Provider Advisor

Spring 2016

Credentialing, provider enrollment, physician referral, and provider analytics solutions are by no means the only serious challenges facing medical executives. The healthcare industry is changing at a rapid pace, and leaders are confronting many other critical issues.

In this edition of Provider Advisor we talk with HFMA President and CEO Joseph J. Fifer about the new role physicians are being asked to play in helping patients make informed financial decisions about their health. Consumers are confused by their high-deductible health plans and their insurance coverage under the Affordable Care Act, with the result that physicians are feeling pressured to act not only as healthcare providers but also as financial counselors to their patients.

We also take a deep dive into mandates to reduce unnecessary readmissions. Mary Alice Worrell from St. John Providence Health System talks about the steps their system took in recent years in conjunction with EchoAccess to reduce readmission rates by 25% and reduce CMS fines by almost $2 million. This same readmission reduction program will be implemented by CMS in skilled nursing facilities beginning in October 2018. We explore some of the ramifications for the post-acute industry and best practices that can be implemented now in anticipation of the upcoming mandates.

Finally, we look at some new product innovations. One is the increasing delivery of behavioral healthcare via telemedicine. Companies such as MindCare Solutions (Franklin, TN) are making it possible to offer virtual psychiatric consultations in nursing homes, correctional facilities, rural environments, and anywhere a good Internet connection can be found. We at Echo are also announcing a new product called EchoOneEDI that automates common provider-payer transactions.

  • Feature Article
    How St. John Providence Health System Reduced Preventable Readmissions
  • Feature Article
    MindCare Solutions Uses Telemedicine to Deliver Behavioral Health Consults to Patients Near and Far
  • Feature Article
    Teaching Consumers About the Financial Side of Healthcare: An Interview with HFMA’s President and CEO Joe Fifer
  • Executive Letter
    Physicians Face Major Industry Challenges
  • Industry Challenge
    Creating Moments that Matter: It’s Not Always Easy, But It’s Always the Right Thing to Do
  • Product Innovation
    Less Paperwork, Faster Payments—Are You Ready to Automate Your Provider-Payer Transactions?
  • Under the Microscope
    The SNF 30-Day All Cause Readmission Measure—Get Your House in Order Now to Avoid CMS Penalties 
  • Expert Opinion 
    Transitioning to Value-Based Healthcare 
  •  Get Engaged with HealthStream

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