integration, efficiency & quality of care...integration, efficiency & quality of care a...

Integration, Efficiency & Quality of Care

A practical approach to technology in your workflow

2011 Phreesia Confidential Information

This panel will focus on technologies that help medical practices improve revenue, streamline billing, maximize staff efficiency and enhance clinical outcomes.

Today, we will cover:

• Healthcare trends and financial best practices

• A case study of a longtime GE Centricity user

• An overview of technology that can help practices maximize their investment in Centricity, increase cash flow and save staff time

Overview

2 2012 Phreesia Confidential Information

Introductions


• Nathan Hall, Director of Product Marketing, Integration (Phreesia)

• US Bank Representative

• MaryJo McKenna, Practice Manager

(Northern Virginia Urology)

Panel Participants


Healthcare Trends & Financial Best Practices


Payers (Insurance Co’s.

Consumers

Employers

Healthcare Transaction

Clearinghouses

Revenue Cycle Management Technology Providers (EDI, OCR, ERP, etc.

Card Associations & Non-Bank Card Co’s.

Government

Healthcare Providers (Doctors, Hospitals, Dentists, Rx, etc.)

Banks

Pre

miu

m P

aym

en

ts

Me

dic

are

, Me

dic

aid

Re

gula

tio

n, C

om

plia

nce

= Information Flow = Transaction Flow

Source: Celent

The Problem with Healthcare Payments


The Problem

The problem: Rapidly rising health care costs

Economics are driving Consumer-Driven Healthcare (CDH) adoption

Double digit healthcare

cost increases average cost

per-employee of health

benefits by $9,660

Employers looking for options to

decrease the cost per employee of health

benefits

Employers becoming more

aggressive in managing their

health care costs

Implementing a CDH program is one of the

leading healthcare strategies for

employers

Currently only 17% of

employers offer a full

replacement CDH program

Number of CDH programs to increase

in 2010

20

10

$7,284 20

04

$9,660

Employer: $1,524

Employee: $5,760

Employer: $2,160

Employee: $7,500

An illustration…


83% of employers reported that they revamped or expect to overhaul their healthcare strategy within the next two years.

Future of Consumer-Driven Healthcare

54% of companies have a CDHP in place. Median enrollment rises with 46% of employers reporting enrollment rates above 20%.

0%

50%

100%

2010 2012

40%

50%

60%

2009 2010

UP 24%

UP 6%

* Towers Watson


0

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

2005 2006 2007 2008 2009 2010

Nu

mb

er

of L

ive

s C

ove

red

Other**

Other Group*

Large-Group Market

Small-Group Market

Individual Market

2010 HDHP Enrollment Reaches 10 Million

Growth of HSA/HDHP Enrollment

* AHIP Center for Policy and Research


• Growth of CDH driving consumer involvement and responsibility

• Increasing recognition from providers, employers, and consumers that health and wellness is ultimately a personal responsibility

• Unintended consequence?

– Receivables/Collections/Bad Debt/Fraud

How will this change the relationship between, and the behavior of, employers, consumers, and providers?

Healthcare Consumerism Applied


• Growth of CDH accounts

– More consumers with health insurance = more consumers on high deductible plans = more consumer “first dollar” responsibility

– More consumer “first dollar” responsibility = potentially, higher provider collection costs and bad debt expense

What’s Changing for Providers?

*Source: “Patient-to-Provider Payments: Sizing and Opportunities for Issuers and Acquirers, April 2010, Aite Group, LLC

“The market shift towards adopting high deductible plans has greatly accelerated the amount of Consumer Responsibility – this number is

expected to grow to $356B by 2012.”*


Diminishing Payment Assurance


Patient Payments as % of Provider Revenue

0%

2%

4%

6%

8%

10%

12%

14%

16%

2005 2006 2007 2008 2009 (est) 2010 (est) 2011 (est)

“Physicians and hospitals typically collect only about 50 percent of [billed patient charges] – and only 10 to 20 percent for self-pay patients. Across the sector, this adds up to almost

$60 billion in bad debt annually.” Source: The McKinsey Quarterly, June 2007

• Healthcare provider revenue from Patient Payments is increasing rapidly, exacerbating the inefficiency in the system and reducing providers’ Payment Assurance.

• Healthcare Consumerism is here to stay

• CDH accounts are here to stay

• Consumers want to participate but are still fearful

• Employer approaches to CDH/consumerism can spell the difference between success and failure

• Providers, potentially, have increased financial risk but there are ways to manage it

• The convergence of consumerism and technology creates opportunities to do this right

In Summary

Case Study: A Centricity User


MaryJo McKenna, Practice Manager

Northern Virginia Urology, PLLC

• 19 doctors

• 7 clinics

• 50,000 total patients

• GE Centricity user since April 2006

Practice Profile


Physician reluctance to spend on technology

Inadequate training for front-desk staff

Limited staff understanding of revenue cycle

Practice Challenges

Challenge 1

Challenge 2

Challenge 3


Financial Best Practices

Collect accurate/comprehensive patient information during intake

Verify eligibility and benefits before every visit

Ask for payment upfront

Technology Helps!


Innovating to Maximize Efficiency & Increase Cash Flow


Phreesia, the Patient Check-in Company

A comprehensive self-service check-in solution


Used by thousands of clinicians and millions of patients each year!

Collect accurate/comprehensive patient information during intake

Collect complete clinical interview

Verify eligibility and benefits before every visit

Ask for payment upfront

Best Practices for Engaging Patients and Improving Workflow


Collect accurate patient information Increase

Cash Flow Save Time

Digitize paper forms

Personalize patient interviews

Maintain up-to-date meaningful use data

Generate comprehensive Patient Reports

Workflow Best Practices


Collect complete clinical interview Increase

Cash Flow Save Time

Digitally capture comprehensive and up-to-date medical history

Automatically identify relevant patients and administer risk assessments

Ensure that CPT-coded events are completed, documented and reimbursed



Electronically verify eligibility and benefits during check-in

Increase Cash Flow

Save Time

Verify patient information with insurance companies

Calculate accurate copays

Immediately identify patients with inactive or outdated insurance



Ask patients to pay at every visit Increase

Cash Flow Save Time

Collect patient copayments before the exam

Offer flexible payment plans to patients with large balances or high deductibles

Offer patients the convenience of online payment applications



Phreesia Delivers Significant ROI

Practice Info Impact

Family Medicine: • 4 clinicians • 2 location

• 2 additional copayments collected per day • 17 hours per week saved for staff

“Phreesia gives us increased documentation of what patients owe, and where they incurred payment, which amounts to greater levels of transparency for all” – Billing Manager

Pediatrics: • 6 clinicians • 1 locations

• $2,950 monthly increase in balance collection • Decrease in write-offs of $500 per month

“Phreesia has been a phenomenal addition to our practice. It has revolutionized the way our front office operates.” – Site Manager

Dermatology: • 11 clinicians • 1 location

•Increased patient revenue by $2,750 per month • 27 hours per month saved at front desk

“Receptionists are no longer overloaded with paperwork and we now offer much better customer service” – Practice Manager


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