U.S. hospitals lose a total of $8.3 billion annually due to inefficient communications technology, according to a new report from the Ponemon Institute the Wall Street Journal's "CIO Journal" reports.

The report was sponsored by Imprivata, a provider of health care security software and services.

For the report, Ponemon surveyed 577 health care and health IT professionals at medical facilities that ranged in size from having fewer than 100 beds to having more than 500 beds.

Findings on Communications Tools

The survey asked participants about the challenges they encounter in using communications tools, finding that:

• 52% of respondents said that pagers are inefficient
• 39% said that Wi-Fi is not available
• 38% said that their email system is inefficient
• 36% said that text messaging is not allowed
• 28% said that personal mobile devices are not allowed

Findings on HIPAA's Effects

The survey also asked participants about the effects of complying with HIPAA, finding that:

• 85% of respondents said that HIPAA reduces the amount of time available for delivering care
• 79% said that HIPAA makes accessing electronic patient data difficult
• 59% said that the complexity of HIPAA requirements were a major barrier to modernizing the health care system
• 56% said that HIPAA restricts the use of electronic communications

Findings on Time Spent Communicating

Survey participants also answered questions related to time spent communicating. The survey found that:

• Clinicians said they waste an average of 46 minutes daily as a result of using outdated communications technology
• Clinicians estimated that only 45% of each workday is spent with patients, with the remaining 55% being spent communicating and collaborating with other clinicians, as well as using electronic health record systems and other IT tools
• 65% of respondents said that they believe that secure text messaging could cut patients' discharge time by 50 minutes

Findings on Costs

The report estimated that inefficient communications technology causes the U.S. hospital industry to lose:

• More than $5.1 billion annually as a result of decreased physician productivity and the decreased time that physicians have available to spend with patients
• About $3.2 billion annually as a result of lengthy patient discharge times

Source: California Healthline, May 9, 2013.

HHS released four final rules expanding and updating the Health Insurance Portability and Accountability Act (HIPAA).

The rules implement tougher privacy and security provisions.

• Clarify when breaches must be reported to HHS' Office for Civil Rights;
• Establish new standards for the use of patient-identifiable information for fundraising and marketing;
• Expand liability to "business associates" of hospitals and other "HIPAA-covered entities," such as data miners and health information technology service providers; and,
• Raise the maximum penalty for noncompliance to $1.5 million per violation.

According to HHS, the rules stemmed in part from an executive order that directed HHS to conduct a retrospective review of existing regulations to determine ways to reduce costs and increase flexibility under HIPAA.

Click here to view the final rules. 

Source: California Healthline, January 18, 2013.

The Department of Health and Human Services (HHS) postponed the use of ICD-10 diagnostic codes until October 1, 2014.

The 1-year delay comes in response to complaints by organized medicine about the administrative burden of converting to ICD-10. SFMS, CMA, AMA, and other medical societies told HHS that converting to the more voluminous and complicated set of diagnostic codes could cost medical practices tens of thousands of dollars and interfere with their migration to electronic health records and electronic prescribing.

ICD-10 stands for the International Statistical Classification of Diseases and Related Health Problems, 10th Revision. The Centers for Medicare and Medicaid Services (CMS) mandated the switch from ICD-9 to ICD-10 as part of implementing the Health Insurance Portability and Accountability Act (HIPAA). HHS considers ICD-9 outdated and imprecise.

ICD-10 contains 68,000 diagnosis codes, which is roughly 5 times the number in ICD-9. The new codes also run to a maximum of 7 characters compared with 5 in the current codes.

HHS also announced establishing a standard format for health plan identifier (HPID) codes that is designed to simplify billing for clinicians and hospitals. Identifiers for health plans now in use differ in format, and that variety invites errors, leading to misrouted transactions, rejected claims, and problems determining patient eligibility, according to HHS. The department estimates that implementing a standard HPID will save the healthcare industry up to $6 billion over the course of 10 years.

Click here for more information on the HHS announcement.

Under the new Health Insurance Portability and Accountability Act (HIPAA) version 5010 standards, the electronic remittance advice (ERA) transaction has been enhanced to include such information as a patient’s coverage expiration date and the claim received date. In addition, ERAs for Medicare claims will include national and local coverage determinations so physicians can easily identify which items and services Medicare will cover. These changes will eliminate much of the time-consuming research physicians previously had to perform.

Click here to learn more about the benefits of using ERA from an AMA webinar. 

Accepting electronic remittance advice (ERA) and automating your claims process can:

• Speed up payment
• Save time spent on manual processes such as opening mail, filing and phone calls to health insurers
• Eliminate lost EOBs and expedite filing to secondary payers
• Free time for revenue-enhancing functions such as ensuring correct payment

Cost of paper EOBs: $2.96 x 6200 = $18,600
Cost of electronic remittance advice: $1.48 x 6200 = $9,176

Annual savings from claims automation per physician: $9,424*
*Based on an annual average of 6,200 claims submitted for a single physician. Source: Milliman, Inc., Electronic Transaction Savings Opportunities for Physician Practices. Technology and Operations Solutions. Revised: January 2006

 

The deadline for transitioning electronic transactions to the updated 5010 version of the Health Insurance Portability and Accountability Act (HIPAA) transactions standards is July 1, 2012. The Centers for Medicare & Medicaid Services (CMS) had previously moved back the enforcement date to allow the industry more time to convert to the new format. CMS now believes that a sufficient number of practices have effectively made the transition and physicians will begin seeing rejected claims as of July 1, if they are not submitted in the new format. You will be required to conduct electronic transactions such as claims submissions, eligibility verification, claims status, remittance advice and referral authorizations using the updated transaction standards.

 

If you have not successfully converted your programs to 5010, consider using the free CMS software programs PC-Ace Pro 32 (for Medicare claim submission) and EasyPrint (for Medicare electronic remittances). Both programs are available for download from the Palmetto GBA website, www.palmettogba.com/j1b. Click on EDI in the left menu, then on "Software and Manuals."

 

Commercial payors will also require practices to submit electronic claims in 5010 format on July 1.

 

SFMS/CMA surveyed the major payors in California to determine their claim submission requirements. While some did require 5010 on January 1, others allowed for contingencies.

 

Click here to access our member-only reference guide to help with transitioning to 5010 as well as a list of requirements by payor.