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Learn MoreThis blog post is taken from a recent interview HealthStream conducted with Joanne Aquilina, CFO at Bethesda Health in South Florida. We talked about her view of the current healthcare financial climate and asker her to forecast what’s ahead. This post excerpts the conversation.
Ms. Aquilina agrees the key to achieving good patient and financial outcomes is strong physician relationships. She highlights the importance of the CFO’s commitment to this end. “Over the last two to three years, my involvement with physicians has grown significantly. I am part of a team that is focused on improving clinical documentation by upgrading the process and technology used by our clinical documentation improvement specialists who round on patient floors to verify doctors are documenting appropriately.” Appropriate documentation is critical for coding accuracy, which, in turn, ensures appropriate reimbursement from payors, benefitting the physician and the hospital.
With the advent of Medicare bundled payments, hospitals and physicians are now partnering to manage patient care from the acute to post-acute setting.” As a CFO, Ms. Aquilina says, “I am involved with these opportunities, whether it’s about optimizing technology or establishing a patient navigator role at the hospital.” She and her team work with physicians to follow the care of patients for 30 and 90 days after they leave the hospital to appropriately manage bundled payments and avoid costly readmissions.
Collaboration, Facilitated By Clinically Integrated Networks
Ms. Aquilina sees the formation of clinically integrated networks (CIN) as the next level of collaboration between CFOs and physicians. As healthcare reimbursement moves to a value-based care model, the CIN works to improve patient care while reducing operating costs and redundancy. Employed and affiliated physicians negotiate collectively with payers on reimbursement arrangements.
By combining several small care systems into one that connects physicians, hospitals, and post-acute providers, networks can improve efficiency and quality. The ability to share patients’ clinical and financial data across the network creates a more complete view of the patient than the more siloed, traditional fee-for-service model.
“Our CIN is still in its infancy,” she says. “We haven’t yet applied for Medicare’s Shared Savings Plan or formalized any agreements with our managed care partners, but we’re seeing increased interest from our medical staff providers. Based on our prior partnerships, doctors are welcoming the opportunity to offer high quality care as we manage the topline – the revenue side – together.”
The Power and Role of MACRA
Another opportunity for collaboration between physicians and the CFO is the Medicare Access and CHIP Reauthorization Act of 2015, better known as MACRA. “We have a team working with our physicians from a technology standpoint to make sure our EHR system is set up to comply with all MACRA components,” explains Ms. Aquilina. “I think they’re on the right path,” adding, “one of our primary care physicians is leading the charge to educate the rest of our employed physicians.”
She believes physicians respond better hearing from a peer rather than hearing from their hospital employer’s C-suite. A director on her staff shares data with the doctors and works individually with each practice, communicating the implications of non-compliance.
A Need to Reduce the Stress of Documentation and Complex EHR Systems
When it comes to documentation and EHR issues in general, the biggest stressor for physicians, she says, is the sheer number of mandated requirements. “This has added time to their day. Their biggest concern is the time it takes with each patient, especially a new patient, to check off each bell and whistle in the electronic program versus simply facing the patient and talking to them.” At least one of Bethesda’s affiliated physicians has hired scribes in his practice to enter information on the computer so he can focus on his patient, notes Ms. Aquilina.
For some physicians, Bethesda’s EHR upgrade to better accommodate MACRA-required changes was challenging. Others took it in stride. “Tech-savvy doctors viewed going from the old system to the new system as something they could easily manage,” she explains.
HealthStream’s learning management system and healthcare training solutions support medical training initiatives and allow for the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceBe confident in your staff’s ability to reduce risk by providing compliance training that changes behavior.
View All ProductsDevelop next-level people for next-level care by prioritizing quality and safety improvements.
View All ProductsEstablish a culture of belonging with education supporting DEI, wellness, engagement, and leadership development.
View All ProductsUtilize patient access solutions and advanced reimbursement solutions to manage clinical denials and improve your organization’s reimbursement strategy.
View All ReimbursementExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ProductsOur competency development solutions personalize learning for clinicians to bridge the gap between theory and practice for your nurse residents.
View All ProductsEnhance maternal & child nursing care with solutions focused on improving the quality of care for mothers, infants, and children.
View All ProductsAddress staffing orientation challenges to easily achieve and maintain certification with our emergency and acute care training solutions.
View All ProductsAs a premier provider of healthcare education, we are committed to promoting safer, more successful surgical and sedation outcomes for each and every patient.
View All ProductsOur solutions are designed to cater to the needs of patients, healthcare professionals, and organizations dealing with illnesses or chronic conditions.
View All ProductsOnline clinical placement software allows schools, healthcare organizations, and students to seamlessly manage clinical and nursing rotations.
View All ProductsComprehensive, industry-leading provider onboarding and credentialing software that validates health outcomes and supports provider assessment.
View All CredentialingOur affordable CVO credentialing services establish patient safety by enabling primary source verification for your healthcare organization.
View All ProductsIntegrate with Epic to validate and add new providers directly to your provider master file.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare workforce management is essential. We provide advanced scheduling solutions for organizations to solve issues such as nurse retention
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