by Stephen Reed | Accounting News, Healthcare, Industry - Healthcare, News, Newsletter
Electronic Health Records (EHR) deliver enhanced efficiency, improved patient care, and streamlined workflows. However, the implementation of EHR systems is complex and challenging. In this article, we explore common challenges faced during EHR implementation and provide insights into overcoming these challenges to achieve a seamless transition.
Choosing the Right EHR System
The market is flooded with various options for EHR systems, so organizations need to carefully evaluate and select a system that aligns with their specific needs. This typically necessitates thorough research of vendors and systems, as well as having a grasp of the timeline needed for implementation. Additionally, you’ll want to establish a generous and flexible budget that allows for additional or emergency resources. Implementing a system that caters to the unique requirements of the practice with an expert vendor that is transparent and knowledgeable ensures a smoother transition.
Communication and Training
When implementing EHRs, effective communication and patience during the rollout are paramount. Here are some valuable tips for fostering smoother communication and ensuring successful training:
- Enable and Support the Launch Team: Healthcare providers should grant launch staff the authority to proactively manage unexpected challenges. A clearly defined escalation strategy helps to swiftly address emergencies and mitigate potential frustrations among both staff and patients.
- Develop resolution strategies: Go-live support teams should establish detailed protocols for identifying and resolving technical issues, including issues with both hardware and software. Designate individuals responsible for each type of problem and be share they share solutions for issues. Keeping everyone involved in all stages of identifying and solving issues will go a long way in making the transition as smooth as possible.
- Support from Leadership: Implementing EHRs can be disruptive to a working environment. Leaders who communicate effectively to staff and patients on successes at setbacks, who can acknowledge the benefits and the challenges of an EHR rollout, and who can make sure users are aware of available support staff if issues arise can ensure a smoother implementation experience.
Workflows
Emphasizing the significance of workflows is crucial for healthcare professionals as they strategize, document, and communicate information regarding EHR implementation. Recognize that healthcare workflows vary, with certain processes being more integral to the well-being of patients.
Consider these workflows that warrant special attention in your EHR implementation:
- Blood banks: Blood banks play a vital role where lives depend on efficient processes. Therefore, it is imperative to ensure that your EHR implementation thoroughly addresses the intricacies of this workflow.
- Medication Reconciliation: Before the EHR system goes live, organizations need to confirm that the system effectively tracks patients’ medications both pre- and post-admittance.
- Patient Movement: Tracking patients’ movements throughout their hospital stay is paramount for ensuring proper care. This aspect of the workflow is critical to maintaining a holistic view of patient care and facilitating effective communication among healthcare teams.
- Level of Care: Accurately documenting a patient’s stages, whether they are in the ER or ICU, significantly influences accurate medical billing and ensures appropriate levels of care.
- Careful Transport: The careful monitoring of how patients are physically transported within the facility deserves special consideration during EHR implementation so that patients are moved smoothly and securely.
by Daniel Kittell | Accounting News, Healthcare, IRS, News
On the mind of many Americans in recent months is how our new President will alter the healthcare system. His promise throughout the campaign was that Obamacare would be “repealed and replaced” as quickly as possible. However, we all know the feeling when our time frame for getting things done doesn’t always work out, or how we envisioned a project would turn out isn’t often the final product either. Just last week, the House passed an initial bill that reconfigures the healthcare system as it is today; however, it still has to pass the Senate, and will likely go through many changes and amendments before being finally accepted into law. Although Trumpcare may not look exactly how President Trump imagined, nor has it “repealed and replaced” Obamacare as rapidly as he may have originally hoped, here are some key differences between his plan and our current system.
- Immediate repeal of the 3.8% net investment income tax, which taxes income from royalties, interest, rents, dividends, passive activities and gains for those with a gross income over $200,000.
- Immediate repeal of the individual mandate excise tax, or the tax owed if you did not have health insurance.
- Health savings account withdrawal penalties would drop from the 20% under Obamacare to what it was before, 10%. This penalty only occurs if you withdraw money from an HSA before 65 for non-medical expenses.
- Removal of the $2,500 cap on the amount of pre-tax funds allowed to be placed in a healthcare flexible spending account. Decisions to impose a cap or not would be left up to employers.
- Those with FSA’s or HSA’s would also be allowed again to utilize those pre-tax funds on over-the-counter meds.
- Lowers the rate for medical itemized deductions. If you were under 65, Obamacare only allowed deductions for medical expenses that exceeded 10% of your adjusted gross income, whereas Trumpcare would take it back down to the previous 7.5% of your adjusted gross income.
- While Trumpcare would eventually repeal the 0.9% additional Medicare surtax on those with gross incomes over $200,000, it would not do so until 2023, which is later than the first healthcare bill the House introduced.
For the time being, these are the tax adjustments in place, although these could presumably change once the bill works its way through the Senate. This version of Trumpcare certainly differs from the House’s first proposal, but Americans may see many months pass and many modifications occur before the healthcare system truly moves away from Obamacare.
If you have any questions, please feel free to contact me at [email protected].
Take a look at my article on a similar topic: “The New GOP Healthcare Plan and What That Means for You”.
by Daniel Kittell | Healthcare, News, Tax Planning, Tax Planning - Individual
Our world is filled with seemingly constant changes and developments, however, most Americans have been paying close attention to the potential changes coming out of Washington. While President Trump made many statements about how he would revamp Washington if elected, one long-awaited claim has finally been revealed: his, and the GOP’s, promise to repeal and replace Obamacare. Now that their plan has been presented to the general public, questions many are asking include, what exactly does the plan entail? And how, or will, it affect me specifically, the taxpayer? Below are several points that will attempt to identify the main differences between the GOP’s plan and Obamacare, and what that truly means for you, the taxpayer.
- Changes the Insurance Mandate
Under Obamacare, individuals and employers are required to either buy or offer coverage, or else face a fine. The GOP’s plan would do away with those penalties for both individuals and employers. However, in an attempt to prevent individuals from simply adding coverage when they need care, the GOP’s plan would permit insurance companies to enforce higher premiums on individuals who do so for the first year of their coverage.
- Changes in Medicaid
Another major difference between Obamacare and the GOP plan is how they approach Medicaid. Many who gained coverage under Obamacare did so through Medicaid provisions, including an expansion that covered those within 138% of poverty levels, as well as a federal payout to those states that expanded their coverage and insured those newly eligible. The GOP plan would eventually eliminate the expansion, only giving states extra funding for those enrolled before 2020, and provide a set amount of money to states based on their enrollment numbers in 2016, rather than providing open-ended matching for Medicaid beneficiaries.
- Changes in Age-based Premiums
While Obamacare did allow insurance companies to vary their premiums based on factors such as location, tobacco use and age, there was a 3-to-1 limit based on age. Essentially, the premium for an older individual could not be more than three times the amount charged for a younger person purchasing the same plan. The GOP would alter this limit and allow insurance companies to charge older individuals up to five times the amount of those who are younger.
- Changes in Tax Credits
The tax credits under Obamacare subsidized insurance for those using government-run insurance exchanges, providing credits based on the enrollee’s income and cost of coverage in their area. The GOP’s plan would tie credits to age and income (rather than cost of coverage), and would look to end cost-sharing subsidies. Credits would start at $2,000 for those in their 20’s and increase gradually, reaching to $4,000 for those over 60. However, these credits would only be available to individuals making $75,000 or less and households making $150,000 or less.
The GOP’s bill would still allow adults under the age of 26 to be covered under their parent’s plans, as well as maintain the provision blocking insurers from denying coverage to those with pre-existing conditions. Because the plan has significant reviews to undergo , and most likely many amendments to be made, before American’s see a final proposal, many will want to wait and see before assuming they may qualify for specific credits or that their coverage may be affected based on age or income. Though change will certainly occur, taxpayers would be advised to maintain their current coverage until the final bill is passed.
If you have any questions about how the changes to the Health Care Laws may affect you, please contact me at [email protected].
by Pete McAllister | Accounting News, Audit and Accounting, Healthcare, IRS, News, Professional Services, Resources, Retail & Distribution, Tax Consulting, Tax Planning, Tax Planning - Individual, Tax Preparation - Individual
As the third year of the Patient Protection and Affordable Care Act (PPACA) approaches, employers need to be aware of additional fees that will be assessed on insurers and plan administrators of self-insured plans beginning in 2013. In addition, reporting health care costs to the government begins.
The new fees will increase the cost of providing group health plans for employees. They include:
- Fees to fund research on patient-centered outcomes
- Transitional reinsurance fees
- Pay or play penalties
- Cadillac tax
Fees to fund research on patient-centered outcomes
Health care reform created the Patient-Centered Outcomes Research Institute (PCORI), which is charged with promoting research to evaluate and compare the health outcomes and clinical effectiveness, risks, and benefits of medical treatments, services, procedures, and drugs. PCORI is to be funded in part by fees assessed on health insurers and sponsors of self-insured group health plans. This fee is commonly referred to as the “comparative effectiveness fee” or “PCORI fee.” The PCORI fee will be assessed at $1.00 times the average number of covered lives (employees and dependents) for the first plan or policy year ending on or after October 1, 2012. Employer plan sponsors must choose a method for calculating the average number of covered lives for their required annual fees by December 31, 2012, for calendar year plans.
Transitional reinsurance fees
The transitional reinsurance program will require health insurance issuers, as well as certain plan administrators on behalf of self-insured group health plans, to make contributions to a transitional reinsurance program for the three-year period beginning January 1, 2014. This fee is likely to result in additional costs for employer plan sponsors and – depending on whether the plan at issue is self-administered – certain additional reporting obligations.
Pay or play penalties
In 2014, large employers with fifty or more full-time equivalent employees could be subject to two potential penalties: the No Coverage Penalty and the Unaffordable Coverage Penalty. The No Insurance Penalty subjects certain employers to a $2,000 per full-time employee penalty (excluding the first thirty full-time employees) under specific conditions. The Unaffordable Coverage Penalty applies if an employer offers its full-time employees the opportunity to enroll in coverage under an employer plan that either is unaffordable (relative to an employee’s household income) or does not provide minimum value. This penalty is $3,000 for every full-time employee who receives a subsidy for coverage in a state exchange.
In some cases, the total cost of these penalties may be less than the total cost of providing coverage. CliftonLarsonAllen’s Health Insurance and Penalty Calculator provides information about the impact of reform on individual companies.
Cadillac tax
Starting in 2018, insurers of employer-sponsored plans or companies that self-insure their own plans will be subject to an excise tax if their premiums are in excess of $10,200 for individual coverage and $27,500 for family coverage. Roughly 60 percent of large employers believe their plans would trigger the tax unless they take action to avoid it, according to a 2011 survey by Mercer, a human resources consulting firm. Although the tax is to be imposed on insurers, the effects are likely to trickle down to consumers.
Many health care reform provisions will impact the cost to provide health care coverage for employees. Employers should be aware of the additional fees and reporting requirements and work with their benefits consultants to determine the financial impact of health care on their businesses. Plan sponsors should have already verified that they have the systems in place to determine and report the aggregate cost of applicable employer-sponsored coverage for 2012 on employees’ Forms W-2.
Click Here to read full article
