ICD-10 and What the Ebola Virus Means for Healthcare Reimbursement

Public health officials are learning more every day about the procedures required to care for Ebola patients. But one thing that the Ebola crisis has revealed is that the health care system lacks the classification codes to track the disease and ultimately, to reimburse for care of patients who have the disease.

what the ebola virus means for healthcare reimbursementICD-9 has no specific code for Ebola. Under the classification system, the hemorrhagic fever would currently fall under 078.89 – the code for “other specified diseases due to viruses.” That means Ebola shares a code with many other viruses that have not yet been assigned a specific code. The next iteration of the classification system, ICD-10, gives Ebola the code A98.4. But the U.S. Congress in the spring delayed implementation of the new classification system. The fact that the United States still uses ICD-9 will make it more more difficult to share information about the disease and its movement with other countries, HIT Consultant reported. All of the world’s industrialized nations use ICD-10 and use the codes in the newer system to report health information to the World Health Organization.

Besides disease tracking, health officials are starting to learn what the Ebola virus means for healthcare reimbursement. The classification codes are also important for reimbursing the cost of care. When health claims are submitted to payers, the claim must include a code to indicate a particular disease or procedure. If any more Ebola cases arise in the United States, ICD-9 allows no way for a health care provider to submit a claim specifically for Ebola. Thomas Eric Duncan, the Liberian man who was treated at Texas Health Presbyterian Hospital in Dallas, had health care costs estimated at $1,000 an hour, Bloomberg News reported. That cost takes into account not only the care provided to Duncan, but also the expense of isolation procedures for an Ebola patient. The Texas hospital is not expected to recover any of the costs associated with the care of Duncan, who was uninsured.

The Texas hospital has offered to pay the health care costs of Nina Pham, one of the nurses who treated Duncan and was later diagnosed with Ebola, while she was in the hospital’s care. Pham was recently declared Ebola free after being treated at the the National Institutes of Health; that bill will likely be picked up by the federal government.

ICD-10 offers a way to submit health care claims for Ebola and also file for reimbursement for treating patients with the disease. But its implementation did not come in time for Ebola’s arrival in the United States. Much is still being learned about the procedures hospitals need to use to care for Ebola patients and it’s unclear whether new codes will be needed. But what is now clear is that the health system has a classification code for Ebola but for now, it has no way to use it. To learn more, contact us.

The Early Days of Ebola vs. HIV: Similarities and Differences

In the early 1980’s a new disease entered the U.S. that had doctors scrambling to find answers. A number of gay men in both New York and California were experiencing treatment resistant diseases and cancers that were extremely uncommon. Luckily, doctors were able to relate the diverse presentations of the new disease fairly quickly. In the early days, this disease didn’t have a name. Today, we know it as Human Immunodeficiency Virus or HIV. To put U.S. cases of HIV in perspective, currently the CDC

“estimates that 1,144,500 persons aged 13 years and older are living with HIV infection, including 180,900 (15.8%) who are unaware of their infection1.”

ebola vs. hiv: similarities and differencesWith new cases of Ebola presenting in the U.S., it is important to compare our handling of patients to that of the early days of the HIV outbreak. When we look at Ebola vs. HIV: similarities and differences, we can find ways to improve our initial response thereby gaining better control of the spread of diseases with no currently known cure and high death rates.

Misinformation in the early days of HIV caused many to believe that only gay men need fear the infection. Since then, we have learned differently. Many of the early cases of HIV could have been prevented had we known about the danger to our blood supply and had a more complete understanding of how HIV spreads. Currently Ebola is on the tipping point between those who want to believe it is “someone else’s disease” and those who fear contracting it from any stranger they meet. This combination of fear and denial is the perfect atmosphere to create larger spread of the infection. Although Ebola does not hide in a person’s system creating the risk of invisible carriers, its early symptoms are flu-like. We live in a country that is very used to going to work when they are ill. Ebola becomes contagious once symptoms present so denial is a dangerous attitude. Until real, truthful information on prevention is widely understood, diseases are far harder to contain.

Early treatment is also very important. Luckily, we have known options for the treatment of Ebola. We have been developing medications to battle the outbreak in Africa for some time and feel that we understand how to fight the illness. Advances in these treatments are already in development. This differs greatly from early treatment of HIV where doctors were forced to try options based on best guesses pulled from incomplete evidence. Had we been studying the HIV virus for as long as we have been studying Ebola, we would have had much better chances to minimize its effects on our population.

Avidity Medical Design currently has a comprehensive course under development to explore this topic in more detail. Be one of the first 100 students to enroll and get a 50% discount. Contact us for more details. Early knowledge and understanding is the key to treating illness before it can become an epidemic.

Why Medical Terminology Is So Important To Learn

Medical terminology is important if you work in the healthcare field. It is the basis for all that you will do. It is used to describe symptoms, diagnoses, tests that need to be ordered and ran, and special medical equipment. The terminology is spoken and written in charts so you must learn to say, spell, and read medical terms.

Medical terminology is important for many reasons.medical terminology

  • It allows all healthcare workers to communicate in one language.
  • You will use it every day when you work in the healthcare field.
  • If you have to get your medical dictionary out every time you get asked to do something, you will be wasting valuable time. Nurses, doctors, and other health care professionals do not have time to waste, especially in an emergency situation.
  • One small mistake can make a big difference. You could give the wrong medication or just give the right medication the wrong way. It can be the difference between ordering the right test or the wrong one! You need to understand medical terms
  • Common abbreviations are used in patient records. This helps doctors and nurses write quickly and efficiently in the records so that they can be onto the next patient. It also allows you to read and understand the records quickly.

If you want to do a great job in the health care field, you need to learn medical terminology and understand it! You do not want to have to reach for a medical dictionary every time you are told to do something. If you are unsure, it is better to check your dictionary than get something wrong. However, with a basic understanding of medical terminology, you will be able to communicate quickly and efficiently with other healthcare professionals.

Contact us whether you need a full course or a refresher course on medical terminology!

How To Improve Employee Workplace Performance

An article recently published in the Journal of Organizational Psychology states that research found that employees do, in fact, draw support from their subordinates, and each employee can play an important role in the supportive environment of the workplace. The study also revealed a positive relationship between support and job performance, meaning the more supported employees felt in the workplace, the better they were at their job. The following are a few tips on ways in which you can improve employee workplace performance within your organization.

employee workplace performanceEncourage communication

In this regard, you need to be open-minded and encourage expression of ideas and suggestions without criticizing any part of it. Hold frequent staff meetings, provide suggestion boxes, or conduct surveys. Communicate clear goals and objectives to your employees, while maintaining an open-door policy.

Positive work environment

Keep the workplace setting clean and nice looking to promote a cheerful attitude. Little things such as natural light and personal space for each employee will help in creating a positive work environment. And don’t forget to keep things fun. For example, acknowledge an employee’s birthday by having the team sing happy birthday or putting up a sign in the office.

Show appreciation

Acknowledge achievements and offer words of encouragement, such as ‘nice job.’ This will make an employee feel as if they matter in a way that gives their work a sense of purpose. When things go well at your organization, always extend credit to your staff.

Provide effective training

Employees can be helped to improve their skills through in-house development and on-the-job training. Allow your employees to attend seminars and workshops, or enroll in an online eLearning course. Also, keep in mind that training is not a one time event, but rather a continuous activity.

Job performance and the employees’ level of happiness impact the potential of success for an organization.With both an appropriate performance management system and a positive approach to influencing people that increases happiness, an organization’s key results can more likely be achieved and sustained. Be sure to keep the above tips in mind when working towards improving employee performance in the workplace.

For more information, or if you have any questions or comments, please feel free to contact us at Avidity Medical Design today.

What is the Impact of ObamaCare on Physician Reimbursement?

Healthcare in the United States is still being developed around private insurers and public providers. ObamaCare was signed into law to make affordable healthcare services accessible to patients all over the country. ObamaCare required insurance companies, hospitals, clinics, and private practices to make many changes to accommodate patients without prejudice. Some of these changes have affected how physicians and private practices are reimbursed by insurance companies covering a patient under ObamaCare. This article discusses the impact of ObamaCare on physician reimbursement.

impact of obamacare on physician reimbursement

ObamaCare

ObamaCare, or the Affordable Care Act, has made health insurance a requirement for all Americans. ObamaCare was signed into law on March 23, 2010. Under the terms of ObamaCare, insurance providers cannot deny coverage to patients with pre-existing conditions. ObamaCare also regulates the prices of healthcare plans in accordance with a market of free commerce, so that all patients are eligible for affordable healthcare coverage. Although the free market principle has resulted in low cost insurance, it has also resulted in lower coverage.

Physician Reimbursement

Many physicians and private practices have noticed a decrease in reimbursement from ObamaCare plans. As these plans are provided by private insurers, many doctors felt that their businesses would still receive the same kind of operating revenue as they had been.

According to an article from the New American, one doctor has noticed a substantial decrease in reimbursement.

‘I cannot accept a plan [in which] potentially commercial-type reimbursement rates were now going to be reimbursed at Medicare rates,’ Dr. [Doug] Gerard told NPR. ‘You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on.’

Dr. Gerard is describing how his practice is his business, and that his operating expenses are becoming prohibitive due to reduced payments from ObamaCare health plans.

ObamaCare has resulted in:

  • Reduced reimbursement rates from private insurers of $100 down to $80.
  • Reduced health care availability to consumers because physicians are changing their businesses to a cash only model.
  • Reduced quality of care for consumers as insurers adjust their health plans to match the costs of ObamaCare plans.

Many primary care physicians have felt that ObamaCare is stifling their business, so they are choosing early retirement. The problem is compounded by fewer medical students pursuing careers as a physician.

ObamaCare was provided as a means for Americans to receive healthcare at affordable rates. This required insurance companies to adjust their plans in order to accept lower rates. Many physicians have found that ObamaCare plans reimburse their practices at levels similar to Medicare and lower than private insurance. This has resulted in several unintended side effects within the American healthcare system, that manifest themselves as a reduction in healthcare quality.

Avidity Medical Design provides services for healthcare course development. Please contact us with any questions.