Proper Way for Small Practices to Get Best ROI Using EHR Software

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Even with government Meaningful Use (MU) payments, small practices are finding it hard to get any return on their investment from their EHR systems. However, with the right steps, it’s possible for practices to achieve a return on investment (ROI).

The traditional sources of ROI are increased efficiency and higher charges based on better documentation. Using an EHR to increase efficiency can require major changes in office processes, and the government has recently increased its inquiry into documentation techniques that help practices justify charging more. As a result, not many small practices can achieve ROI on their EHRs through fee-for-service based reimbursement.

These models include: ACOs that participate in shared savings programs, Patient-centered Medical Homes that many insurers incentivize, and pay-for-performance programs that pay quality bonuses. To varying extents, all of these models require the use of EHRs. Therefore, the lack of an EHR represents an “opportunity cost” that can be weighed against the cost of installing a system. Most practices are still receiving very little income from value-based reimbursement, but ACOs and medical homes are increasing. Some physicians are beginning to see the possibility of achieving ROI.

While it’s still possible to get ROI from a combination of MU incentives, efficiency, and higher charges, it’s becoming more difficult. Process redesign is crucial if practices want to increase efficiency, but because of the MU deadlines, enough time isn’t being taken to implement these systems effectively.

The amount of additional revenue practices can receive by improved coding depends on whether they were under-coding before EHRs. However, even if they could raise their charges by improving documentation, CMS is paying close attention to physicians who copy past notes into current notes or who document by exception. As a result, many physicians are coding more cautiously.

Even without an initial ROI, by participating in the programs and alternative care delivery systems available, EHRs can still be used to generate future revenue.

Author: Lauren Daniels

One thought on “Proper Way for Small Practices to Get Best ROI Using EHR Software

  1. Unfortunately, this is a game that the insurance companies are very good at playing. The biggest knock used to be that physicians were not doing complete documentation, thus the coding was reduced. With the introduction of EHR’s, documentation was improved and the coding was justified. As a result, insurance companies had to find a new way to justify reducing coding. Realistically, we are probably heading to a “best practices” model where physicians are paid based on the overall health of their patients as determined by a variety of measurable factors (i.e. improved A1C scores for diabetics, improved pulmonary function for COPD patients, etc). Since EHR’s track this data, as well as outliers, they are still the best way to help achieve future ROI under this scenario.

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