Tuesday, October 13, 2009
Another reason to get an EHR.
There's been a lot of talk at the meeting about stimulus funding for EHR systems (I've never heard the phrase "meaningful use" so many times), but a session on physician profiling offered a new reason that you might want to invest in an electronic system.
In case you missed it, physician profiling refers to insurers' systems of ranking physicians by cost and quality (but mostly cost) and pushing insureds toward the best-value docs. The insurers make mysterious calculations comparing claims data from your patients to comparable others. Then they give you a star or multiple stars if they find your care to be cost-effective.
But if they don't think you're doing well, and you disagree, you can use data from your EHR to fight back. Although the insurers won't reveal their specific formulas, you can pull data from your system on the patients or conditions in question to prove your case (by searching for migraine codes or generic prescriptions or whatever).
One caveat, though: it's a major undertaking, and the physician profiles don't affect reimbursement, so if you have more than enough patients already, you might not want to bother, the speaker said.
Labels: MGMA conference
posted by Stacey Butterfield at
9:00 AM
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