More than $1.2 trillion spent on healthcare each year is a waste of money. Members of the medical community identify the leading causes.
Down the drain: $1.2 trillion.
That's half of the $2.2 trillion the United States spends on healthcare each year, according to the most recent data from accounting firm PricewaterhouseCoopers' Health Research Institute.
What counts as waste? The report identified 16 different areas in which healthcare dollars are squandered. But in talking to doctors, nurses, hospital groups and patient advocacy groups, six areas totaling nearly $500 billion stood out as issues to be dealt with in the healthcare reform debate.
1. Too Many Tests
Doctors ordering tests or procedures not based on need but concern over liability or increasing their income is the biggest waste of health care dollars, costing the system at least $210 billion a year, according to the report. The problem is called "defensive medicine."
"Sometimes the motivation is to avoid malpractice suits, or to make more money because they are compensated more for doing more," said Dr. Arthur Garson, provost of the University of Virginia and former dean of its medical school. "Many are also convinced that doing more tests is the right thing to do."
"But any money that is spent on a patient that doesn't improve the outcome is a waste," said Garson.
Some conservatives have suggested that capping malpractice awards would help solve the problem.
President Obama doesn't agree; instead, his reform proposal encourages doctors to practice "evidence-based" guidelines as a way to scale back on unnecessary tests.
2. Those Annoying Claim Forms
Inefficient claims processing is the second-biggest area of wasteful expenditure, costing as much as $210 billion annually, the PricewaterhouseCoopers report said.
"We spend a lot of time and money trying to get paid by insurers," said Dr. Terry McGenney, a Kansas City, Mo.-based family physician.
"Every insurance company has its own forms," McGenney said. "Some practices spend 40% of their revenue filling out paperwork that has nothing to do with patient care. So much of this could be automated."
Dr. Jason Dees, a family doctor in a private practice based in New Albany, Miss., said his office often resubmits claims that have been "magically denied."
"That adds to our administrative fees, extends the payment cycle and hurts our cash flow," he said.
Dees also spends a lot of time getting "pre-certification" from insurers to approve higher-priced procedures such as MRIs. "We're already operating on paper-thin margins and this takes times away from our patients," he said.
Susan Pisano, spokeswoman for America's Health Insurance Plans, said "hundreds of billions" of dollars can be saved by standardizing procedures and using technology -- something the White House has mentioned as a key to health care reform.
"For that to happen, we need the technology," she said. "Doctors and hospitals must adopt the technology, and we have to develop rules for exchanging of information between doctors, hospitals and health plans."
Pisano said the industry is launching a pilot program later this year that will allow physicians to communicate with all health plans using a standardized process.
3. Using the ER as a Clinic
More insured and uninsured consumers are getting their primary care in emergency rooms, wasting $14 billion every year in health care spending.
"This is an inappropriate use of the ER," said Dee Swanson, president of the American Academy of Nurse Practitioners. "You don't go to the ER for strep throat."
Since emergency rooms are legally obligated to treat all patients, Swanson said providers ultimately find ways to pass on the cost for treating the uninsured to other patients, such as to those who pay out-of-pocket for their medical care.
Dees also took issue with consumers who don't get primary care for their diabetes or blood pressure on a timely basis, hence finding themselves in the ER.
"Going to the doctor for strep throat would cost $65-$70. In the ER, it's $600 to $800," he said.
The $787 billion stimulus bill signed passed by President Obama earlier this year includes allocates $1 billion for a wellness and prevention fund, including $300 million for immunizations and $650 million for prevention programs to combat the rapid growth in chronic diseases such as obesity and diabetes.
4. Medical "Oops"
Medical errors are costing the industry $17 billion a year in wasted expenses, something that makes patient advocacy groups irate.
"Do we have a good health IT system in place to prevent this?" asked Kim Bailey, senior health policy analyst with consumer advocacy group Families USA.
Bailey suggested that processes such as computerized order entry for drugs and use of electronic health records (EHR) could help ensure that patients get the correct dosage of medications in hospitals.
The stimulus bill calls for the government to take a leading role in developing standards by 2010 to facilitate the adoption of health information exchanges across the system, including patient electronic health records by 2014.
Obama has repeatedly said that the use of technology in the health sector will help boost savings, enhance the coordination of care and reduce medical errors and unnecessary procedures.
5. Going Back to the Hospital
Bailey suggested that processes such as computerized order entry for drugs and use of electronic health records (EHR) could help ensure that patients get the correct dosage of medications in hospitals. Discharging patients too soon is a "huge waste of money," said Swanson.
"This happens a lot with elderly patients who are discharged prematurely because of insurance, bed unavailability or ageism," she said.
Many times, patients also don't follow instructions for care after discharge. "So complications arise and they are readmitted in a week," Swanson said.
PricewaterhouseCoopers estimates the cost of preventable hospital readmissions at $25 billion annually.
Among the reform plans, one proposal being considered is for Medicare to potentially penalize hospitals who readmit patients within 30 days of discharge.
6. You Forgot to Wash Your Hands!
Those ubiquitous dispensers of hand sanitizer are in hospitals for a reason: PricewaterhouseCoopers estimates that about $3 billion is wasted every year as a result of infections acquired during hospital stays.
"The general belief is that hospitals are getting much better in managing this than they have in the past," said Richard Clarke, CEO of Healthcare Financial Management Association, whose members include hospitals and managed care organizations.
Something as simple as hand-washing often can reduce the problem.
"Sometimes doctors are the most difficult people to convince to do this," said Clarke. "The challenge here is that patients sometimes come in with infections which then spread in the hospital."
The stimulus bill signed by Obama earlier this year includes $50 million for reducing healthcare-associated infections.
Other areas of waste identified in the PricewaterhouseCoopers report included up to $493 billion related to risky behavior such as smoking, obesity and alcohol abuse, $21 billion in staffing turnover, $4 billion in prescriptions written on paper, and $1 billion in the over-prescribing of antibiotics.
Increase in heart disease and diabetes has provoked innovators to think about medical technologies for preventive care that would be easy to use, portable and can allow remote monitoring. Freescale Semiconductor introduced a prototype of a product, which has capability to collect patient health data. This data can be seen by the doctor, either on site, if installed in hospital or could be assessed remotely through cloud computing servers. David Niewolny, Medical Segment Marketing Manager, gave me a demonstration of the Freescale Medical Kiosk, which can do the following:
This Medical Kiosk is designed for hospitals to log basic condition of patients, instead of gathering it on forms. At this time Kiosk is somewhat large, about size of your refrigerator, but Freescale wants to develop portable instruments based on the sensors they have developed.I see utility of this technology very useful in remote areas where healthcare is not assessable in small towns. This way doctors/hospitals can keep a watch on their patients remotely, by either setting up the Medical Kiosk in towns themselves or bringing these systems to towns in a van on regular basis, like every month.
- take patients weight and height to calculate BMI
- monitor blood pressure, heart rate and even ECG
- option of selecting different languages
- pulse oximetry to know amount of oxygen in blood (by a photodiode sensor, no piercing)
- glucose level by integrated glucometer (based on needle prick technology)
- spirometry – blow into a device to gauge lung capacity (critical for asthma patients)
- information can be uploaded to your computer, cloud (Internet) and downloaded by your doctor
BAC Medical Marketing has partnered with Mitochon Systems to be able to offer a free EMR system to all qualified medical providers, who will then qualify for as much as $44,000.00 of the American Recovery and Reinvestment Act (ARRA) Incentive Program (SEE BELOW). Skeptical? Sound too good to be true? While this offer may sound too good to be true, we assure you it isn’t. Really! Let us prove it to you today!We are not just offering another “me-too” EMR solution. We view our high- quality mConnect and mEMR products as a means to reach a greater goal, that of partnering with physicians to build the nation’s first fully functioning Virtual Medical Community (VMC). We deliver a low-impact, user-friendly, secure entry point into the VMC, which is what physicians, patients and hospitals have desired for years.OverviewBAC Medical Marketing offers a free EMR platform to connect physicians, patients, and hospitals into a Virtual Medical Community (VMC), that provides a secure platform for the exchange of healthcare information. We seek to empower physicians, patients and hospitals to make the most accurate, efficient, and cost effective healthcare decisions. Through the deployment of the mEMR and mConnect products, we are on the path to creating the world’s largest and best VMC for physicians, patients, insurance carriers, pharmaceuticals and other entities involved in the healthcare sector.Our Core Values:
mEMR | mConnect | ePrescribe Solution
- We protect and enhance the physician-patient relationship, which is at the heart of superior healthcare delivery.
- We believe that the true value of our software and services is only realized through the creation of a connected medical community, the VMC.
- The creation of the VMC is wholly dependent on the relationships we create between and among physicians, hospitals and patients.
- We are responsive and sensitive to the needs of our physicians, patients, hospitals and the VMC at large and seek to implement our solutions in a manner that causes minimal disruption to the physician’s practice.
- In the end, we believe that the products we offer and outcomes we generate should benefit society as a whole by helping people live longer, healthier lives.
mConnect: Healthcare Information Network
- All of the benefits of enhanced EMR, Scheduler and Patient Portal
- Our mEMR product allows for automatic synchronization of patient Personal Health Record (PHR)
- All mConnect connectivity features are also included in mEMR Solution
- Single source solution
- A free practice web site
- Practice web site and portal construction
- Developed by physicians for physicians
ePrescribe Solution from Mitochon & H2H (Optional, for a nominal fee)
- With mConnect your office can connect and share clinical data via nearly any EMR system with colleagues, hospitals and patients via our Healthcare Information Exchange (HIE).
- Deliver an even higher level of patient care with patient clinical data and history easily at hand.
- Flexible technology adoption
- Simple implementation process. All you need is a scanner and Internet access to get started.
- Ongoing IT support and guidance offered by us
- State-of-the-art JAVA / J2EE platform available to any authorized Physician over the Internet, with no special software or hardware required within the physician’s office
- Integration with SureScripts™ (formerly RxHub) for real-time determination of patient eligibility, up to date formulary listings, as well as a complete listing of ALL medications written for their patients, regardless of who the originating Physician was or where in the country the prescription may have been filled
- Real-time drug-drug, drug-food, drug-allergy, drug-dose, and duplicate therapy information provided to Physicians, along with mechanisms that take into account those medications that were prescribed by other Physicians and that were perhaps filled somewhere else in the United States, paying particular attention to those interactions that may pose a risk to the patient.
- Electronic messaging directly from pharmacies for refill requests made by patients, affording the Physician the opportunity to immediately authorize, deny, or defer until the patient has scheduled a follow-up appointment, etc., as well as notifications pertaining to new data regarding side-effects and medication precautionary information
- Integration with SureScripts™ to provide distribution of the completed prescriptions to the vast majority of retail pharmacy chains, as well as many independent pharmacies, as selected by the patient. Pharmacies that are not yet part of the SureScripts network will automatically receive completed prescriptions via facsimile, transparent to the physician.
We have built our system to meet and exceed developing Health & Human Services (HHS) requirements for EMR functionality. This adherence will allow physicians users to position themselves to qualify for The Health Information Technology for Economic and Clinical Health (HITECH) incentive payments for meaningful use. Concierge Consultant
BAC Medical Marketing will provide your practice and/or facility, with a highly-skilled Concierge Consultant (for a nominal fee), who will oversee every stage of the presentation, consultation, implementation and integration of our EMR system. Virtual Medical Community (VMC) Our Virtual Medical Community (VMC) is the net result of the empowering connectivity and enabling the exchange of information between physicians, patients and hospitals. It is a platform and an environment where information can flow easily and inexpensively from physician to physician, physician to patient and from patient to physician. We offer physicians and their patients an entry point into a VMC through the deployment mConnect and mEMR, our EMR and practice management tool. Once in the VMC, physicians can engage and connect, electronically sharing patient history with authorized physicians (inpatient or outpatient) or healthcare organizations, reducing life threatening errors and increasing efficiency.Why our Virtual Medical Community (VMC) is important to physicians, patients and hospitals? Approximately 98,000 patients die annually in the United States due to poor medical decision making. In California alone, over 50,000 incorrect medical decisions are made daily. At the heart of this epidemic lies a deficiency of communication, connectivity and collaboration between hospitals, physicians, and patients. We have, as our mission, a drive to address and remedy this issue by creating the platform to supply on-demand, highly accurate health care information to physicians, patients and hospitals within a VMC. It is a concept that has long been a goal of those in the medical community but attempts by the medical community itself, insurance carriers and governmental bodies have fallen short in the past due to many factors. The method for bridging this connectivity gap centers on a free EMR solution coupled with a gateway to our VMC, the platform where the information sharing and collaboration can occur.ARRA Incentive Program
The American Recovery and Reinvestment Act (ARRA) authorizes incentives for physicians who demonstrate meaningful use of electronic health records to receive incentive payments totaling $44,000.00 per provider. The definition for meaningful use will progressively increase from Stage 1 in 2011 to Stage 2 in 2013 to Stage 3 in 2015.
Three Reasons to Choose Our EMR
Yes, it's a free EMR!
mEMR is a free best-in-class EMR that will compare favorably to any costly EMR on the market. mEMR is an ad-supported system that's easy to install and simple to use. It was built by physicians, for physicians, so it works how you work, rather than forcing you to change how you practice.
We are guaranteeing our EMR will meet HHS certification. More EMRs will fail to meet government requirements than will qualify, but ours has met 90% of the published HHS criteria and we await the final set of qualification criteria.
$44,000.00 is Yours to Keep!
Our EMR has been built to enable your practice and/or facility to meet meaningful use requirements and to capture the $44,000.00 offered by the federal government. While the journey from where you are today to establishing meaningful use and capturing ARRA funding may seem daunting, we will be there with your practice and/or facility every step of the way, ensuring your success. Now let's get it done!
To learn more and tschedule a no obligation demo, go to http://www.BACMedicalMarketing.com/Free-EMR.html.
WASHINGTON – U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced final rules to help improve Americans’ health, increase safety and reduce health care costs through expanded use of electronic medical records (EMR) / electronic health records (EHR).“For years, health policy leaders on both sides of the aisle have urged adoption of electronic health records throughout our health care system to improve quality of care and ultimately lower costs,” Secretary Sebelius said. “Today, with the leadership of the President and the Congress, we are making that goal a reality.”Under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, eligible health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to achieve specified objectives. One of the two regulations announced today defines the “meaningful use” objectives that providers must meet to qualify for the bonus payments, and the other regulation identifies the technical capabilities required for certified EHR technology.Announcement of today’s regulations marks the completion of multiple steps laying the groundwork for the incentive payments program. With “meaningful use” definitions in place, EHR system vendors can ensure that their systems deliver the required capabilities, providers can be assured that the system they acquire will support achievement of “meaningful use” objectives, and a concentrated five-year national initiative to adopt and use electronic records in health care can begin.“This is a turning point for electronic health records in America, and for improved quality and effectiveness in health care,” said David Blumenthal, M.D., National Coordinator for Health Information Technology. “In delivering on the goals that Congress called for, we have sought to provide the leadership and coordination that are essential for a large, technology-based enterprise. At the same time, we have sought and received extensive input from the health care community, and we have drawn on their experience and wisdom to produce objectives that are both ambitious and achievable.”Two companion final rules were announced today. One regulation, issued by the Centers for Medicare & Medicaid Services (CMS), defines the minimum requirements that providers must meet through their use of certified EHR technology in order to qualify for the payments. The other rule, issued by the Office of the National Coordinator for Health Information Technology (ONC), identifies the standards and certification criteria for the certification of EHR technology, so eligible professionals and hospitals may be assured that the systems they adopt are capable of performing the required functions.As much as $27 billion may be expended in incentive payments over ten years. Eligible professionals may receive as much as $44,000 under Medicare and $63,750 under Medicaid, and hospitals may receive millions of dollars for implementation and meaningful use of certified EHRs under both Medicare and Medicaid.The CMS rule announced today makes final a proposed rule issued on Jan, 13, 2010. The final rule includes modifications that address stakeholder concerns while retaining the intent and structure of the incentive programs. In particular, while the proposed rule called on eligible professionals to meet 25 requirements (23 for hospitals) in their use of EHRs, the final rules divides the requirements into a “core” group of requirements that must be met, plus an additional “menu” of procedures from which providers may choose. This “two track” approach ensures that the most basic elements of meaningful EHR use will be met by all providers qualifying for incentive payments, while at the same time allowing latitude in other areas to reflect providers’ needs and their individual path to full EHR use.“CMS received more than 2,000 comments on our proposed rule,” said Marilyn Tavenner, Principal Deputy Administrator of CMS. “Many comments were from those who will be most immediately affected by EHR technology – health care providers and patients. We carefully considered every comment and the final meaningful use rules incorporate changes that are designed to make the requirements achievable while meeting the goals of the HITECH Act.”Requirements for meaningful use incentive payments will be implemented over a multi-year period, phasing in additional requirements that will raise the bar for performance on IT and quality objectives in later years. The final CMS rule specifies initial criteria that eligible professionals (EPs) and eligible hospitals, including critical access hospitals (CAHs), must meet. The rule also includes the formula for the calculation of the incentive payment amounts; a schedule for payment adjustments under Medicare for covered professional services and inpatient hospital services provided by EPs, eligible hospitals and CAHs that fail to demonstrate meaningful use of certified EHR technology by 2015; and other program participation requirements.Key changes in the final CMS rule include:
CMS’ and ONC’s final rules complement two other recently issued HHS rules. On June 24, 2010, ONC published a final rule establishing a temporary certification program for health information technology. And on July 8, 2010 the Office for Civil Rights announced a proposed rule that would strengthen and expand privacy, security, and enforcement protections under the Health Insurance Portability and Accountability Act of 1996.As part of this process, HHS is establishing a nationwide network of Regional Extension Centers to assist providers in adopting and using in a meaningful way certified EHR technology.“Health care is finally making the technology advances that other sectors of our economy began to undertake years ago,” Dr. Blumenthal said. “These changes will be challenging for clinicians and hospitals, but the time has come to act. Adoption and meaningful use of EHRs will help providers deliver better and more effective care, and the benefits for patients and providers alike will grow rapidly over time.”
- Greater flexibility with respect to eligible professionals and hospitals in meeting and reporting certain objectives for demonstrating meaningful use. The final rule divides the objectives into a “core” group of required objectives and a “menu set” of procedures from which providers may choose any five to defer in 2011-2012. This gives providers latitude to pick their own path toward full EHR implementation and meaningful use.
- An objective of providing condition-specific patient education resources for both EPs and eligible hospitals and the objective of recording advance directives for eligible hospitals, in line with recommendations from the Health Information Technology Policy Committee.
- A definition of a hospital-based EP as one who performs substantially all of his or her services in an inpatient hospital setting or emergency room only, which conforms to the Continuing Extension Act of 2010
- CAHs within the definition of acute care hospital for the purpose of incentive program eligibility under Medicaid.