thriving as an independent practice

This event is live as of XYZ

Thriving as an Independent Practice

Emily NovotnyManager, athenahealth

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Care is moving out of the hospital while outpatient visits continue to

rise

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Source: MedPac Medicare Payment Advisory Commission, A Data Book: Health Care Spending and the Medicare Program, June 2014 http://www.medpac.gov/-documents-/data-book

20062007

20082009

20102011

2012

353025201510

50

-5-10-15

Fiscal Year

Cum

ulat

ive

Perc

ent C

hang

e 28.5

-12.6

Outpatient services per FFS Part B beneficiaryInpatient discharges per FFS Part A beneficiary

There has been an enormous trend of hospitals buying hospitals…

5

As of August 2013

50

50

60

60 5

0

76

93

105

46

2005 2006 2007 2008 2009 2010 2011 2012 2013

Hospital Mergers and Acquisitions

First signs that physician consolidation has leveled off

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Source: athenahealth’s addressable market (physicians) based on athenahealth analysis using SK&A, HIMSS, and self-collected data

% Employed Physicians 800

700

600

500

400

300

200

100

-2011 2012 2013 2014

650K

676K

684K

692K

44%

50%

57%

57%

56%

50%

43%

43%

EmployedIndependent

Given the opportunity, doctors want to stay independent

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Survey of the Epocrates user base. February 2015. Answered: 2,144 Skipped: 642

I would prefer to practice

independently

I would prefer to be employed by a

larger group

I am not sure

58.14%

20.10%

11.75%

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Independent providers see

16% morepatientsthan employed providers

Independent practices see5.9% fewerno-showsthan owned practices

5.9%

9

Patients wait

4 days longerto see an employed PCP than an independent PCP

Nevertheless, practices are turning to employmentbecause they are struggling to survive

Clinical Transformation: New Business Models for a New Era in Healthcare. Accenture, 2012. http://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Clinical-Transformation-New-Business-Models-for-a-New-Era-in-Healthcare.pdf#zoom=50

Top Concerns That Influence Decision to Seek Employment

Business Costs & Expenses

Prevalence of Managed Care

EMR Requirements

Maintaining/Managing Staff

Number of Patients Required to Break Even

87%

61%

53%

39%

53%

10

12

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1.Case Study:Financial control and visibility

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ESD Pediatric GroupDr. Jeff Drasnin

2 nurse practitioners

Nearly 30,000 patient visits annually

2 offices

5 physicians

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They struggled to control revenue.• Moved to outsourced billing in order to keep pace in a

changing economic environment• Initial vendor did not provide transparency• Severe cash flow problems

o Had no idea of what money was coming ino Collections were inconsistent o Claims were being written off or not collected per contract.o Days in accounts receivable at 45+

• Significant time was being spent by office staff and management to keep the office afloat

ESD Pediatric Group Dr. Jeff Drasnin

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They changed strategy.• Selected a cloud-based service for EHR, practice management

and patient communications• Co-sourcing (rather than outsourcing) allowed for full transparency • Efficient delegation of patient scheduling, billing, invoicing, claims

processing, etc. • No need to upgrade. When network upgrades, they’re upgraded.

ESD Pediatric Group Dr. Jeff Drasnin

Back officework can be done off site.

Remote network management by experts.

Easy access to robust financial and operational reporting

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21

ESD Pediatric Group Dr. Jeff Drasnin

Results

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ESD Pediatric Group Dr. Jeff Drasnin

60% practice

collections

11.11%

decrease in no-show rate

51% decrease in days in accounts

receivable

2.Case Study:Competing with the local hospital

Austin Cardiac

Clinic4 full time employees

5,500 patient visits annually

1 physician

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A quest to stay independent.• Declining Medicare reimbursements for cardiology• State regulations add complexity to filing claims and

collecting revenue• Competition with local hospital across the street

Austin Cardiac Clinic

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Dr. Tiblier on the cloud… • Practice runs lean and efficient to allow financial

flexibility and independence • Able to charge less than local hospitals• Flexible online tools create higher patient satisfaction

and more patient loyalty

Austin Cardiac Clinic

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Austin Cardiac Clinic

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Pharmacies

Payers

Public Health

Labs

Patients Practices andHospitals

3.Case Study:Achieving lofty clinical and strategic goals

Midlands Orthopaedics,

P.A.3 locations

20,000 unique patient visits annually

14 physicians

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An independent practice with lofty goals, held back by poor technology.• 14 progressive, innovative physicians aiming to deliver

unparalleled orthopaedic care• Unusable software lead to reliance on paper-based records• Not enough time and resources to perfect and perform

innovative outpatient procedures• Low visibility into practice data made it near impossible to

convince payers to reimburse for certain procedures

Midlands Orthopaedics, P.A.

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The cloud provided the support needed to innovate and excel. • Used athena’s data and reports to convince payers to

reimburse the procedures • 170 hip resurfacing and total hip replacement surgeries• 24 partial knee replacements• 24 total knee replacements

Midlands Orthopaedics, P.A.

athenahealth’s award-winning services can help you thrive through change

33 “2014 Best in KLAS Awards: Software & Services,” January, 2015. © 2015 KLAS Enterprises, LLC. All rights reserved. www.KLASresearch.com

#1 Practice

Management System

(1-10, 11-75 physicians)

#2 Practice

Management System

(over 75 physicians)

#2 EHR

(over 75 physicians)

#2 Patient Portal

#2 Overall

Physician Practice Vendor

2014 Best in KLAS

• 64,000+ providers on athenaNet®

• Clients ranging from 1 to 5,000+ providers

• 50 states and 112 medical specialties• $14 billion in client collections per year• Acquired Epocrates March, 2013

Despite consolidation, athena’s independent base continues to expand

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Annual Growth Rate- Nationally v. athenahealth

SOURCE: athenahealth’s addressable market (physicians) based on athenahealth analysis using SK&A, HIMSS, and self-collected data

19.5%

-5.2%Increase among athenahealth clients

Decrease in independents nationally

Independent practices grow revenue by 6-8% YOY on athena’s network

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6% increase in collections

32% reduction in

days in accounts

receivable

8% decrease in no show rate

94% first pass

resolution rate

NO faxes

Across our client base, athena achieves results

We navigate regulatory change so practices don’t have to

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National average:

70% 95.8%

athenahealth clients:

Meaningful Use Stage 1 attestation

Meaningful Use Stage 2 attestation

ICD-10

National average:

15% 98.2%

athenahealth clients:

Is your vendor ready and tested?

athena clientsready since Jan 2014

The Meaningful Use Guarantee

The ICD-10 Guarantee

The PQRS Guarantee

And by joining our network they are clinically integrated with the care continuum

• 165,000+ Interfaces• 65,000+ Trading Partners• 7,000+ new interfaces

created per month• Less than 0.01% message

processing error rate• 64,000+ Providers• 60 million patients• 350+ Imaging Centers• 39,000+ Pharmacies• 1000+ Labs• 320+ hospitals, IPAs, HIEs• 47 Registries

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