How a practice’s EHR helped offset its declining Medicare reimbursement

First Settlement Physical Therapy is a family owned and operated provider of orthopedic outpatient physical therapy services. Founded in 1999 as a single clinic in Marietta, Georgia, it has grown to 37 clinics with approximately 200 employees, providing a wide range of medical and rehab services to patients in both suburban and rural communities throughout the Mid-Ohio Valley provide.

Problem

Physical therapy and rehabilitation practices depend on software to enable scheduling, billing and other critical functions related to the business. When First Settlement went looking for IT tools, staff found the market lacked the ability to expand into a digital platform as a practice connects patients, therapists and services.

“Our inability to grow our business means we may not be able to capitalize on the overall growth expected for the physiotherapy industry,” said Simon Hargus, owner and CEO of First Settlement. ,Fortune Business Insights predicts that the US occupational and physical therapy services market will grow from $50 billion in 2022 to $73 billion in 2029. This increase is fueled by an aging population and an increase in both chronic conditions and sports-related injuries.

“As an organization that provides care to both suburban and rural communities, we needed a digital solution that would not only maintain the quality of our care, but facilitate growth and advance our chances for success, He continued. “We had experienced exponential organic growth in recent years, and naturally with it came growing pains.”

Proposal

Addressing the challenges in billing and revenue cycle management was one of the group’s first priorities. This required software that could handle authorization processes. It was losing money by not being able to manage its medical billing needs, and the entire process had become costly and inefficient.

“We also realized we needed to step up our marketing and patient engagement strategy,” Hargus said. “Our marketing team needed more opportunities for outreach and engagement, and needed a software platform that could support the sales funnel. Although there is third-party lead gen software that can do this, we wanted an all-in-one, comprehensive solution.”

marketplace

There are a wide variety of electronic health-record vendors on the market today, including Allscripts, Athenahealth, Kerner, eClinicalWorks, Epic, Greenway Health, Medicomp Systems, Meditech, MedSphere Systems, and NextGen Healthcare.

meet the challenge

First Settlement implemented Raintree’s all-in-one electronic health record system. It includes a set of business intelligence tools that provide remote access capability – vital for a practice with so many clinic sites in one area.

“The EHR platform includes automated patient engagement tools that allow us to advance our clinics in medically under-served areas,” Hargus explained. “These tools help us keep up with internal and external campaign efforts. Attracting and retaining new patients is now easier for us using lead tracking tools and the ability to monitor patient trends.

“Front-desk automation, such as scheduling technology, has given our office workers the opportunity to cover more responsibilities and save resources,” he continued. “On the billing side, an automated claims appeals system that associates certain codes with troublesome claims translated directly into money and time savings.”

He added that the EHR platform comes with artificial intelligence business intelligence tools, which saves physician time by quickly analyzing a patient’s medical history, current symptoms, and other relevant information to make accurate diagnoses. AI is also used to monitor patient progress, adjust treatment plans as needed, and alert the physician to take preventive action against potential complications.

Result

By streamlining and optimizing existing processes, the first settlement has been able to nurture organic growth.

“Automating complex workflows across medical billing, marketing efforts and regulatory reporting – such as Medicare’s merit-based incentive payment system – enables us to focus time and resources on providing quality care to patients,” Hargus explained. makes.” “The resulting organic growth more than offset the decline in reimbursement for Medicare beneficiaries.

“Not only can these technologies help reduce pain faster, but they also reduce the amount of time a patient spends in physical therapy, allowing our therapists to see more patients without sacrificing treatment quality.” can see,” he said.

Another feature that has proven useful is the EHR’s ability to separate student metrics from employee metrics so that staff can more easily balance student opportunities with ongoing efforts to provide quality care.

“Physical therapy and rehab practices like ours are under pressure to grow with the market or risk falling behind competitors, even as we contend with staffing challenges and reimbursement reductions,” Hargus said. “We rely on advanced technologies such as AI and automation to ensure that we have the tools to grow our business while maintaining high levels of patient satisfaction and engagement.”

advice for others

“Plan for growth by choosing a solution that is highly scalable and easy to transition, especially for your clinician,” concluded Hargus. “There is a learning curve, yes, but it should only take hours, not weeks.”

Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him at: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.