Medaxiom Blog

A few weeks ago, I wrote about how EHRs have drastically changed the way that we deliver healthcare. From 2004 to 2015, practice EHR use shot from 20.8% - 86.9%.1 Many thought that the EHR implementation would allow for better access to data, better communication, and improved workflows. All of these occurred in other industries that adopted automation and computerized systems. But that's not what happened in healthcare.

The recent flurry of press generated by last week’s Consumer Electronics Show (CES) has me thinking a lot about technology and its role in healthcare and improving health outcomes. Health-related technology was front and center at last week’s show as more than 100 companies displayed their latest health-related devices, software and services in the hope of gaining exposure and credibility in the crowded health-tech market. For example, consumer “wearables” were bigger than ever this year. Devices to monitor your ECG, hydration levels, brain activity, skin pH and even a device to measure baby diaper activity were all introduced. A new device from Black & Decker was particularly interesting…a voice-recognizing digital assistant optimized for home healthcare. Time will tell if it is effective, but I appreciated the effort to help seniors age in place rather than a nursing home or assisted-living center.

Last week we discussed some of the industry trends and growth strategies that practice administrators are focusing on in 2019, as well as some ways to apply them. I thought a good follow up would be to encourage members to take a step back and assess how their organizations are doing on the inside before they start tackling new initiatives.

A report published by the New England Healthcare Institute opened by stating that ‘Adults in the United States receive only about half of the health care they need when they need it.’[i] The report outlines the reasons why clinical care guidelines that improve health outcomes aren't being followed and proposes industry changes that would improve this.

Remember the “old” days when you would put the telephone receiver into a transmission dock and receive pacemaker data through the phone line? Clearly—we have come a long way since then. Today’s automated, remote management (RM) technologies are far less clunky and they deliver far more data. Add to that the need for in-person visits, the complexity of patient compliance, and capturing charges for these services and it’s understandable that the deluge of data has put so many practices on tilt.

Every day I am thrilled to have the opportunity to be on the leading edge of healthcare innovation. A part of that leading edge is a full visual into transformative technologies and trends impacting the cardiovascular market. One trend that is beginning to cement itself as a rock-solid strategy is the evolution of the Cardiovascular Ambulatory Surgical Center (ASC). The Office Based Lab (OBL) has been a great strategy as an extension of practice, but moving into a recognized ASC facility (or creating a hybrid OBL/ASC) allows versatility and diversification if volumes or payment rates change over time, as they are sure to do across procedures and specialties.

Value-based care has been an area that I have found fascinating ever since I was first introduced to the concept in 2010. At the time, it made so much sense—creating an environment where the keys to effective patient care are incentivized and resources are available—yet it seemed elusive. Almost 10 years later, we have many different ‘value’ type models emerging both in public and private payer sectors, but I wonder if we are seeing the results that we were hoping to get.

In thinking about next week’s CV Transforum conference, a lot comes to mind on the need to re-engineer the way we do things. And from my work assisting groups who are thinking about the different alternative payment models, and helping programs develop their care team models, I have many stories that illustrate the need for change. Today, before I get into the problem areas, I want to start with a story that shows how things can go right.

Peer surveys, like the MedAxiom Cardiovascular Provider Compensation and Production Survey, annually publish a measure showing compensation per work Relative Value Unit (wRVU). Table 1 below shows data from the most recent MedAxiom report for cardiology. This statistic is perhaps the most misunderstood of the published compensation data and, as a result, is often misused in contract negotiations.