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Today, over 50% of physicians across the country are employed – either by a hospital or practice group. Those who wish to remain independent are now joining associations to help negotiate better payer reimbursements or lower costs for certain services. Many independent practices find that they do not have the capital to add EHRs and ancillary services that may be required to remain competitive in the current era of healthcare reform. Several organizational models have recently emerged, aimed at further consolidating and connecting disparate healthcare systems. These models carry names such as Patient-Centered Medical Homes (PCMHs), Accountable Care organizations (ACOs), Clinical Integrated Networks (CINs) and Independent Practice Associations (IPAs), all with the aim of lowering healthcare delivery costs while improving quality and outcomes in healthcare.

The payment model which drives the healthcare industry is undergoing major structural change, shifting to one where reimbursements will be tied to improved outcomes and quality of care. This fundamental shift will require better coordination amongst healthcare professionals to improve efficiency, regardless of practice location or employer.

The emergence of these new organizational models began with PCMH’s and have expanded into ACO’s, aimed at driving new systems of care coordination. The Affordable Care Act (ACA) is at the heart of these new incentives, and in January of 2013, the AMA launched a set of new billing codes (CPT Codes) which allow physicians to bill for non face-to-face encounters. Such billable services include coordination of care for those with chronic diseases, communications that help prevent hospital readmission, facilitation of access to care, identification of community services, development of comprehensive care plans, and medical team conferences about care plans. Today, these new codes are reimbursed by Medicare and private payers when care coordination begins within two days of a hospital discharge. Before DocbookMD, it was not common for the primary care physician to know of their patients’ hospital discharge, making the two-day follow-up challenging. Because DocbookMD can be used to alert the primary care physician about a patient’s discharge real-time, including details of the discharge plan, it has become an essential tool to not only help improve the care of patients during this transitional care period, but it also now serves as a means for reimbursement through documentation of this transitional care management. Medical team coordination of these patients can now be documented through the weeks of communication on DocbookMD. Because this type of encounter is billable, using these new codes, at the end of each calendar month, based on cumulative time spent, it is often tricky to document in a traditional electronic health record. By using DocbookMD for this type of on-going coordination of care, the entire thread can be used to document the type of complex care delivery never before captured. Despite the complexity of this new era in health care delivery, innovations must help physicians capture payment for additional time spent which helps patients – and saves the system money.

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