It was 2013 and the providers and staff of Atlanta’s oldest orthopedic practice, Peachtree Orthopedics, were worried. The switch to ICD-10 was quickly approaching and their healthcare IT vendor didn’t seem to be prepared for it. “We knew the complexity was growing significantly with ICD-10, but we just didn’t think our vendor had a plan,” Erika Noll, OTR/L, CHT, Peachtree’s director of clinical services, says. “We did not want to resort to having code books on every physician’s desk.”
It was not the first time Peachtree had run into problems with their IT services. Their vendor’s limited reporting capabilities made meeting federal reporting requirements a recurring struggle. Because their services weren’t cloud-based and because their vendor offered limited support, staff were also responsible for manually updating their servers. And every day, providers and staff alike felt the minor and major inconveniences of using EHR and practice management services that couldn’t talk to each other.
With the transition to ICD-10 looming and their frustrations mounting, Peachtree knew the time had come to make a change. After a long search, they switched to athenahealth and were onboarded in only three months to ensure they were ready for ICD-10. Since then, athenahealth’s integrated services have armed Peachtree with the insight they need to weather many more changes.
Real-time visibility into performance takes the stress out of reporting
Today, Peachtree devotes a single staff member to monitoring their MIPS dashboard. If a provider or team is underperforming, she can easily spot the problem and intervene before there’s any impact on the group’s outcomes. When it appeared, for example, that one physician wasn’t meeting his e-prescribing goal, Peachtree intervened and learned that, although the physician was writing prescriptions for non-controlled substances in the athenaNet application, he was not using e-prescribing for controlled substances—the majority of his prescriptions. Once aware of the problem, the physician was able to quickly improve his performance.
Peachtree staff can’t imagine being able to course-correct so quickly and easily with their previous services. Before switching to athenahealth services, spotting a problem – or meeting reporting requirements in general – required multiple staff members to spend hours manually pulling data and performing calculations. “I remember trying to get all the data together for Meaningful Use at the end of 2013, before athena, and there being a lot of stress around it,” Noll says. “We don’t experience that stress anymore. It just handles itself.”
In particular, Peachtree staff explain that athenahealth’s reporting module, search function, and ability to sync with third-party services have made reporting significantly easier. “The reporting was absolutely non-existent on our legacy system by comparison,” Saranya Chiaravalloti, Peachtree’s director of revenue services adds. “Now, we can adjust our workflows in the middle of the month if we see a provider is not performing well or projecting to end in the negative.”
Integrated services improve financial decision-making and boost collections
Moving to a single, integrated solution has improved Peachtree’s financial health. Before the switch, gathering data was a struggle. Today, Peachtree can extract real-time data from across their EHR and revenue cycle management services, improving their ability to forecast, set goals, and address problems quickly. Since their go-live, Peachtree has been able to more than double their time-of-service collections, from an average of 20 percent to 50 percent.
“I don’t feel like I’m flying blind every day when I’m planning,” Chiaravalloti explains. “I feel really good about athena’s ability to give us good data and help us make financial decisions. I can see who’s collecting and who’s not. I can see in real time how much we brought in yesterday.”
Billing has also improved. Before the switch, Peachtree used a paper superbill to capture charges. Providers filled out a paper form for every clinic visit that they would hand over to the checkout staff, who then entered the charges manually. There was no system in place to catch errors, since their services couldn’t share data. If a provider forgot to capture something they did during the visit, or checkout staff misread what a provider had written on the paper form, Peachtree staff wouldn’t know to bill for it. “We were leaving money on the table—a lot of it,” Noll adds.
Today, Peachtree has coded all of their procedures into athenaNet. When they get the superbill, providers only need to determine the right level of visit and E&M code, and add any necessary unites and modifiers. “We can get that done before the patient gets to checkout and the checkout team process the claim, collect any co-insurance if there’s a percentage due,” Noll says. “Before, we did not have that capability and we’d be stuck sending a bill after the visit.”
With increased visibility into their performance data, Peachtree is better able to track their cost savings and quality outcomes. Peachtree’s patients have also benefitted; greater visibility into their data has allowed Peachtree providers to share more accurate cost information with their patients, enabling them to make better-informed decisions about their care.
Automation and support wick away administrative work
Switching to an integrated service has also freed up Peachtree providers and staff to focus on higher-value work. In addition to handling all updates for them, athenahealth teams wicked away manual work by automating, eliminating, or taking it on. On the administrative side, Peachtree previously employed an assistant for every physician. The high staffing ratio was necessary because assistants were bogged down with time-consuming manual work like processing documents, reviewing transcripts, and faxing documents. “Now that work has all gone away and we’ve moved to a model where one assistant supports three or four physicians,” Noll explains.
A similar transformation also happened on the clinical side. Whereas Peachtree’s clinical assistants were once bogged down with manual work, they can now take on more complex work like entering HPI and performing reviews of systems. As a result, Peachtree has found itself hiring and retaining higher-skilled staff. And with less administrative work on their plates, providers and staff at Peachtree have been able to focus on higher-value tasks like managing physician schedules, building client relationships, and growing priority areas for the business—including Peachtree’s personal injury and worker’s compensation businesses.
A partnership that pays for itself
When Peachtree began the search for a new vendor, it had a long list of requirements. With athenahealth, the orthopedic group got much more than expected—including a powerful network that has allowed Peachtree to learn from the experiences of other orthopedic practices. “I’m the only revenue cycle person in my practice, but now I feel like I’m one of many,” Chiaravalloti says. “We share best practices. We brainstorm together. athena has given us that opportunity.”
I don’t feel like I’m flying blind every day when I’m planning. I can see who’s collecting and who’s not. I can see in real time how much we brought in yesterday. I know the day before what our time-of-service collections goal should before for the next day.
— Saranya Chiaravalloti, director of revenue service