Medical and specialty practices also have to deal with changing regulations, coding challenges tied to payment denials, varying patient requirements, shifting care delivery models, and so on and so forth. All of this can begin to feel overwhelming, but it doesn't have to.
Take a deep breath, and let's talk about report building.
The most obvious aspect of report building is integration with existing healthcare data that originates from your entire practice, including that provided by your EHR, practice management solution (PM) and online patient portals. Your insights are only as trustworthy and as useful as the data they were extracted from. Again, this is particularly important for Value-Based Care (VBC), which requires close examination of patient-recorded outcomes and the relationship those outcomes have to existing operations.
On the RCM side of things, VBC-driven regulations like the Medicare Access and CHIP Reauthorization Act's (MACRA) Merit Based Incentive Payments System (MIPS) put greater pressure on practices to accurately track their charges. In order to excel in the Clinical Quality Measures (CQMs) that now directly impact reimbursement values, practices will invariably need to make changes to their operational workflows – if for no other reason than to track CQMs effectively. Process adjustments should be well-thought-out, and implemented only if and when you can quantitatively demonstrate your practice's ability to maintain financial independence.
The rise of VBC introduces a host of new practices and complexities, not only to the process of patient care, but also to your cost of providing it. Therefore, it’s critical to track the burdens imposed by these new processes, so that those that are too costly can be identified and adjusted before causing significant harm to your bottom-line. This will require your PM’s report builder to not only have seamless integration with EHR data that demonstrates patient progress but also with the different PM processes involved in facilitating that progress. In other words, it answers this question: "What resources, technology and additional steps have we taken to achieve our desired QCMs, how much did it cost, and what was the monetary value of the yielded healthcare outcomes?"
Ideally, your front-desk staff shouldn't have to spend hours chasing down the information that would go into this type of high-level business analysis. And with a good report builder that's integrated into your PM tool and EHR, they won't have to. That data will already be recorded and ready to be incorporated into a report.
"When patients forgo referrals, provider organizations lose revenue because the missed opportunities translate into problems, such as low completion rates (no-shows), lost staff efficiency from time spent coordinating appointments, and a poor patient experience for those who never receive the care they were prescribed," Fusacchia wrote.
It seems like a pretty obvious correlation when you look at it that way. Yet, not many practices will pause and linger on the fact that something as simple as not being more proactive with referrals might be a missed source of revenue - it's simply because they couldn't see it.
The purpose of creating and reviewing reports on a weekly, monthly or even quarterly basis is to see these types of opportunities. A spreadsheet won't make something like that jump out at you. But a referral-to-patient conversion report might give you enough pause to ask the question, "what's happening here?" Some say a good picture is worth a thousand words. In practice management, it's worth thousands of dollars.
Last but not least, the amount of time spent creating these visualizations should not interfere with other job functions and responsibilities. You're already at an advantage if your PM comes equipped with a report-building function, since the data is already structured and there for your convenience – no IT support or manual, painstaking data migrations necessary.
But, a best-in-class report builder like AllMeds' Report Designer goes yet a step further by providing pre-made reports for the obvious metrics such as billing collection rates, charge lag days, percent of denied claims, days to account receivable and so on. What's more, AllMeds’ Report Designer uses a simple drag-and-drop interface to facilitate the creation of custom reports that can feature drill-down capabilities for deeper data analysis. Reports can be easily exported in a variety of formats to share with practice stakeholders.