An orthopedic group sees collections soar with the insights of a national healthcare network and the backing of a supportive partner.
Operating for more than 50 years, Georgia Hand, Shoulder & Elbow is based in downtown Atlanta in a neighborhood dense with orthopedic activity. The medical group is across the street from one of the largest rehabilitation hospitals in the country and just down the road from a hospital at which its providers serve as the trauma team. Its subspecialty in hand and upper-extremity orthopedics makes the practice a hub not only for patients in its immediate neighborhood and surrounding counties in Greater Atlanta, but also for those traveling from Alabama, Tennessee, North and South Carolina, and Florida.
When GHSE started looking for a new healthcare IT partner, it was important to find someone that could support its success as an orthopedic group. “Everything we heard from athena was very similar to our culture: being all about the patient and trying to make it a better experience for the patient and the physician, and yet being efficient enough to be able to collect and bill,” says CEO Lynn Wolff on her group’s decision to switch to the athenaOne suite of medical record, revenue cycle management, and patient engagement services. Since joining the athenahealth network, GHSE has tapped into a much larger neighborhood of orthopedists — to the benefit of its business, employees, and patients.
Orthopedic insights from across town and across the country
In athenahealth, GHSE found not only a likeminded partner, but also a nationwide network of orthopedists from which the group could learn and benefit. Because all its customers are connected to a single, cloud-based network, athenahealth can analyze their activity to identify clinical and financial trends and share the resulting insights to help organizations of the same size, specialty, or region learn from one another. “We liked the idea that athenahealth could take information from all of their users and actually put it to use. You could actually learn from another practice, and every other vendor we looked at, you operated solo — you had your own practice, and you made mistakes,” says Wolff.
For example, clinical workflows in athenahealth’s EHR are informed by the behavior of other orthopedists on the network, including surfacing the most commonly used diagnosis and treatment suggestions in a given situation. When it comes to the revenue cycle, athenahealth’s Billing Rules Engine includes more than 40 million permutations of payer rules, which are updated any time an organization on the athenahealth network experiences a denial to prevent others from facing the same result.
Being part of athenahealth’s network also connects GHSE to over 220 partner organizations in the athenahealth Marketplace, which offers customers plug-and-play solutions that have pre-built connections to the athenahealth network. GHSE is using Marketplace partners to support dictation for its providers and its website marketing, among other things. “Going to the Marketplace and looking for those solutions is wonderful, because then we already know they’re going to work with athena,” says Wolff.
Getting paid under any reimbursement model
In addition to the knowledge gained through the athenahealth network, athenahealth’s revenue cycle management service also helps GHSE’s small billing team save time on the work it takes to get paid. GHSE employs four full-time billing staff to support its three departments. Thanks to the insights collected in the Billing Rules Engine, the team doesn’t waste time submitting claims that are likely to be denied. Wolff appreciates that the claims workflows make it difficult to submit a claim that doesn’t meet a payer’s criteria, while making it easy to address any errors. “It’s not just telling me I have an error — it’s telling me where I have an error and what I need to do to correct it, to drop that claim,” she says.
As healthcare organizations across the country increasingly move toward new payment models, athenahealth helps make sure groups like GHSE are ready to adapt. For example, multiple payment options make it easier for patients to pay their balances, including through portals, payment plans, and the ability to keep credit card information on file. Wolff says patients appreciate the convenience of paying through the patient portal: “The patients like that, and they’re learning to use it to make payments.”
When it comes to participating in quality programs, Wolff feels confident that GHSE is well equipped to succeed. “I feel like I am guaranteed to attest and get it right, and the only way that happens is because of athena,” she shares. GHSE’s customer success manager checks in to make sure the group’s reporting is on track during the year. Wolff and her staff can easily review providers’ progress as they capture quality measures in their clinical workflows. “I don’t know that that would be happening if we were on another solution. And I think most of the orthopedic folks I talk to feel that same way – that that’s the number one thing athena does for us that makes our lives easier,” says Wolff.
A profitable partnership
When GHSE switched to athenaOne, the group appreciated that it could get started on a new solution without a large, upfront capital investment. Instead, a percent-of-collections pricing model ensured that its new partner would be invested in GHSE’s success.
Wolff has seen the results herself. After reviewing GHSE’s progress over its first four years with athenahealth, the CEO determined that the group’s collections had increased by about $1.5 million per year, on average, while only increasing its charges by a small amount. “The collections end of it has improved drastically, and I have to say that that was athena. Even with the increase in cost to pay for that support with athena, as a percentage of collections, we realized quite a bit of an increase in profit,” reports Wolff.
A better experience for patients and providers
In addition to the financial benefits, partnering with athenahealth helps GHSE maintain the culture that is an important part of its identity. “We’re going to come in, work hard, and take care of patients. We would like to get paid for it – and that’s my job. But I don’t want the doctors to have to think about it. I want them to able to come in and provide the very best care they can, and my staff, too,” says Wolff. “And the people we’ve met through working with athena all seemed to carry that same culture.”