanding to help clinical and operational leaders achieve value from predictive and prescriptive models. Investing time and effort to ensure model understanding is necessary for broad scale adoption.
An Overview of Kaiser Permanente - Integration and Information Systems in Hea...Empreender Saúde
Apresentação da Kaiser Permanente para o Brazilian Healthcare Trek: Mission Silicon Valley.
What is Kaiser Permanente?
Kaiser Permanente is committed to helping shape the future of health
care. We are recognized as the largest integrated delivery system in the
U.S. and one of the leading health care providers and not-for-profit
health plans.
Our strategy is to excel in providing high-quality, affordable health care
through our integrated delivery system, our investment in technology,
and our vision of supporting Total Health.
Our Mission and Vision
Mission: to provide high-quality, affordable
health care services and to improve the
health of our members and the communities
we serve.
Vision: To be a leader in Total Health by
making lives better.
7 regions serving 8 states and the District of
Columbia
More than 9.3 million members
More than 17,000 physicians and 174,000
employees (including 48,000 nurses)
38 hospitals (co-located with medical
offices)
608 medical offices and other outpatient
facilities
70 years of providing care (opened in 1945)
Mercy Hospital Freedom Program“Hospital Based Preventive Care Program coupled with Patient Financial Incentives”
William D. Kirsh, DO, MPH
Medical Director,Department of Preventive Medicine
During this webinar, we'll review CMS regulations and what’s required from providers for both Price Transparency and the No Surprises Act. We'll review strategies for implementation of both and talk about how CMS is currently responding to providers that haven't complied with Price Transparency requirements yet.
HXR 2016: The Health IoT: Remote Care and Mobile Solutions -Manu Varma, PhilipsHxRefactored
Through new telehealth technologies and increased data analysis physicians are gaining insights into patients like never before, allowing them to facilitate early interventions, improve adherence, and reduce readmission rates -- not to mention at a price more affordable than ever. The companies you’ll hear from in this session are using a healthy and innovative mix of data, educational tools, sensors, and more to improve patient outcomes.
Leveraging Medicare Fee-for-Service Reimbursement to Address Social Determina...PYA, P.C.
This presentation given at the 2019 HCBS Conference by PYA Principals Martie Ross and Kathy Greenlee provides:
- A practical explanation of CCM and RPM billing rules.
- Examples of CBO-delivered aging services for which Medicare reimbursement is available, such as in-home assessment, CCM, medication reconciliation and adherence, health promotion, and chronic disease self-management.
- Explanations for establishing relationships and negotiating contractual arrangements with healthcare providers to maximize funding.
-Examples of financial projects and successful partnerships.
It's no secret that any EHR takes away essential time with the patient and doctoring in general. See what athenahealth is doing to help remedy these frustrations and to make the best out of a bad situation.
Go deeper with athenahealth specialists to discover all that you need to know and some things you may not know about Meaningful Use Stage 2 and the newest government updates.
Learn about 2016 trends in government and private healthcare spending, employer costs, and the patient-as-consumer movement that's spurring new provider models.
Physician Payment Reforms: The Future of MIPS and APMs – Value-Based Payments...Epstein Becker Green
Epstein Becker Green Webinar with Attorney Lesley Yeung - Value-Based Payments Crash Course Webinar Series - May 16, 2016.
Topics include:
* An overview of the physician payment reforms included in the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”)
* A summary of the Merit-Based Incentive Payment System (“MIPS”) and Alternative Payment Models (“APMs”) Proposed Rule (publication is expected in the spring of 2016)
* Opportunities for provider engagement with the Centers for Medicare & Medicaid Services to shape physician payment reform efforts
http://www.ebglaw.com/events/physician-payment-reforms-the-future-of-mips-and-apms-value-based-payments-crash-course-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Physician-Hospital Integration Strategies to Maximize the Bottom Line for Ort...Wellbe
Economic pressures on physicians and hospitals have increased attention on integration and collaboration between providers. The passage of the Patient Protection and Affordable Care Act (ACA) has propelled physician-hospital integration onto the national stage, forcing physicians and hospitals to change and accelerate their alignment structures with each other to meet the ACA’s mandates: quality excellence, population health management, efficiency, and cost savings. This presentation provides a detailed overview of strategies for the orthopedic service line that have been successfully implemented in order to achieve the Triple Aim while enhancing alignment with the service line’s physicians.
About the Speaker:
DanielleDanielle L. Sreenivasan, MHA is a senior manager with The Camden Group with more than ten years of healthcare experience. She specializes in strategic and service line business planning, facility planning, financial feasibility analyses, and medical staff planning and alignment on behalf of community hospitals, healthcare systems, academic medical centers, and physician medical groups. Ms. Sreenivasan has worked with clients analyzing current and potential markets and developing population-based healthcare strategies.
Prior to joining The Camden Group, Ms. Sreenivasan directed the Virginia Cardiac Network, LLC for Inova Fairfax Hospital located in Falls Church, Virginia. Her responsibilities included the development of strategic business plans and scorecards for clinical quality and budgeting processes, as well as oversight for the implementation of operational performance improvement plans. Ms. Sreenivasan’s experience also includes departmental and operational audits, and reimbursement analysis.
Ms. Sreenivasan received her master’s degree in health administration from Medical University of South Carolina with Honors, and her bachelor’s degree in accounting, business administration, and finance from the College of Charleston. She is a member of the American College of Healthcare Executives.
White Paper - eCQMs: It's Time to Make Data Quality the No. 1 Priority Q-Centrix
This white paper will examine eCQM data quality issues and their implications. It will raise questions hospitals should consider when developing strategies to improve their eCQM capabilities. Lastly, it will outline how they can benefit from implementing better data quality control practices and present new developments in eCQM data collection and reporting.
3 Perspectives to Better Apply Predictive & Prescriptive Models in HealthcareHealth Catalyst
In healthcare we tend to think of predictive or prescriptive model building and deployment as technical challenges. We do not put enough emphasis on the importance of change management. This disorientation leads to uneven adoption and results. In this webinar Jason Jones discusses and demonstrates three perspectives, accompanied by tools, to help you drive action and deliver better outcomes.
We develop predictive and prescriptive models in healthcare to improve Quadruple Aim outcomes—population health, patient experience, reduced cost, and positive provider work life. Successful adoption of predictive and prescriptive models heavily depends upon behavior change. This requires more than technical accuracy. While prediction algorithms abound, tools to facilitate change management remain scarce. During this webinar, we will discuss how to achieve model understanding using three perspectives: functional, contextual, and operational.
View the webinar to learn:
- Why a predictive or prescriptive model endeavor is more a change management challenge than a technical one
- How to apply three types of model understanding to a use case in your own organization
In this webinar, Jason Jones, PhD, Chief Data Scientist at Health Catalyst discusses and provides examples of our work using three perspectives of understanding to help clinical and operational leaders achieve value from predictive and prescriptive models. Investing time and effort to ensure model understanding is necessary for broad scale adoption.
An Overview of Kaiser Permanente - Integration and Information Systems in Hea...Empreender Saúde
Apresentação da Kaiser Permanente para o Brazilian Healthcare Trek: Mission Silicon Valley.
What is Kaiser Permanente?
Kaiser Permanente is committed to helping shape the future of health
care. We are recognized as the largest integrated delivery system in the
U.S. and one of the leading health care providers and not-for-profit
health plans.
Our strategy is to excel in providing high-quality, affordable health care
through our integrated delivery system, our investment in technology,
and our vision of supporting Total Health.
Our Mission and Vision
Mission: to provide high-quality, affordable
health care services and to improve the
health of our members and the communities
we serve.
Vision: To be a leader in Total Health by
making lives better.
7 regions serving 8 states and the District of
Columbia
More than 9.3 million members
More than 17,000 physicians and 174,000
employees (including 48,000 nurses)
38 hospitals (co-located with medical
offices)
608 medical offices and other outpatient
facilities
70 years of providing care (opened in 1945)
Mercy Hospital Freedom Program“Hospital Based Preventive Care Program coupled with Patient Financial Incentives”
William D. Kirsh, DO, MPH
Medical Director,Department of Preventive Medicine
During this webinar, we'll review CMS regulations and what’s required from providers for both Price Transparency and the No Surprises Act. We'll review strategies for implementation of both and talk about how CMS is currently responding to providers that haven't complied with Price Transparency requirements yet.
HXR 2016: The Health IoT: Remote Care and Mobile Solutions -Manu Varma, PhilipsHxRefactored
Through new telehealth technologies and increased data analysis physicians are gaining insights into patients like never before, allowing them to facilitate early interventions, improve adherence, and reduce readmission rates -- not to mention at a price more affordable than ever. The companies you’ll hear from in this session are using a healthy and innovative mix of data, educational tools, sensors, and more to improve patient outcomes.
Leveraging Medicare Fee-for-Service Reimbursement to Address Social Determina...PYA, P.C.
This presentation given at the 2019 HCBS Conference by PYA Principals Martie Ross and Kathy Greenlee provides:
- A practical explanation of CCM and RPM billing rules.
- Examples of CBO-delivered aging services for which Medicare reimbursement is available, such as in-home assessment, CCM, medication reconciliation and adherence, health promotion, and chronic disease self-management.
- Explanations for establishing relationships and negotiating contractual arrangements with healthcare providers to maximize funding.
-Examples of financial projects and successful partnerships.
Webinar: “While You Were Sleeping…Proposed Rule Positioned to Significantly I...PYA, P.C.
You likely know from the headlines that the 2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule slashes payments for surgical specialists. But the impact of the Proposed Rule is far broader, reflecting a fundamental realignment driven by the transition to value-based payments. In our webinar, “While You Were Sleeping…Proposed Rule Positioned to Significantly Impact Physician Compensation,” PYA experts addressed these proposals, helping you understand and prepare for the changes ahead.
Following this presentation, attendees were able to:
Understand how a handful of wRVU changes would alter Medicare reimbursement for nearly all physicians.
Appreciate the operational impact of these changes.
Recognize the challenges to existing physician compensation models.
Identify strategies and tactics to prepare for and manage these impacts.
Presenters include PYA Principals Angie Caldwell, Martie Ross, and Valerie Rock. The webinar took place Thursday, September 10 and was hosted in conjunction with the Florida Hospital Association.
If you have additional questions about the MPFS Proposed Rule and its impact on physician compensation or need assistance with any matter involving physician compensation, valuation, strategy and integration, or compliance, contact a PYA executive below at (800) 270-9629.
Trends From The Trenches : Adapting to Affordable Care Act: Provider and Heal...Andrea Simon
As the Affordable Care Act is implemented and healthcare expenditures continue to rise, providers and payers need to explore how to best set themselves up to succeed in an evolving marketplace. In this 5th webinar, Margaret Davino will discuss how the relationships between hospitals, physicians and other providers are changing and what structures are being used for providers and payers to work together, including accountable care organizations (ACOs). Margaret will also describe the different models of collaboration between hospitals and physicians, how these affect reimbursement, and what to expect in the future.
JOIN US Thursday, Nov 17, 2016 1:30 PM - 2:30 PM EST to learn about the 1099 Chronic Care Medical Sales Opportunity with CareSync, the leading provider of technology & services for care coordination & chronic disease management. Platform provides in combination with our 24/7 nursing services facilitates care coordination for patients, their providers, family,& caregivers.
Check out the CareSync Slideshare to learn more about chronic care management. J
Join the Conference Call THURSDAY , Nov 17th 1:30 pm ( ET)
Call (213) 929-4232
Access Code: 226-975-231
CareSync 1099 Medical Sales Opportunity !
JOIN US Thursday, Nov 17, 2016 1:30 PM - 2:30 PM EST to learn about the 1099 Chronic Care Medical Sales Opportunity with CareSync, the leading provider of technology & services for care coordination & chronic disease management. Platform provides in combination with our 24/7 nursing services facilitates care coordination for patients, their providers, family,& caregivers.
Check out the CareSync Slideshare to learn more about chronic care management. J
Join the Conference Call THURSDAY , Nov 17th 1:30 pm ( ET)
Call (213) 929-4232
Access Code: 226-975-231
JOIN US Thursday, Nov 17, 2016 1:30 PM - 2:30 PM EST to learn about the 1099 Chronic Care Medical Sales Opportunity with CareSync, the leading provider of technology & services for care coordination & chronic disease management. Platform provides in combination with our 24/7 nursing services facilitates care coordination for patients, their providers, family,& caregivers.
Check out the CareSync Slideshare to learn more about chronic care management. J
Join the Conference Call THURSDAY , Nov 17th 1:30 pm ( ET)
Call (213) 929-4232
Access Code: 226-975-231
JOIN US Thursday, Nov 17, 2016 1:30 PM - 2:30 PM EST to learn about the 1099 Chronic Care Medical Sales Opportunity with CareSync, the leading provider of technology & services for care coordination & chronic disease management. Platform provides in combination with our 24/7 nursing services facilitates care coordination for patients, their providers, family,& caregivers.
Check out the CareSync Slideshare to learn more about chronic care management. J
Join the Conference Call THURSDAY , Nov 17th 1:30 pm ( ET)
Call (213) 929-4232
Access Code: 226-975-231
JOIN US Thursday, Nov 17, 2016 1:30 PM - 2:30 PM EST to learn about the 1099 Chronic Care Medical Sales Opportunity with CareSync, the leading provider of technology & services for care coordination & chronic disease management. Platform provides in combination with our 24/7 nursing services facilitates care coordination for patients, their providers, family,& caregivers.
Check out the CareSync Slideshare to learn more about chronic care management. J
Join the Conference Call THURSDAY , Nov 17th 1:30 pm ( ET)
Call (213) 929-4232
Access Code: 226-975-231
Please send your questions, comments & feedback to: Pat@patlicata.com
JOIN US Thursday, Nov 17, 2016 1:30 PM - 2:30 PM EST to learn about the 1099 Chronic Care Medical Sales Opportunity with CareSync, the leading provider of technology & services for care coordination & chronic disease management. Platform provides in combination with our 24/7 nursing services facilitates care coordination for patients, their providers, family,& caregivers.
Check out the CareSync Slideshare to learn more about chronic care management. J
Join the Conference Call THURSDAY , Nov 17th 1:30 pm ( ET)
Call (213) 929-4232
Access Code: 226-975-231
Understand what patient engagement truly means, its benefits for both patients and providers, and how to increase patient engagement through marketing.
Convert with Confidence: Barriers and Benefits of the EHR Switchathenahealth
Is your current electronic health record not working the way you want it to? Switching to a new system can be difficult without the right partner with the knowledge and support to help.
ICD-10 Progress Report: How Practices are Handling the Transitionathenahealth
Tracking network data from over 73,000 providers across the country, athenahealth monitors the success of our practices' transition to ICD-10. Find out how we made the change easy and effortless.
Join athenahealth maven Dr. Tidwell as he explores issues surrounding independent practices who wish to remain so and what steps physicians can take to thrive on their own, with just a little help from an EMR.
Keeping Community Hospitals Thriving and Independentathenahealth
Research showing hospitals how to best maintain their independence while conducting a thriving business model in changing times of governmental regulation.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
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R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
3. 3
Projected Medicare Fee-for-
service Payment Cuts per
the ACA
2014 2015 2016 2017 2018 2019 2020
Projected number of Medicare
beneficiaries
54M 56M 57M 59M 61M 63M 64M
-14B -21B -25B -32B -42B -53B -64B
Source: CMS, “2013 Annual Report of the Boards of Trustees of the Federal Hospital Insurance
and Federal Supplementary Medical Insurance Trust Funds,” May 31, 2013, available at: http://downloads.cms.gov/files/TR2013.pdf
4. FFS versus FFV
Eliminates incentive
to increase volume
Eliminates incentive
to provide high-cost
services over equally
effective low-cost
services
Quality-based incentives
Shared risk
Emphasizes the role of
primary care providers
Encourages
coordination of care
Fees billed per units of
service
Income maximized
through volume
No penalty for poor
quality
Providers lose money if
they reduce
unnecessary services
Volume
Driven
Health Care
Value
Driven
Health Care
Fee-for-service Value-based
payments
5. 2018: 90%
of Medicare
payments
tied to quality.
2020: 75% of
commercial
plans will be
value-based.
Jan 2015. http://www.hhs.gov/news/press/2015pres/01/20150126a.html
8. 2007
PQRI starts
2016
PQRS VM
applies to
all HCPs
2011
Meaningful
Use Stage
1
2014
Meaningful
Use Stage
2
2017
Start MIPS
or APM
2015
Meaningful
Use
penalties
hit
2015
ICD-10
2015
PQRS
penalties
hit
11. Two options to demonstrate value
SOURCE: The Medicare Access and CHIP Reauthorization Act of 2015; Advisory Board analysis.
Merit-Based Incentive Payment System1
2020:
-5% to +15%
2019:
-4% to +12%
2022 and on:
-9% to +27%
2021:
-7% to +21%
2018: Last year of separate MU,
PQRS, and VBM penalties
1. Positive adjustments may be scaled by a factor of up to 3 times the negative adjustment to ensure budget neutrality. Actual positive adjustments may
be lower than numbers shown here. In addition, top performers may earn additional adjustments of up to 10 percent.
1
2. APM participants who are close to but fall short of APM bonus requirements will not qualify for bonus but can report MIPS measures and receive
incentives or can decline to participate in MIPS.
2019 - 2024: 5% participation bonus
2019 - 2020: 25% Medicare
revenue requirement
2021 and on: Ramped up Medicare or
all-payer revenue requirements
Advanced Alternative Payment Models22
14. 14
1 MD
Solo Family Practice
1,410
Patients
per year
$909,322
Annual
revenue
12%
OF TOTAL 2016
ANNUAL REVENUE
$119,144 AT STAKE
800K 860K 920K 980K 1.04M 1.1M
$35,532 CCM (1 month)
$42,540 TCM (avg. complexity)
$26,578 VM & HCC
$104,650 REWARD
MU $7,247
PQRS & VM $7,247
PENALTY $14,494
15. 15
5 MDs
Group Family Practice
4,078
Patients
per year
$3,299,569
Annual
revenue
13%
OF TOTAL 2016
ANNUAL REVENUE
$426,542 AT STAKE
3M 3.2M 3.4M 3.6M 3.8M 4M
$102,766 CCM (1 month)**
$123,033 TCM (avg. complexity)1
$129,903 VM & HCC*
$355,702 REWARD
MU $35,420
PQRS & VM $35,420
PENALTY $70,840
16. 16
10 MDs
Orthopedic Practice
5,920
Patients
per year
$11,621,454
Annual
revenue
9%
OF TOTAL 2016
ANNUAL REVENUE
$1,094,736 AT
STAKE
11M 11.4M 11.8M 12.2M 12.6M 13M
$178,606 TCM (avg. complexity)t
$5,000 Bundles
$646,651 VM & HCC*
$830,257 REWARD
MU $105,792
PQRS & VM $158,687
PENALTY $264,479
17. 17
30 MDs
Multi-Specialty Practice
14,876
Patients
per year
$11,196,511
Annual
revenue
18%
OF TOTAL 2016
ANNUAL REVENUE
$2,021,573 AT
STAKE
10M 10.8M 11.6M 12.4M 13.2M 14M
$374,863 CCM (1 month)**
$448,794 TCM (avg. complexity)t
$1,250 Bundles
$849,303 VM & HCC*
$1,674,210 REWARD
MU $138,945
PQRS & VM $208,418
PENALTY $347,363
20. MU versus PQRS
Eligible providers
PQRS Meaningful Use
MEDICARE PHYSICIANS
Doctor of Medicine X X
Doctor of Osteopathy X X
Doctor of Podiatric Medicine X X
Doctor of Optometry X X
Doctor of Oral Surgery X X
Doctor of Dental Medicine X X
Doctor of Chiropractic X X
PRACTITIONERS
Physician Assistant X
Nurse Practitioner X
Clinical Nurse Specialist X
Certified Registered Nurse Anesthetist X
Certified Nurse Midwife X
Clinical Social Worker X
Clinical Psychologist X
Registered Dietician X
Nutrition Professional X
Audiologists X
THERAPISTS
Physical Therapist X
Occupational Therapist X
Qualified Speech-Language Therapist X
21. PQRS versus MU
Number of measures
9
out of
287
measures
PQRS Meaningful Use
20
out of
23
measures
22. PQRS versus MU
Measurement style
Report first.
Then,
performance
against your
peers.
PQRS Meaningful Use
Measure
thresholds.
23. Value-Based Payment Program uses data in
PQRS to rate practices on cost & quality
23
(above average) COST (below average)
QUALITY
24. 0% +2% +4%
-2% 0% +2%
-4% -2% 0%
Rewards and penalties are based on how
practices perform relative to the nation
24
(above average) COST (below average)
QUALITY
25. PQRS versus MU
Practices facing penalties in 2015
Nearly 40% of
eligible providers face a
payment reduction for
not reporting in 2013.
PQRS Meaningful Use
More than 30%will
be penalized for not
meeting requirements in
2013 and 2014.
28. Transitional Care Management
pays for the work of reducing re-hospitalization
Medicare Physician Reimbursement:
Evaluation & Management versus TCM
Moderate Complexity High Complexity
$300
$200
$100
$0
$111
$239
$75
$171
E&M TCM
29. 29
During the first 30 days after
discharge…
• Interactive communication between patient and
caregiver within 2 business days of discharge
• Non-face-to-face services, such as reviewing
discharge information or assisting in follow-up with
other providers
• A face-to-face visit within either 7 or 14 calendar
days of discharge
32. 32
Chronic care management pays for care
between visits for chronic conditions
$42.60 Medicare Payment
20+ Minutes per month
Patients with 2 or more Chronic Conditions
Aimed at PCPs, open to any specialty
33. 33
• Alzheimer’s disease and related dementia
• Arthritis (osteoarthritis and rheumatoid)
• Asthma
• Atrial fibrillation
• Autism spectrum disorders
• Cancer
• Chronic Obstructive Pulmonary Disease
• Depression
• Diabetes
• Heart failure
• Hypertension
• Ischemic heart disease
• Osteoporosis
Examples of eligible Chronic Conditions
35. 35
EHR Connectivity
& Interoperability
Data Registries
Patient &
Provider
Portals
Data Warehousing
& Mining
Acute
Care
PHARMAC
Y
SPECIALT
Y
CARE
PATIENT/FAMILY
SUPPORTS
HOME CARE
ACUTE
CARE
EMERGENCY
CARE
SUPPORTIVE
/PALLIATIVE
CARE
TELEHEAL
TH
LONG
TERM
CARE
Medical Home
PCMH helps provide better access to and
more coordinated primary care
36. PCMH Recognition Through NCQA
36
Three Levels of Recognition
✔
✔
✔
Level 1: 35-59 points
Level 3: 85-100 points
Level 2: 60-84 points
37. A partner for VBR:
athenahealth’s
Full Value Program
46. 46
Our clients are already performing better…
Meaningful Use
Stage 2 attestation
% of HCPs avoiding
PQRS penalties in 2015
NATIONAL
AVERAGE
60%
ATHENAHEALTH
CLIENTS
93.6%
NATIONAL
AVERAGE
33%
ATHENAHEALTH
CLIENTS
98.2%
47. 47
Our PCMH program was the first of its type,
and remains the best in the business
85
35.25
45.5
0
20
40
60
80
100
Minimum amount of
points for NCQA Level 3
Practice Responsibility
4.25
athena-Enabled
Auto Credits*NCQA
Level 1
NCQA
Level 2
*pre-validated NCQA points
*practice support points
athenahealth PCMH
Accelerator Program
NCQA
Level 3
50. 50
OUR VISION:
Build the health
information backbone that
makes health care work
as it should.
Practice
management
system
Patient
Portal (ambulatory)
Most usable
EHR
#1
#1
#1
Why is VBR even happening? What is starting all of these changes? Well, the government is dramatically changing the way doctors are getting paid. Why is that?
It’s because the number of Medicare beneficiaries has been and will continue to increase exponentially over the next five to ten years, mostly driven by the “baby-boomers” hitting the retirement age. So as to not bankrupt the country, the Medicare fee cuts have to be cut just as much to compensate.
The big shift is moving from what is known as a “fee-for-service” environment to a “fee-for-value” environment, or “value based”. These value based payments are very different in that they really incentivize quality based care. Instead of high volume where money is made form providing more care, it is all about high quality, where payments come from the type of care that is provided.
As of January of this year, the government has committed that 90% of their Medicare payments will be tied to quality by 2018. The commercial payers have followed this example and have committed that at least 75% of their plans will be value-based by 2020.
This leads a lot of practices to feeling like they’ve hit the end of the trail and may not quite know where to go from here or even how to navigate through all these governmental changes going forward, what path to take, so to speak.
-------------------------------------
2015 is a year of intense change. New legislation, rulings, announcements, proposals, and constant changes from the government surrounding the healthcare community have been especially noticeable this year just by the sheer amount coming from the capitol. Much of the changes are pushing aggressively toward reworking payment systems into exclusively quality based programs and unfortunately a lot of the resulting work will fall at the feet of healthcare professionals. Keeping up with all these recent developments can feel a bit like hiking out into uncharted territory, especially now that you’re put in the position of needing to know more about new reporting and documentation measures than ever before.
Image source: https://www.flickr.com/photos/33346716@N03/8036177029
For many practices or small practices in the country, VBR can feel like one more thing to juggle in addition to all the other change facing them over the last few years, and VBR is definitely a big change. It’s really hard to get your head around and it’s a big umbrella for a lot of programs, making it a good one to really buckle down and focus on. Plus, the fact that it comes with some very significant fee cuts, starting actually based on your performance this year, a practice could see a 4% fee cut in years ahead.
----------------------------
Note: you can’t talk about everything and all the buckets but you might want to pick out a few so as they appear so you can narrate along as they pop up: “PCMH, ACO, Self-Pay, ICD-10, Meaningful Use….”
It’s already difficult enough with all the changes to payers, hospitals, patients and government.
Patients are more involved today and payers are coming up with new strategies like ACOs, hospitals are acquiring practices, etc, etc.
So it can feel like trying to run your practice is like walking a tightrope, trying to balance all this change while you keep getting handed more to juggle, more things that can upset your balance
----- Meeting Notes (9/2/15 12:37) -----
revenue hit - make more clear
16, 17, 18 (-10)
no dark version
In order to set some context, let’s talk about the history of those programs. PQRS started back in 2007 then called PQRI. Meaningful Use was introduced in 2011 as part of the American Recovery and Reinvestment Act. In 2014, Meaningful Use Stage 2 went into effect, it was delayed a couple of years but many providers have since attested for Stage 2. In this year, 2015, it’s the first year that your performance is going to be directly tied to quality of care, in other words if you don’t perform well you could see a penalty associated with your Medicare payments. 2015 is also the same year you have to successfully transition over to ICD-10 so it’s a pretty full year. Then next year in 2016, PQRS will apply to all health care professionals. Up until now, it’s only been for about six providers or more but in 2016 the value-based modifier will apply to everyone which will make it a lot more complicated. In 2017, this is the part of the SGR Repeal bill that was written into law, Meaningful Use and PQRS will actually go away and be recreated as a new program called MIPS. Hopefully this means it will all be simplified although CMS has not yet revealed all the details of that program.
Before getting into the details of the here and now and what you should be thinking about when it comes to value-based reimbursement, I want to give you a quick update of what’s been going on in Washington, D.C. Many of you are aware that the sustainable growth rate repeal bill passed back in April. In the bill, there was a small line item that is causing some very big ripples by changing the way Meaningful Use and PQRS programs are going to exist in the future.
Even so, the idea behind MIPS is to take Mr. Potato head and make him look a little simpler and less intimidating if not just less jumbled.
The line item included in the SGR Repeal bill is called MACRA basically has two parts. You can either join MIPS, the merit-based incentive payment system, it starts in 2015 and is essentially fee-for-service with incentives and penalties depending on how you do with your reporting of quality and cost. Or you can become an alternative payment model and substantially change how you practice medicine. An example of an alternative payment model is a patient centered medical home and if you become a PCMH you could see a 5% bonus in your Medicare payments.
--------------------------------
To dive a little deeper, per MACRA, providers will have two Medicare value-based reimbursement options, starting in the 2017 reporting year to impact reimbursement in 2019: the Merit-Based Incentive Payment System (MIPS) or Alternative Payment Models (APMs).
Furthermore, under MIPS, the swing in Medicare FFS rates will increase to 36% by the year 2022. These are big variants with real revenue impact.
However, providers have another option – those that can successfully participate in an alternative payment model or “APM” are exempt from MIPS (though many APMs also require quality reporting, but that quality reporting is taken care of as part of the participation in the APM, so MIPS would be kind of redundant.
With MACRA, legislators have made it clear that they want to offer significant incentive for practices to make the move to providing care through APMs, some of which have proven to bring about greater levels of care coordination and patient-center health management, such as PCMH. The bill proposes that starting in 2019, providers receive an automatic 5% participation bonus simply for proving that they are participating in an APM.
All of that is in the future, though not the very distant future. However you still need to be aware of value based reimbursement programs today and making sure you’re a) avoiding the penalties and b) cashing in on all the incentive payments that are out there between now and 2018.
To simplify it a little bit for you we like to group all these programs into three buckets. There are the programs that come with revenue threats, Medicare fee cuts if you don’t preform well. There are the programs that come with incentives if you participate. Then there are the programs that are essentially a new way of how you get reimbursed which we’re not going to talk about today but many of you are aware of accountable care organizations and similar models that are typically for larger organizations that are taking on risk.
For practices like yours, let’s talk a little about what next year might look like. Here’s an example of a one doctor solo family practice who sees approximately 1,410 patients a year and your annual revenue is a little under a million dollars you essentially have about 120,000 dollars at stake or in play so that is 14,000 in Meaningful Use and PQRS penalties on the downside and over 100,000 in incentives payments coming from programs like Chronic care management, transitional care management, and the value based modifier associated with PQRS.
----- Meeting Notes (9/2/15 12:37) -----
Add poll questions????
10 doctor orthopedic practice – are eligible for bundled payments
----- Meeting Notes (9/2/15 12:37) -----
should it say "2016"
show the red first. then the green.
How do you avoid the ax or avoid the penalties associated with Meaningful Use and PQRS?
Let’s first talk a little bit about what these two programs are.
Almost every health care professional is eligible for PQRS. With Meaningful Use there is a lot, roughly 300,000 but way more with PQRS.
With PQRS as we said there are almost 300 measures which you only have to report out on 9 of them but the trick is finding which 9 measures out of the 300 are best for your practice to be successful in and report out on so it’s pretty complicated in terms of picking those 9 measures. Meaningful Use it’s a little easier to pick since you’re only picking out of 23 but you actually have to report on double the number of measures and be successful in all 20
When it comes to how you get measured, with PQRS you submit a report with all your data and then CMS measures you against your peers to see how you did so essentially you’re measured on a curve. With Meaningful Use you just have to hit thresholds so you have to be good enough at the measures you selected to hit the thresholds set out by CMS
To explain how the PQRS value based modifier works, this is your patient panel. Some of your patients cost more, some cost less, some received really great quality, some maybe didn’t which puts you at an average, about where that red dot is.
CMS then takes your data and compares you to other practices, or the other red dots on this grid. In this case, looks like you did about average which means that you won’t get hit with a payment reduction but you also won’t get an additional payment incentive. If you had done better and ended up in the upper right quadrant you might have seen as much as 4% bump on your Medicare payments.
Nationally the providers have really struggled with both programs. In 2013 40% of eligible providers did not do well enough to avoid the payment reduction. With Meaningful use that was more that 30%
9% 10% 2018
That’s it for the penalty programs, now let’s talk about the additional revenue or incentive programs.
The first one is Transitional Care management or TCM
A program that gives you extra money for doing the work of reducing hospital admissions. Siginifact increase oin your
Communication between patient and provider within 2 business days of discharge
Non-face-to-face services, such as reviewing discharge information or assisting in follow-up
Face-to-face visit within either 7 or 14 calendar days of discharge
20% of discharged patients are readmitted within 30 days*
78% of hospitals penalized in 2015 due to readmission rates**
$12B in preventable readmission costs per year*
For chronic care management this pays for the work done between visits for patients with chronic conditions, at least two chronic conditions
CCM reimbursement was finalized by Medicare in the 2015 Physician fee schedule final rule and the AMA created a new CPT code 99490 also effective 1/1/15 that Medicare decided to use for these services.
So what is CCM? CCM is a payment for non-face to face care coordination services. CCM services include developing and revising a patient’s care plan, communicating with other treating health professionals, and medication management. The 99490 code can be billed once per calendar month if the requirements are met and at least 20 min of care coordination was provided.
Patients eligible must have 2 or more chronic conditions expected to last at least 12 months, place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline. Remember that 65% of Medicare beneficiaries have 2 or more chronic conditions.
While there is no requirement that CCM services be billed by a patient’s PCP, CMS expects the “chronic care management code to be billed most frequently by primary care physicians.”
The Medicare payment for these services each calendar month is around $40 and is subject to patient cost sharing like coinsurance and the beneficiaries deductible.
The last one I’m going to talk to you about is an alternative payment model the Pat
The primary care is at the center of care coordinating care for their patients, specialists, long term care, whatever they become the sort of quarterback for their patients
PCMH helps to provide better access to care and service by promoting a more coordinated approach to managing patients, with an emphasis on the integration of key new technologies and teamwork in support of that coordination. This then leads to returns on an improved patient experience and ultimately improved health.
While the number of medical homes with payment initiatives have grown substantially, more providers must show support for this model to achieve its consistency in the health care community and continue to increase recognition and financial reward for PCMH success.
Sources: http://www.bostonherald.com/news_opinion/opinion/op_ed/2015/06/as_you_were_sayingfinding_care_close_to_home
http://www.washingtonmonthly.com/magazine/july_august_2013/features/first_teach_no_harm045361.php?page=1
https://www.pcpcc.org
In order to become recognized as a PCMH, you need to go through a certification board. The most popular is NCQA which offers three levels of recognition. Most PCMHs try to get to level three because the return on investment is much higher.
A measurable points system goes along with each (click) of the three levels of recognition. Six of six elements are required at each level, and the score for each “Must-Pass” element must be greater than or equal to 50%. (click) athenahealth has the NCQA pre-validated auto-credits and approved “practice support” points needed to automatically get your practice above the 35-point Level 1 threshold and to make getting your practice across the line to achieve Level 3 much easier. We’ll talk more about athena’s support in a moment.
Source: http://www.ncqa.org/Portals/0/Events/BehindtheEnhancements_FINAL.pdf
Animation: Click for all check marks, click again for dotted line and logo
So those are all the programs which might be slightly overwhelming. I’d like to spend the rest of my time just quickly talking about what a partner can look like in order to avoid penalties and secure incentives. At athenahealth, this is our approach:
We at athena have three teams that are tracking over 100 different reimbursement programs
Government affairs team go down to Washington D.C. to monitor changes
Payer performance team, tracking every measure in every program to make sure we are embedding it in the right way in our software
We have a quality management engine that sorts though more that 1,700 clinical rules that works for you
Those measures are surfaced at a point that is not disruptive but it is specific to the patient that comes into the office that is most appropriate to so you can satisfy those measures at the moment of care
We provide real time visibility into how you’re doing
When a practice uses our proven, cloud-based EHR and patient engagement services, achieving PCMH Level 3 recognition is within reach. Follow our simple workflows and you’ll automatically receive 35.25 pre-validated points. Combine those points with our NCQA approved “practice support” appoints, and athenaOne clients are only 4.25 points away from achieving Level 3, the highest level of NCQA PCMH recognition.
We offer a cloud-based integrated service for practices like yours.
Aside from our scale and open platform what makes use unique is our business model. Unlike other vendors, we sell results, not software. We promise clinical and financial results to health care providers and align our incentives with theirs. We then combine the work of expert service teams with the power of an always-on, up-to-date information platform to deliver on that promise. By combining cloud-based software, network knowledge, and robust services we’re able to markedly improve clinical and financial results for our clients, year over year.
So what are the results of the software, knowledge, and services that athenaHealth products can provide?
What goes on, both on your computer screen and behind the scenes at athenaHealth, from before a patient enters your office to the moment you get paid?
Today we are…
At the end of the day, all the work we do to keep our clients on top of change and support them with the technology and services they need to be successful with VBR is to unburden the skilled physician of tedious, time-consuming and unfulfilling administrative work, so they can get back to doing what they want to be doing, what they were trained to do, which is managing patient health through great care.