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Methodology

OVERVIEW

Our goal is to provide users with a brief and simple illustration of a few of the ways that athenahealth, Inc. can help to improve a medical practice's bottom line.

DATA PERIOD AND SCOPE

The data used in this Calculator are based on actual physician activity captured by athenahealth in the course of providing our services, surveys we've taken of vendors, and third-party research published by iData Research Inc. (U.S. Market for Electronic Medical Records, December 2009) and the U.S. Department of Labor, Bureau of Labor Statistics (Occupational Employment and Wages--May 2009, May 2010). The following provides a summary of the data used:

Average Annual Chart Pull Savings: The average annual savings per physician in chart-pull labor costs due to EMR adoption. Source: iData Research (2008)

Average Monthly Collections: The average monthly collections per provider, by specialty. Source: athenahealth data (Q3 2011)

Average Monthly Label Cost: The average price per provider for printed labels used to identify clinical documents faxed to athenahealth during one month. Source: athenahealth data (September 2010), athenahealth vendor survey (October 2010)

Average Monthly Labor Cost: An estimate of the average monthly labor cost per provider for a medical records technician to process a practice’s internal documents for delivery to athenahealth. Source: athenahealth data (September 2010), U.S. Dept. of Labor (Year ended may 2009)

Average Monthly Printer Cost: The average price for a label printer, amortized over a year. Source: athenahealth vendor survey (October 2010)

Average Monthly Visits: The average monthly number of patient visits per provider, by specialty. Source: athenahealth data (Q3 2011)

Medicare Part B Percentage: The average percentage of collections that are received by practices under Medicare Part B, by specialty. Source: athenahealth data (Year to date as of 11/23/2011)

Pre-athena No-show Rate: The average percentage of patients who do not show for appointments for practices that are not live on athenaCommunicator®. Source: athenahealth data (Year ended 8/2011)

Storage & Management Cost Savings: The average annual practice savings in storage space and archive management costs due to EMR adoption, based on the number of practice physicians. Source: iData Research (2008)

ASSUMPTIONS

In developing this Calculator, we relied on our experience with our clients in assuming that a practice will generally have one label printer for every three providers and that a medical records technician will take between one and two minutes to prepare and send an internal document of the practice to athenahealth (documents from third parties are faxed directly to athenahealth without any action required on the part of the practice). We have also assumed that a practice's providers are all eligible ambulatory health care providers and therefore qualify for HITECH Act incentives. CALCULATIONS

The data and assumptions provided above are used to calculate the results in each of the following categories:

Increase Collections: To determine the estimated increase in monthly collections due to use of athenaCollector®, the Average Monthly Collections   for a practice of the selected specialty (a per-provider average) is multiplied by the specified number of practice providers to estimate total practice monthly collections. This number is presented to the user during the initial questions as the default, but it, like the other defaults in the Calculator, may be changed by the user. The entered practice monthly collections is then multiplied by the entered percentage increase in collections. 12% is offered as the default for the percentage increase in collections because that is the average increase for our clients, based on a weighted average for athenahealth clients with valid pre-athenahealth benchmark data that had their 15-month anniversary with athenahealth during 2010. /p>

Increase Patient Volume: To determine the estimated increase in patient volume due to use of athenaClinicals®, the Average Monthly Visits   for a practice of the selected specialty (a per-provider average) is multiplied by the specified number of practice providers to estimate the practice's total number of monthly visits. This number is presented to the user during the initial questions as the default, but it, like the other defaults in the Calculator, may be changed by the user. The entered number of monthly visits is then multiplied by the entered percentage increase in patient volume to get the estimated number of additional visits each month for the practice. 3.8% is offered as the default for the percentage increase in patient volume, because that is the average increase for our clients, based on a comparison of the average change in patient visits for clients without athenaClinicals with that for clients that had their six-month anniversary on the service during the year ended November 2009.

The estimated number of additional visits each month is then monetized by dividing the entered practice monthly collections by the entered number of monthly visits, which gives average per-visit collections, and then multiplying that by the estimated number of additional visits.

Reduce No-Shows: To determine the number of additional visits each month due to use of athenaCommunicator, the entered number of monthly visits (as described in Increase Patient Volume) is multiplied by the Pre-athena No-show Rate   and then the expected percentage improvement in the no-show rate. 16% is offered as the default for the percentage improvement in the no-show rate, because our clients have seen at least that percentage of improvement, based on a comparison of the highest no-show rate among clients with athenaCommunicator® and the average rate for appointments without the service for the year ending August 2011.

The expected number of additional visits each month is then monetized by the same method set forth in Increase Patient Volume.

Qualification for HITECH Act Incentives: For 2011, the HITECH Act authorizes payments to each Medicare provider equal to the lesser of $18,000 or 75% of that provider's total Medicare payments for the year. To determine a provider's expected total Medicare payments for the year, the entered practice monthly collections is divided by the specified number of providers to obtain a per-provider average. This average and the Medicare Part B Percentage   for a practice of the selected specialty are then multiplied and annualized. The lesser of $18,000 or 75% of the average provider's total Medicare payments for the year is then multiplied by the selected number of practice providers to determine the practice's total payments for 2011 under the HITECH Act in regard to Medicare.

Qualification for PQRI: To determine the monthly payment for participation in PQRI, the entered practice monthly collections (as described in Increase Collections) is multiplied by the Medicare Part B Percentage   and then by CMS's average PQRS incentive payment rate (which is 1%).

Qualification for e-Rx: To determine the monthly payment for participation in e-Rx, the entered practice monthly collections (as described in Increase Collections) is multiplied by the Medicare Part B Percentage and then by CMS's e-Rx incentive payment rate (which is 1%).

NOTE: If a provider is eligible and opts to receive HITECH incentives, that provider does not qualify for e-Rx incentives per the HITECH Act rules. The Calculator will exclude e-Rx incentives if the user indicates that HITECH Act incentives are to be included.

Document Services Cost Savings: As a rough estimate of the monthly document services cost savings from use of athenaClinicals, the Average Annual Chart Pull Savings   (a per-physician average) is multiplied by the specified number of practice providers and then added to the Storage & Management Cost Savings   for a practice of the specified number of providers (since the iData Research data underlying this calculation are based on the number of practice physicians, the specified number of practice providers is used as a proxy for purposes of this calculation). This number is then divided by twelve to obtain a monthly average document services cost savings.

In an effort to represent the athenaClinicals cost savings fairly, we then make sure to back out an estimate of the document services expenditures incurred in the use of athenaClinicals. To do this, we subtract the following from the monthly average cost savings: (1) the Average Monthly Printer Cost,  multiplied by the specified number of practice providers and then divided by three (i.e., the assumed number of providers per label printer); (2) the Average Monthly Label Cost   (a per-provider average), multiplied by the specified number of practice providers; and (3) the Average Monthly Labor Cost   (a per-provider average), multiplied by the specified number of practice providers.

As background, the average monthly costs used in this calculation are determined as follows. Average Monthly Printer Cost   is based on our market research of the going price of suitable label printers, and the average cost of such printers is then divided by twelve to obtain the monthly expenditure (note that this is only an expense in the first year). Average Monthly Label Cost   is based on the average number of bar-code-labeled clinical documents that Athena receives from each athenaClinicals client in a month, multiplied by the average cost of a single label (as determined through our market research). Average Monthly Labor Cost   is based on our understanding of the time taken to label a practice's internal clinical document (converted to an hourly fraction), multiplied by the average number of such documents that we receive per month from each athenaClinicals client, and then multiplied by the 2009 median U.S. hourly wage for medical record technicians (i.e., $15.04).

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Welcome to the athenahealth Revenue Calculator! Answer 3 quick questions
and see the potential improvements to your practice's bottom line.

How many providers are in your practice?

Question 2 of 3

What is your specialty?
  • Anesthesiology
  • Cardiology
  • Dermatology
  • Emergency Medicine
  • Endocrinology
  • Family Practice
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  • General Surgery
  • Internal Medicine
  • Multi Specialty
  • Nephrology
  • Neurology
  • OB/GYN
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  • Oncology/Hematology
  • Orthopedic Surgery
  • Otolaryngology
  • Pain Manangement Specialist
  • Pediatrics
  • Physical Therapy
  • Plastic Surgery
  • Podiatry
  • Radiology
  • Rheumatology
  • Urgent Care
  • Urology
  • Vascular Surgery
  • Other

Question 3 of 3

What are your average monthly collections?

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Retrieving your estimated savings
Get more money and more control for better financial health.

Boost Your Practice's bottom line.

Now that we know a little about you, let us tell you a little about athenahealth and how we can help improve your practice's financial health. Explore any of the opportunities for boosting your financial health on the right to get a more customized view of how our services can improve your bottom line.

The data used in this tool is based on historical data from athenahealth clients as well as third-party research. Give us a call at 888.805.0067 to schedule a meeting to explore the specific ways our services can drive better results for your practice.

Get Started

Increase your collections

With athenaCollector's® patented billing rules database, you benefit from the collective experience of over 52,000 providers. On average 94% of claims get resolved the first time and our clients see an average 32% reduction in days in accounts receivable. We help you secure more revenue by:

  • Reducing denials from billing errors or rules exchanges
  • Catching and responding to unexpected changes to payer rules
  • Helping you qualify for and receive government incentive payments

The result: On average, our clients see an 6% increase in collections.

Reduce your practice's no-show rate.

athenaCommunicator®, our on-demand, live, and automated patient communication service, streamlines patient interactions outside the exam room, identifying in advance which patients have confirmed their visit and which need to reschedule. Our system:

  • Frees up valuable staff and physician time
  • Offers patients convenient phone access to your practice
  • Gives patients an efficient 24-hour web portal where they can schedule appointments, make payments, and receive test results and health information

The result: On average, our clients see an 8% lower no-show rate.

Guaranteed "Meaningful Use" Incentive Dollars

Under the HITECH Act, physicians who meet 'meaningful use' EHR requirements are eligible to receive incentive payments, with up to $39,000 available for providers who begin in 2013. We are so confident in athenaClinicals® that we are guaranteeing our eligible physicians will receive their federal stimulus Medicare payments in year one.*

If you are opted in for Meaningful Use incentives:

  • You're eligible to receive payments equal to 75% of Medicare allowable charges up to a maximum of $11,760
  • You can't receive both e-Rx and HITECH incentives

*Visit www.athenahealth.com/BonusFAQ

Get the PQRS incentives you deserve.

Our experts stay on top of Physician Quality Reporting System (PQRS), and other Pay-for-Performance and government incentive programs to ensure you bank the revenue you're eligible to receive.

Thanks to our cloud-based rules database, we're able to make available the latest industry requirements and government incentives to our entire network, making it easy for you to participate and stay up to date.

The Revenue Calculator only includes additional PQRS Medicare Payments. However, for many of our practices, we are able to help them qualify for and obtain reimbursements from many other P4P programs.

Save time and money on paperwork.

Our data shows that every full-time practitioner handles about 1,150 pieces of documentation per month. That adds up to significant staff time and costs for your practice. At athenahealth, we take on the bulk of your practice's paperwork, saving you money and freeing up staff to focus on more value-add work.

  • We scan and categorize incoming faxes
  • We match clinical documents to existing patients and orders
  • We maintain electronic connections to your pharmacies, labs, and hospitals
  • We alert you to documents that require attention via your athenaClinicals Inbox
Boost Your Financial Health
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Increase Collections by:
Reduce No-Show Rates by:
Meaningful Use Incentives:
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Qualifications for PQRS Medicare:
Yes
No
Save on Paperwork:Yes
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