thriving as an independent practice
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Thriving as an Independent Practice
Emily NovotnyManager, athenahealth
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Care is moving out of the hospital while outpatient visits continue to
rise
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Source: MedPac Medicare Payment Advisory Commission, A Data Book: Health Care Spending and the Medicare Program, June 2014 http://www.medpac.gov/-documents-/data-book
20062007
20082009
20102011
2012
35
30
25
20
15
10
5
0
-5
-10
-15
Fiscal Year
Cum
ula
tive P
erc
ent
Change 28.
5
-12.6
Outpatient services per FFS Part B beneficiary
Inpatient discharges per FFS Part A beneficiary
First signs that physician consolidation has leveled off
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Source: athenahealth’s addressable market (physicians) based on athenahealth analysis using SK&A, HIMSS, and self-collected data
% Employed Physicians
800
700
600
500
400
300
200
100
-2011 2012 2013 2014
650K
676K
684K
692K
44%
50%
57%
57%
56%
50%
43%
43%
Employed
Independent
Given the opportunity, doctors want to stay independent
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Survey of the Epocrates user base. February 2015. Answered: 2,144 Skipped: 642
I would prefer to practice
independently
I would prefer to be employed by a
larger group
I am not sure
58.14%
20.10%
11.75%
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Independent providers see
16% morepatientsthan employed providers
Independent practices see
5.9% fewerno-showsthan owned practices
5.9%
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Patients wait
4 days longerto see an employed PCP than an independent PCP
Nevertheless, practices are turning to employmentbecause they are struggling to survive
Clinical Transformation: New Business Models for a New Era in Healthcare. Accenture, 2012. http://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Clinical-Transformation-New-Business-Models-for-a-New-Era-in-Healthcare.pdf#zoom=50
Top Concerns That Influence Decision to Seek Employment
Business Costs & Expenses
Prevalence of Managed Care
EMR Requirements
Maintaining/Managing Staff
Number of Patients Required to Break Even
87%
61%
53%
39%
53%
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1.Case Study:Financial control and visibility
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ESD Pediatric Group
Dr. Jeff Drasnin
2 nurse practitioners
Nearly
30,000 patient visits annually
2 offices
5 physicians
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They struggled to control revenue.• Moved to outsourced billing in order to keep pace in a
changing economic environment
• Initial vendor did not provide transparency
• Severe cash flow problemso Had no idea of what money was coming ino Collections were inconsistent o Claims were being written off or not collected per contract.o Days in accounts receivable at 45+
• Significant time was being spent by office staff and management to keep the office afloat
ESD Pediatric Group Dr. Jeff Drasnin
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They changed strategy.• Selected a cloud-based service for EHR, practice management
and patient communications
• Co-sourcing (rather than outsourcing) allowed for full transparency
• Efficient delegation of patient scheduling, billing, invoicing, claims processing, etc.
• No need to upgrade. When network upgrades, they’re upgraded.
ESD Pediatric Group Dr. Jeff Drasnin
Back officework can be done off site.
Remote network management by experts.
Easy access to robust financial and operational reporting
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ESD Pediatric Group Dr. Jeff Drasnin
Results
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ESD Pediatric Group Dr. Jeff Drasnin
60% practice
collections
11.11%
decrease in no-show rate
51% decrease in days in accounts
receivable
2.Case Study:Competing with the local hospital
Austin Cardiac
Clinic
4 full time employees
5,500 patient visits annually
1 physician
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A quest to stay independent.
• Declining Medicare reimbursements for cardiology
• State regulations add complexity to filing claims and collecting revenue
• Competition with local hospital across the street
Austin Cardiac Clinic
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Dr. Tiblier on the cloud…
• Practice runs lean and efficient to allow financial flexibility and independence
• Able to charge less than local hospitals
• Flexible online tools create higher patient satisfaction and more patient loyalty
Austin Cardiac Clinic
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Austin Cardiac Clinic
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Pharmacies
Payers
Public Health
Labs
PatientsPractices and
Hospitals
athenahealth’s award-winning services can help you thrive through change
34 “2014 Best in KLAS Awards: Software & Services,” January, 2015. © 2015 KLAS Enterprises, LLC. All rights reserved. www.KLASresearch.com
#1 Practice
Management System
(1-10, 11-75 physicians)
#2 Practice
Management System
(over 75 physicians)
#2 EHR
(over 75 physicians)
#2 Patient Portal
#2 Overall
Physician Practice Vendor
2014 Best in KLAS
• 64,000+ providers on athenaNet®
• Clients ranging from 1 to 5,000+ providers
• 50 states and 112 medical specialties
• $14 billion in client collections per year
• Acquired Epocrates March, 2013
Despite consolidation, athena’s independent base continues to expand
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Annual Growth Rate- Nationally v. athenahealth
SOURCE: athenahealth’s addressable market (physicians) based on athenahealth analysis using SK&A, HIMSS, and self-collected data
19.5%
-5.2%
Increase among athenahealth clients
Decrease in independents nationally
Independent practices grow revenue by 6-8% YOY on athena’s network
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6% increase in collections
32% reduction in
days in accounts
receivable
8% decrease in no show rate
94% first pass
resolution rate
NO faxes
Across our client base, athena achieves results
We navigate regulatory change so practices don’t have to
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National average:
70%95.8%
athenahealth clients:
Meaningful Use Stage 1 attestation
Meaningful Use Stage 2 attestation
ICD-10
National average:
15%98.2%
athenahealth clients:
Is your vendor ready and tested?
athena clientsready since Jan 2014
The Meaningful Use Guarantee
The ICD-10 Guarantee
The PQRS Guarantee
And by joining our network they are clinically integrated with the care continuum
• 165,000+ Interfaces
• 65,000+ Trading Partners
• 7,000+ new interfaces created per month
• Less than 0.01% message processing error rate
• 64,000+ Providers
• 60 million patients
• 350+ Imaging Centers
• 39,000+ Pharmacies
• 1000+ Labs
• 320+ hospitals, IPAs, HIEs
• 47 Registries
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