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MGMA: IT Costs for Healthcare Organizations Continue to Rise

August 10, 2016
by Rajiv Leventhal
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Since 2009, technology costs at physician-owned multispecialty practices have increased by more than 40 percent

According to new data from the Englewood, Col.-based Medical Group Management Association (MGMA), physician-owned multispecialty practices spent more than $32,500 per full-time physician on information technology equipment, staff, maintenance, and other related expenses in 2015.

The findings come from the 2016 MGMA Cost and Revenue Report, a widely-used cost survey and benchmarking tool for healthcare organizations in the U.S. Since 2009, technology costs at physician-owned multispecialty practices have increased by more than 40 percent, the MGMA data shows, with the largest increase in technology costs occurred between 2010 and 2011, corresponding to implementation of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act.

Indeed, the HITECH incentives led to a significant increase in the number of organizations adopting electronic health record (EHR) systems. However, these incentives tapered down significantly after 2011, requiring practices to shoulder a larger percentage of the cost to upgrade and maintain the technology.

Furthermore, the growing adoption and complexity of healthcare IT may have also contributed to the growing IT staff expenses practices have experienced in recent years. Physician-owned multispecialty practices have seen steady year-over-year increases in IT staff expenses, which have escalated by nearly 47 percent per full-time physician since 2009. Increased staff costs suggest that larger investments in technology have yet to result in significant administrative efficiencies for practices.

Other trends in the healthcare industry may have also contributed to increased technology costs. For example, many practices have invested in online patient portals that allow patients to view their personal health information, make payments, or schedule appointments online, among other functions. More than 50 percent of nearly 850 respondents to a recent MGMA Stat poll—a real-time text-based polling initiative—reported that patients can request or make appointments via their practice’s patient portal.

What’s more, total operating costs are growing throughout the healthcare industry, putting greater pressure on practices as they move toward providing value-based care. Physician-owned multispecialty practices reported that total operating costs increased by nearly 15 percent per full-time physician in 2015, according to the new MGMA data, outpacing the more than 10 percent increase in total revenue these practices enjoyed last year.

Other noteworthy nuggets from the report include:

•             Physician-owned multispecialty practices that are part of an accountable care organization (ACO) enjoyed lower costs and higher total medical revenue after operating costs last year than in 2014.

•             Examining the payer mix for multispecialty groups with both primary and specialty care in 2015, Medicare accounted for a nearly identical share of charges—roughly 33 percent—at both physician-owned and hospital-owned practices. However, hospital-owned practices reported that Medicaid represented 14 percent of charges last year, which is more than twice the nearly 7 percent reported by physician-owned groups.

•             Physician-owned specialties reported having a higher total number of full-time support staff on payroll—including personnel who oversee business operations, the front office, and clinical support—than their hospital-owned counterparts did in 2015. However, primary care specialties at both physician and hospital-owned practices reported a small decline in total support staff throughout the past two years, while nonsurgical and surgical specialties reported support staff increases over that period.

“While technology plays a crucial role in helping healthcare organizations evolve to provide higher-quality, value-based care, this transition is becoming increasingly expensive,” Halee Fischer-Wright, president and CEO of the Medical Group Management Association, said in a statement. “We remain concerned that far too much of a practice’s IT investment is tied directly to complying with the ever-increasing number of federal requirements, rather than to providing better patient care. Unless we see significant changes in the final MIPS/APM rule, practice IT costs will continue to rise without a corresponding improvement in the care delivery process.”

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Survey: Healthcare Organizations Skeptical of athenahealth, Virence Merger

December 3, 2018
by Heather Landi, Associate Editor
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Healthcare organization leaders are expressing some initial skepticism about the merger of athenahealth with Virence Health Technologies, as a result of Veritas Capital and Elliott Management’s recent acquisition of athenahealth.

Current customers of the two vendors say they are in “wait and see” mode following the merger of the two companies, however, the majority of non-customers say they do not plan to purchase health IT technology from the combined company, according to a new survey from Reaction Data, a market research firm focused on the healthcare and life sciences industries.

The Reaction Data survey gauges how patient care organization leaders are reacting to the acquisition of athenahealth by Veritas Capital and Elliott Management, and the subsequent merger with Virence/GE Healthcare. While mergers and acquisitions in healthcare are becoming the new normal, the merger of Virence/GE Healthcare and athenahealth is unique, the report states.

In July, Veritas Capital acquired GE Healthcare’s revenue cycle, ambulatory care, and workforce management product lines, and then several months later rebranded it as Virence Health Technologies. On November 12, private equity firm Veritas Capital and hedge fund Elliott Management announced the acquisition of athenahealth, the Watertown, Massachusetts-based electronic health record (EHR) and practice management vendor, for $5.7 billion,

Following the deal’s closing, Veritas and Evergreen Coast Capital, a subsidiary of Elliott Management, expect to combine athenahealth with Virence Health. The combined business is expected to be a leading, privately-held healthcare information technology company with an extensive national provider network of customers and world-class products and solutions to help them thrive in an increasingly complex environment, the companies said in a press release.

The deal concludes a six-month acquisition process and a tumultuous period for athenahealth and its leadership. Elliott Management, the sometimes-activist fund run by billionaire Paul Singer, has put pressure on athenahealth leadership to take the company private or explore a sale since the hedge fund acquired a 9-percent stake in the company in 2017.

For the survey, Reaction Data collected feedback from patient care organization leaders about how aware the market is about the M&A event and an analysis on how likely the newly combined company will attract, or repel, new business.

Of the respondents, 22 percent are practice administrators, 18 percent are CIOs, 12 percent are chief financial officers (CFOs) and the remaining respondents are chief medical officers, CEOs, physicians, chief nursing officers, medical directors and chiefs of staff. Thirty-two percent of respondents are athenahealth customers, 19 percent are Virence customers and 49 percent aren’t customers of either company.

While Veritas acquired several important product lines from GE Healthcare six months ago, less than half of respondents (44 percent) were aware of that M&A event. Conversely, the majority of respondents (60 percent) are aware that Veritas and Elliott Management are acquiring athenahealth and plan to merge it with Virence (GE Healthcare).

Looking at overall impact, 45 percent of respondents are neutral on the impact of the merger, while 26 percent expressed a positive opinion and 29 percent have a negative opinion on the merger. Half of respondents who are current customers (51 percent) say they are in “wait and see” mode when it comes to sticking around for the long haul, with the remaining respondents are equally split between leaving (25 percent) and staying (24 percent).

“Reassuring the customer base that integration pains will be minimized and that investment and support will continue will be key priorities for the new ownership team,” the report says.

The rest of the market (non-customers) is another story. As of right now, the majority (57 percent) state they are unlikely to consider Virence or athenahealth for future purchases. Thirty percent of non-customers are in “wait and see” mode.

“While, at present, this certainly isn't an optimistic result, if the new owners execute the integration at a high level, word will quickly get out that the new combined entity truly is greater than its individual parts and the pendulum will swing back in its favor,” the report says.

The report authors also note that skepticism among healthcare organizations is expected among healthcare M&A deals. “Enough of these events in healthcare have gone south that it's perfectly reasonable for customers, and the market alike, to be professionally skeptical about its future. However, it should be noted, that these are two sizable companies brought together by two world-class private equity firms so it is entirely possible that this new company will emerge as a truly formidable competitor to industry titans Cerner and Epic,” the report authors wrote.

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Survey: Providers Remain Challenged with Optimizing Revenue Cycle-Related EHR Functions

November 29, 2018
by Rajiv Leventhal, Managing Editor
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Healthcare providers continue to focus on technology to spearhead revenue cycle improvements, but remain challenged with optimizing electronic health record (EHR) functionality, according to new research from consulting firm Navigant and the Healthcare Financial Management Association (HFMA).

The survey of 107 hospital and health system chief financial officers and revenue cycle executives, released this week, found that 68 percent of respondents said their revenue cycle technology budgets will increase over the next year, down from 74 percent last year.

Results also showed that, compared to last year: 39 percent fewer executives project a budget increase of 5 percent or more; and 53 percent more executives predict no change to their budgets.

However, this slowing of IT spending does not mean providers are satisfied with their current EHR functionality, researchers noted. Fifty-six percent of executives said their organizations can’t keep up with EHR upgrades or underuse available EHR functions, up from 51 percent last year.

Further, 56 percent of executives suggested EHR adoption challenges have been equal to or outweighed benefits specific to their organization’s revenue cycle performance. Both hospital-based executives and those from smaller hospitals cited more challenges than benefits, compared to health system and larger hospital executives. This is likely due to greater capacity and scale in health system and larger hospital IT departments, researchers concluded.

“Hospitals and health systems have invested a significant amount of time and money into their EHRs, but the technology’s complexity is preventing them from realizing an immediate return on their investments,” Timothy Kinney, managing director at Navigant, said in a statement accompanying the survey. “When optimized correctly, a good portion of the ROI can come from EHR-related revenue cycle process improvements.”

When asked which revenue cycle capability their organization is most focused on for improvement over the next year, most executives (76 percent) once again selected technology-related capabilities. Revenue integrity continues to be the top area of focus among them, cited by 24 percent of executives who noted such revenue integrity program benefits as reduced compliance risks, and increased revenue capture and net collection.

The survey results also showed that, compared to last year, EHR optimization as an improvement priority rose from 15 percent to 21 percent, while physician documentation fell from 18 percent to 12 percent.

What’s more, even though providers do appear to be better prepared to address consumer self-pay, the area continues to be an issue, the research revealed. Eighty-one percent of executives said they believe the increase in consumer responsibility for costs will continue to affect their organizations, down from 92 percent last year. Among them, 22 percent think that impact will be significant, compared to 40 percent last year. Executives from health systems and larger hospitals believe their organizations will be more heavily impacted by consumer self-pay.

Related Insights For: Revenue Cycle Management

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CQL in the Cloud: How to Benefit from the New CMS-Required Language

Thursday, November 8, 2018 | 1:00 p.m. ET, 12:00 p.m. CT

Centers for Medicare and Medicaid Services (CMS) will require the use of Clinical Quality Language (CQL) for electronic clinical quality measures (eCQMs) reporting in 2019. But what is CQL? And how can health enterprises actually put it to work? CQL, an HL7 standard, is a new computable expression language designed specifically for healthcare, bringing together the worlds of clinical quality measures and clinical decision support (CDS).

In this webinar we will review the origins of CQL, the value of the language in eCQMs, electronic care pathways (ePathways) and CDS, and how health enterprises can easily get started with CQL by leveraging the benefits of the cloud.

See more on Revenue Cycle Management

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