How Debt Collection Has Changed

By Robert Hale, MBA, Director of Business Development, Receivables Management Corporation

2022 Alliance sponsor article courtesy of Receivables Management Corporation

1. Regulation F took effect on November 29, 2021. Regulation F is large and complicated. The document containing the final rule and official interpretation is over 350 pages.
2. Key Points: debt collectors cannot report a Debt to a credit bureau before they contact you. Collection vendors must supply more information in the Notice of Debt.
   • An itemized date can be one of five different dates: the date of the last statement, the charge off date, the date of the last payment applied to the debt, the date of the transaction that gave rise to the debt, and the judgement date if there is court judgement on the debt.
   • Validation Information: the collection vendor must supply the consumer with more extensive validation information, including the debt collector’s name and mailing address, the consumer’s full name and mailing address, the account number associated with the debt, the name of the creditor to which the debt is currently owed, the amount of the current debt, and an itemized list of any payments made.
   • Dispute and Information prompts: the debt validation notice must contain a returnable form. The prompt will allow the consumer to check an “I want to dispute the debt because” option. The consumer can then check one of several boxes, for example, “this is not my debt,” or “the amount is wrong,” or “other.”
   • Disclosure of Rights: the debt validation notice must contain information advising the consumer of their right to dispute the debt and request further information.
   • Regulation F clarifies that email and text messages can be used. It also states the consumer can specify what communication channels the collector can use.
   • Limits on communication: Regulation F puts strict limits on how often a collector can contact a debtor. A collector cannot call a debtor more than seven times within seven consecutive days. If a collector speaks to the debtor on the phone, the collector must wait seven days before calling again.
3. Additional Changes:
   • Starting July 1, 2022, medical debt that has been paid in full will no longer be included on credit reports from Equifax, Experian, and Trans Union. It is the responsibility of the credit agencies to remove the paid in full medical debt from the consumers credit report. In addition, the credit bureaus are increasing the amount of time before medical debt in collection appears on the debtor’s credit report. Debts will need to be at least one year old before they can be placed on a consumer’s credit report of the credit reporting. Beginning in March of 2023, the three credit reporting agencies will no longer include medical debt in collections under $500.00 on credit reports.

In closing, nearly one in ten adults, or about 23 million Americans, owe at least $250 in medical debt.

Article submitted by:
Robert Hale, MBA
Director of Business Development
Receivables Management Corporation
rhale@rmccollect.com
http://www.rmccollect.com/
Cell (803)-414-0103
1-800-849-2201 Ext. 135

5 Best Practices for Keeping Your Patient’s Medical Data Safe

2022 Alliance sponsor feature article courtesy of TowneBank

Medical identity theft has more than tripled over the past five years, as hackers and cyber-criminals target the healthcare industry at alarming rates. So why are medical records so valuable to data thieves? Personal medical data is said to be more than ten times as valuable as credit card information. Just one patient record contains an enormous amount of identity information that hackers can exploit, including:

• Full name
• Birth date
• Social Security number
• Medicare number
• Email
• Phone numbers
• Home address
• Prescription information
• Driver’s license
• Payment information such as credit card or bank account numbers

This data is incredibly valuable on the black market, just one Medicare number is said to sell for nearly $500. Keeping this patient information safe from cyber-thieves must be a top priority for hospitals, healthcare organizations, and medical offices. The threat of a data breach not only puts an organization or medical practice at risk for a hefty fine or HIPAA violation, but it also threatens the core of the business because it damages patient trust.

The following are five steps to keeping your patient’s medical data safe:

1) Education
Educating your staff may be the best line of defense against data theft. Ensure your employees are informed on privacy policies, security measures, how data breaches occur and how to prevent them. Build staff awareness of medical identity theft and how to keep patient data secure.

2) Mobile devices
Patient data may often be stored on mobile devices. Protecting devices such as laptops, smartphones, and tablets with encryption and passwords is another way to avoid a potential data breach. Also, it is important to ensure employees never leave their mobile devices unattended.

3) Email
Many attempts for data breach occur through unsolicited emails called “phishing.” Be sure to instruct staff not to open any emails that are unfamiliar and never open any attachments or links from an unknown sender.

4) Antivirus
Be sure to keep all software and antivirus programs regularly up to date.

5) Secure your network server and wireless networks
To prevent attacks, practices should make sure their network passwords are secure and changed frequently. Ensure routers and other components are kept up to date. Set up firewalls and antivirus for all devices that connect to the internet. Lock down your network server so that it is difficult to physically remove it from your office and lock up any backup or storage devices.

Common mistakes:

• Employees sharing workstations or user IDs
• Leaving screens or workstations unsecured
• Sending patient medical information via unsecured email
• Using unsecured laptops, tablets, and smartphones
• Sending patient medical information through text messaging
• Speaking about private patient medical information to friends, family, patients, or other medical offices.
• Failure to obtain the proper release/consent form to release patient medical data.

While there is not one sure way to prevent all data breaches, these best practices will go a long way in keeping your patient data safe and secure from potential theft.

Learn more and access more insights and perspectives through the TowneBank Business Resource Center.

The information provided is not intended to be legal, tax, or financial advice or recommendations for any specific individual, business, or circumstance. TowneBank cannot guarantee that it is accurate, up to date, or appropriate for your situation. Financial calculators are provided for illustrative purposes only. You are encouraged to consult with a qualified attorney or financial advisor to understand how the law applies to your particular circumstances or for financial information specific to your personal or business situation.

Changes Are Coming to the HIPAA Privacy Rule: Are You Prepared?

By Laura M. Cascella, MA, CPHRM

2022 Alliance sponsor article provided courtesy of MedPro Group

With a turn of the calendar year, 2022 will likely usher in the most significant changes to the HIPAA Privacy Rule in almost a decade. These changes will come on the heels of several years of information-gathering, proposals, and public comments, which kicked off December 2018 when the U.S. Department of Health and Human Services (HHS) Office for Civil Rights issued a request for information on HIPAA rules. HHS subsequently released and published the Notice of Proposed Rulemaking (NPRM) in December 2020 and January 2021, respectively. A public comment period on the NPRM followed, which concluded May 6, 2021.¹

The proposed changes to the HIPAA Privacy Rule are targeted at helping fulfill HHS’ Regulatory Sprint to Coordinated Care by breaking down barriers to care coordination, information-sharing, and interoperability (in alignment with the 21st Cures Act and the HITECH Act); supporting value-based care; enhancing patient engagement and right of access; and reducing unnecessary administrative and regulatory burdens.²

Some of the significant provisions of the Proposed Rule include introducing and modifying key definitions, strengthening patients’ rights to access their information, supporting information sharing and care coordination, allowing broader disclosures, and modifying policies and information associated with the Notice of Privacy Practices (NPP).

Key Definitions

As part of the Proposed Rule, HHS seeks to add definitions for two key terms — electronic health record (EHR) and personal health application (PHA). Neither of these terms currently is defined in the HIPAA Privacy Rule, although the HITECH Act does include a definition of EHR.

The Proposed Rule seeks to expand on and clarify the HITECH definition, defining EHR as “an electronic record of health-related information on an individual that is created, gathered, managed, and consulted by authorized health care clinicians and staff.”³

Likewise, the Proposed Rule aims to build on HITECH’s definition of personal health record by defining PHA as “an electronic application used by an individual to access health information about that individual in electronic form, which can be drawn from multiple sources, provided that such information is managed, shared, and controlled by or primarily for the individual . . .”⁴

The addition of both of these definitions — EHR and PHA — to the Privacy Rule are intended to address the gap in current regulatory definitions as well as clarify and support individuals’ right of access related to electronic protected health information (ePHI).⁵

The Proposed Rule also addresses confusion regarding the term “healthcare operations.” The current Privacy Rule permits uses and disclosures of PHI for treatment, payment, and healthcare operations without patient authorization. The definitions of treatment and healthcare operations overlap to some extent in terms of the type of activity and who is performing it — for example, case management activities performed by a healthcare provider (treatment) vs. a health plan (healthcare operations). However, the definition of healthcare operations specifically mentions population-based activities but not individual-level care. Thus, HHS proposes to clarify that healthcare operations includes both individual-level and population-based care coordination and case management activities.⁶

Right of Access

A predominant focus in healthcare legislation and reform is giving patients more access to and control over their health information. The proposed changes to the HIPAA Privacy Rule reflect this goal and aim to enhance patients’ right of access through various provisions, including:

• Strengthening patients’ right to inspect their PHI in person. The Proposed Rule would allow patients to take notes and use personal resources (e.g., smartphones) to capture images of their PHI, as long as it does not pose unacceptable security risks. However, providers are not required to let patients connect personal devices to their information systems.
• Condensing the current timeline to respond to requests for PHI. Providers currently have 30 days to response to patients’ requests for PHI, with an optional 30-day extension. The Proposed Rule seeks to shorten the timeframe to 15 days with an optional 15-day extension.
• Clarifying patients’ right to receive their PHI in the form and format requested, if it is readily producible. Under the Proposed Rule, “readily producible” copies of PHI would include ePHI requested through secure, standards-based application programming interfaces (APIs), using applications chosen by individuals. Providers also would be required to provide copies of PHI in any form and format required by applicable state and other laws.
• Easing identity verification requirements. Although verifying individuals’ identities is a crucial step when responding to requests for PHI, unreasonable or onerous identity verification requirements can create barriers to patients’ right of access. The Proposed Rule would prohibit covered entities from imposing unreasonable verification measures, such as requiring a notarized signature or showing proof of identification in person (when another credible, more convenient method is available).
• Providing more information about fees associated with obtaining PHI. The Proposed Rule specifies when PHI must be provided free of charge (e.g., during in-person viewing) and amends fees related to responding to requests to send PHI to third-parties. Providers also would be required to (a) post estimated fee schedules on their websites, (b) offer individualized fee estimates, and (c) provide itemized bills for completed requests.⁷

Information Sharing and Care Coordination

Certain aspects of the current HIPAA Privacy Rule can be construed as restrictive or limiting the ability of providers to share information in the pursuit of comprehensive, coordinated care for patients. The Proposed Rule seeks to address this issue and break down some of the barriers to information sharing.

As noted earlier, the more detailed definition of healthcare operations facilitates the sharing of individual patient data to support individual-level care coordination and case management. The Proposed Rule also establishes a pathway for patients to direct sharing of ePHI among providers and health plans by allowing patients to request that a provider or health plan submit an access request for PHI in an EHR to another healthcare provider.⁸ The provider or health plan (the “requester-recipient”) would facilitate requesting the information from the other provider (the “discloser”) and receive an electronic copy of the PHI.

The proposed changes also modify the rules related to “minimum necessary standard.” Under the current Privacy Rule, covered entities must use, disclose, or request only the minimum PHI that is required to accomplish the task at hand. The Proposed Rule makes an exception to the minimum necessary standard for use by, disclosure to, or requests from a covered entity for care coordination and case management.

The Proposed Rule also permits covered entities to disclose PHI to third-party organizations that provide health-related services for the purposes of individual-level care coordination and case management (for treatment or healthcare operations). Examples of such third parties include social service agencies, community-based organizations, home-based and community-based service providers, and other similar organizations. HHS notes that, in some cases, these organizations might not be subject to HIPAA.

Expanded Disclosures

In addition to supporting measures that facilitate sharing information and coordinating care, the Proposed Rule also aims to increase flexibility around the disclosure of PHI to an individual’s family members or other caregivers who are trying to assist the individual with a serious condition or emergency situation. Examples of such conditions and situations include substance use disorders, serious mental illnesses, incapacitation, and health-related emergencies.

To do this, HHS proposes replacing the “exercise of professional judgment” standard with a “good faith belief” standard, which would permit certain uses and disclosures of PHI if they are in the best interests of individuals. HHS also notes that the exercise of professional judgment standard implies disclosure by a licensed healthcare provider, while the good faith belief standard “may be exercised by other workforce members who are trained on the covered entity’s HIPAA policies and procedures and who are acting within the scope of their authority.”⁹

Five areas of the Privacy Rule would be amended based on this proposal. Those areas relate to disclosing information (1) to parents, guardians, or others acting in loco parentis; (2) for facility directories; (3) when the individual is present; (4) when the individual is not present due to incapacitation or an emergency; and (5) in relation to verification requirements.¹⁰

HHS also proposes to increase flexibility in relation to disclosing PHI to family, friends, and caregivers for the purposes of avoiding harm. The current Privacy Rule allows a covered entity to disclose PHI when a threat to health and safety is “serious and imminent.” HHS acknowledges that determining with certainty whether a threat is imminent may be impossible; thus, the Proposed Rule would permit disclosure of PHI when the threat to health and safety is “serious and reasonably foreseeable.” The proposed change would include a definition of “reasonably foreseeable” to help guide decision-making about disclosure.

Notice of Privacy Practices

To help eliminate an administrative burden of the current HIPAA Privacy Rule, the Proposed Rule eliminates the requirement for direct healthcare providers to obtain — or to document their good faith efforts to obtain — patients’ written acknowledgment of receipt of the providers’ NPP. However, to ensure that patients are able to understand and act on information in the NPP, they would have the right to discuss the NPP with a person whom the healthcare provider designates.

Further, HHS proposes modifying the header of the NPP to specify that the notice provides individuals with information about how to access their information, how to file a HIPAA complaint, and their right to receive a copy of the notice. The NPP header also would need to include a phone number and email address for the designated contact person.¹¹

Next Steps

Although the changes detailed in this article are still proposed and not final, healthcare providers (and other covered entities) should be aware of them and their potential implications. These changes will require providers to update their policies, procedures, NPP, authorization and disclosure materials, and contracts.¹² Further, the significance and breadth of these modifications will necessitate retraining staff on the HIPAA Privacy Rule.

The proposed changes will become effective 60 days after the Final Rule is published, and providers will have 180 days following the effective date to comply. With less than a year to implement these modifications, taking a proactive approach before the Proposed Rule is finalized can help providers prepare for the changes and identify any issues with current or future processes that could hinder implementation or compliance.

The following strategies may prove helpful:

• Make sure your current policies and procedures for the HIPAA Privacy, Security, and Breach Notification Rules are complete and up to date. Doing so will make implementing the proposed changes more straightforward and help avoid confusion.
• Review your current processes related to patients’ requests to inspect and obtain copies of their PHI to determine how well they work and what will need to change based on the Proposed Rule.
• Be aware of any state laws related to the release or disclosure of PHI. HHS notes that the Privacy Rule does not preempt other law that is more protective of individuals’ privacy.
• Make sure your identity verification process to access PHI does not impose unreasonable measures on patients, such as requiring a notarized authorization or other burdensome requirements.
• Consider how the shortened timeframe to respond to patients’ requests for PHI (from 30 days to 15 days) will affect workflow processes. Review your current process and ability to comply with 30-day timeframe to identify potential obstacles for future compliance.
• Review your current forms, materials, and contracts affected by the Privacy Rule to consider what changes will need to be made and the best way to approach those changes. Consider also what updates you will need to make to your website information.
• Begin to educate staff members about the changes in the Proposed Rule, and include them in planning efforts and discussions about new processes and workflows.¹³

More Information

For more complete information and details about all of the proposed changes to the HIPAA Privacy Rule, see the Proposed Modifications to the HIPAA Privacy Rule To Support, and Remove Barriers to, Coordinated Care and Individual Engagement published in the Federal Register on January 21, 2021.

Endnotes

1 Linna, A., & Ishee, J. (2021, October 14). Preparing for major HIPAA changes in 2022 [Webinar]. McGuireWoods. Retrieved from http://www.mcguirewoods.com/events/firm-events/2021/10/preparing-for-major-hipaa-changes-in-2022; Sheppard Mullin Richter & Hampton LLP. (2021, May 24). HIPAA Privacy Rule modification – removing barriers and promoting coordinated care at what cost? SheppardMullin Healthcare Law Blog. Retrieved from
http://www.jdsupra.com/legalnews/hipaa-privacy-rule-modification-7104453/
2 Ibid; Hales, M. (2021, June 1). HIPAA changes ahead. The HIPAA E-Tool. Retrieved from
https://thehipaaetool.com/hipaa-changes-ahead/; Allen, A. L. (2021, August 16). HIPAA at 25 remains a work in progress. The Regulatory Review. Retrieved from http://www.theregreview.org/2021/08/16/allen-hipaa-at-25-remains-a-work-in-progress/
3 Proposed Modifications to the HIPAA Privacy Rule To Support, and Remove Barriers to, Coordinated Care and Individual Engagement, 86 Fed. Reg. 6446 (Jan. 21, 2021) (to be codified at 45 CFR pts. 160 & 164).
4 Ibid.
5 Ibid; Sheppard Mullin Richter & Hampton LLP, HIPAA Privacy Rule modification; Linna, et al., Preparing for major HIPAA changes in 2022.
6 Linna, et al., Preparing for major HIPAA changes in 2022. Hales, HIPAA changes ahead; Proposed Modifications to the HIPAA Privacy Rule To Support, and Remove Barriers to, Coordinated Care and Individual Engagement, 86 Fed. Reg. 6446.
7 Proposed Modifications to the HIPAA Privacy Rule To Support, and Remove Barriers to, Coordinated Care and Individual Engagement, 86 Fed. Reg. 6446; Linna, et al., Preparing for major HIPAA changes in 2022; Sheppard Mullin Richter & Hampton LLP, HIPAA Privacy Rule modification; Hales, HIPAA changes ahead; Compliancy Group. (n.d.). Proposed changes to HIPAA Privacy Rule for 2021 announced by HHS. Retrieved from
https://compliancy-group.com/proposed-changes-to-hipaa-privacy-rule/
8 Proposed Modifications to the HIPAA Privacy Rule To Support, and Remove Barriers to, Coordinated Care and Individual Engagement, 86 Fed. Reg. 6446; Linna, et al., Preparing for major HIPAA changes in 2022; Compliancy Group, Proposed changes to HIPAA Privacy Rule for 2021 announced by HHS.
9 Proposed Modifications to the HIPAA Privacy Rule To Support, and Remove Barriers to, Coordinated Care and Individual Engagement, 86 Fed. Reg. 6446.
10 Ibid; Linna, et al., Preparing for major HIPAA changes in 2022.
11 Proposed Modifications to the HIPAA Privacy Rule To Support, and Remove Barriers to, Coordinated Care and Individual Engagement, 86 Fed. Reg. 6446; Sheppard Mullin Richter & Hampton LLP, HIPAA Privacy Rule modification; Linna, et al., Preparing for major HIPAA changes in 2022.
12 Sheppard Mullin Richter & Hampton LLP, HIPAA Privacy Rule modification; Linna, et al., Preparing for major HIPAA changes in 2022.
13 Hales, HIPAA changes ahead; Linna, et al., Preparing for major HIPAA changes in 2022.

Keys to Success in Value-based Care Systems

By Carlos Jackson, Ph.D. and Paul Mahoney, Community Care Physician Network

2022 Alliance sponsor feature article courtesy of Community Care of North Carolina

The movement to value-based payment systems occurring simultaneously with a pandemic and, in North Carolina, sweeping changes to Medicaid, has made for an incredibly challenging environment for medical practices, particularly independent practices. This new environment requires new workflows and new approaches to managing patient panels.

The good news is that, working together, independent practices can still thrive in this new environment. In supporting the more than 900 practices in the Community Care Physician Network (CCPN), we’ve identified four critical keys to success, highlighted in the graphic below. At CCPN we work with practices where they are, share best practices pioneered by similarly-situated practices and help them find practical solutions to daily challenges.

CCPN exists to help member practices thrive financially, provide high-value care, and enable providers and patients to maximize their satisfaction with the practice of medicine. CCPN is governed by practicing, community-based physicians.

We have found that for many practices, the most challenging piece of this puzzle is making the best use of data. Practices are awash in data, but can they parse it intelligently to pull out what is actionable, and identify the information critical to hitting the metrics that drive present and future revenue?

Click on image to enlarge

CCPN has made significant investments in tapping into the potential of EHR clinical data without practice staff needing to devote significant time in making sense of it all. Through new tools and innovative partnerships, we have built an infrastructure to help our network practices identify opportunities to close care gaps, improve quality and patient engagement and ultimately hit metrics that satisfy payer bonus arrangements, generating significant additional revenue critical to the long-term financial viability of the practice.

Practice Perfect^SM Dashboard
Designed with busy practices in mind, Practice Perfect^SM is a Tableau-based business intelligence tool that distills complex information from multiple data sources, identifying actions you can take right now to boost quality and improve performance. Recommended Actions^SM are an efficient and unique way of viewing worklists taking multiple patient and practice factors into account in order to help you prioritize long lists of care gaps.

The dashboard synthesizes claims, hospital visits, and individual risk scores to prioritize patient needs, as well analyzes the cost, utilization, and disease burden of a practice’s Medicaid patient panel. The dashboard also provides monitoring of performance on contract measures to inform practices of their progress on meeting contract measures. Users can quickly create targeted patient lists to determine where to best focus resources and improve performance. Additionally, Recommended Actions^SM integrate with clinical and scheduling data, as well as ADT and immunization feeds from outside vendors, for more actionable and up-to-date guidance. The dashboards are organized in a way to not overwhelm the provider and offer just enough information to help them be successful.

VirtualHealth™ Provider Portal
The VirtualHealth^TM Provider Portal connects practices with their CCNC Care Management team – partners for improving patient outcomes. This provides secure access to Medicaid patient care management documentation, comprehensive needs assessments, and care plans. Through the portal, clinicians can make referrals to care management and enjoy secure communication with patient care teams. Clinicians can view patient history from claims, pharmacy, and hospital data – keeping them “in the know” regarding what care patients are receiving from outside their practices.

Value-based Informatics Program (VIP^SM)
CCPN has significantly upgraded technology that supports practice success under value-based contracts across all payers and populations – at no additional cost to our CIN practices. We pull clinical data from practice EHRs to measure quality more easily. This greatly helps practices generate bonus payments from insurers. Our system also gathers appointment data to help practices better capitalize on Recommended Actions^SM. We alert practices to care gaps and opportunities to improve the accuracy of RAF scoring. We do this by joining EHR data with claims data for a more comprehensive view of patient care that yields improved insights. These tools also reduce administrative burden on practice staff. We are also piloting some in-line prompting tools that will provide practices with real-time alerts at the point of care. We believe that putting information in the hands of providers at the right time is one of the keys to success in value-based contracting.

While the environment for primary care practice won’t get easier anytime soon, help is available from your peers and CCNC. Together, we can help you find a path to financial strength and greater satisfaction with the practice of medicine for you, your staff, and your patients.

Click on image to enlarge

Community Care Physician Network (CCPN)
CCPN is a physician-led, clinically-integrated network that helps independent primary care physicians deliver high-quality, cost-effective care. CCPN priorities are helping practices thrive financially, provide high value care, maximize provider and patient satisfaction, and take charge of their own destiny.

Review Gating: Google and rater8 Say No

2021 Alliance sponsor feature article courtesy of rater8

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To review gate, or not to review gate, that is the question
Negative reviews can tarnish a doctor’s online brand, so should they review gate?

What is review gating?
Review gating is the process of filtering patients before asking them to leave you a review. Usually, this is done by sending patients an email or text asking them if they had a positive or negative experience. If they had a positive experience, they are directed to leave a review on Google (or any other review site), but if they had a negative experience, they are prompted to leave private feedback and are never sent the option to leave a review publicly.

Click here to access the complete article

Efficient and Effective Pathways to Value-based Care

By Dr. Kenneth Persaud

2021 Alliance sponsor feature article courtesy of Sharecare

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Partnering to Create an Expandable Framework
for Value-based Care Success

Summary:

White-Wilson Medical Center Fort Walton Beach, Florida employs 80 physicians and advanced practice clinicians and had a goal to move to value-based care contracts with payors to improve care and reimbursement.

About White-Wison:

Founded in 1946, White-Wilson Medical Center occupies a unique position on Florida’s Emerald Coast as the largest, multi-specialty, outpatient physician group in the region. With locations in Fort Walton Beach, Crestview, Destin, Navarre, and Niceville, White-Wilson has the community’s largest team of physicians, specializing in more than 20 areas of medicine. In addition to primary and specialty care, White-Wilson offers immediate care services for any urgent care needs at each of its clinics.

The amount we learned from Sharecare is incredible. I can’t say enough about how much they taught us about the value-based care business, the market, and how to apply that learning going forward. Sharecare has been crucial to that process.

Mark Wiacek, Chief Operating Officer, White-Wilson Medical Center

The challenge:

Decreasing reimbursements from the fee-for-service model was limiting growth in revenue and patient outcomes and satisfaction. It was critical to the practice to remain independently owned in a competitive market. Value-based care contracts with Medicare and other payers offered a path to greater growth and better patient care, but the White-Wilson team had no experience in this area and needed expert resources to help them drive these programs. They found that just hiring people didn’t work – they needed processes and technologies to support this transition to value-based care.

Creating an ACO involves putting a framework, including a governing board, into place to provide the coordinated, high-quality, efficient, and effective care that is the goal of the ACO program. The program also offers benefits to providers: when an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program. The program is not without risk, however, as ACOs that do not deliver effective care can lose money. Sharecare engaged as a full partner in this case, offering a contract that shared both risk and reward.

In addition, the coordinated care that is at the core of an ACO program increases emphasis on patient services that positively impact outcomes, such as wellness visits and transition care upon hospital release. These services also offer expanded opportunities for reimbursement and revenue growth.

Sharecare’s team offered expertise, guidance, processes, and technologies to support White-Wilson in their transition to value-based care. In 2016, White-Wilson started their journey by participating in the Medicare merit-based incentive payment system (MIPS), with Sharecare offering technologies that augmented the White-Wilson electronic health record (EHR) systems to produce the data required for value-based care. By 2017, the team had the data benchmarks they needed to create the White-Wilson ACO. In 2018, White-Wilson added risk-adjustment audit services to their ACO contract with Sharecare. By 2019, White-Wilson had won a value-based service contract with a major payor in the market.

Consultative collaboration was the key to success.

The augmentation of the White-Wilson EHR system with Sharecare technology bridged deficiencies in the EHR system to enable the value-based care reporting required by the MIPS program while putting off a costly upgrade to the EHR system that would otherwise have been necessary. The collaboration ensured that White-Wilson’s MIPS program stayed out of penalty and was awarded a “Top Performer” bonus.

The White-Wilson ACO, now serving around 100,000 patients, demonstrated quality improvement scores in the 94th percentile in each year, cost reductions of more than $3M over three years, and improved patient-satisfaction scores through the program along with over $6M in revenue on value-based payments with other payors. White-Wilson was able to put the necessary systems into place to ensure that they avoided penalties, and in those three years, 2017-2019, they saved between $700,000-$1,400,000 a year with Medicare.

White-Wilson’s ACO generated substantial revenue gains by doubling annual wellness visits and post hospitalization transition visits over the same period, with 2021 already on track to continue this trend. Most importantly, White-Wilson’s patients have received better, more coordinated, and effective care through these programs.

White-Wilson was able to develop payor-agonistic strategies and has already expanded the framework to private-payor value-based contracts. With this framework, they found that they could build an organization to manage a larger population and generate higher revenue without adding any full-time employees. In 2019, White-Wilson landed a sizeable multi-year agreement that will bring significant revenue to the practice. The momentum is built in the direction of more of these kinds of private-payor contracts in the future.

White-Wilson has adopted other Sharecare solutions, including diabetes management programs to optimize care, close gaps, and maximize revenue for their more than 24,000 eligible diabetes patients. The practice is also an early adopter of the Sharecare telehealth platform, which allows them to address patients’ important healthcare needs safely and conveniently remotely.

In the future, White Wilson is planning to expand to commercial private-payor value-based contracts and continue the partnership with Sharecare to offer more services to patients and expand revenue in key markets.

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Image 1 (left): Sharecare Value-based care patient population view
Image 2 (right): Sharecare Individual patient care gap closure view
(Click on each image for a larger view)

About Sharecare:

Sharecare value-based care enables payors to work with providers to offer the right care at the right time, improve population outcomes and the member experience while reducing per capita costs for healthcare. Sharecare is an all-inclusive value-based payments platform to help achieve better and more sustainable financial outcomes.

Sharecare offers the strength of many trusted individual solutions, with options to bundle each component and create unified actionable metrics that drive intelligent decision support for the entire healthcare ecosystem.

All together, better.

Want to know more about how to duplicate White-Wilson’s success? Contact us!

Does Your Brand Have a Strong Voice?

2021 Alliance sponsor feature article courtesy of Social Joey

Originally published to the Social Joey blog | Reprinted with permission

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How’s it going? As more and more businesses across the country reopen and we start to carve out a new normal, how are things going for your business?

Let’s face it: COVID-19 has caused—and will continue to cause—us to pivot and change course more often than we’d like to think about. That applies to everything from our physical stores to our marketing!

If you’re taking a thoughtful look at your marketing efforts these days, you aren’t alone. That’s why we thought it would be good to hone in on an important part of any effective strategy: a distinctive brand voice.

Your audience can’t hear what you’re saying if your voice isn’t strong. Read on as our Social Joey team offers a deep dive into why a brand voice is so important.

Why a Brand Voice Is Important

As we step forward toward the post-COVID-19 future, it’s more important than ever to stand out from other businesses offering the same product or service.

People are spending more time than ever online and on social media specifically, making them more likely to be educated buyers. They’re looking for helpful, useful and relevant guidance and resources to help them make good buying decisions when they need something.

They’re also looking for something that helps them determine which brand is the best.

When you’re trying to stand out, your words and messaging play a key role in setting your business or franchise apart from your competitors. Having a distinctive and strong brand voice is essential for carving out your place in an increasingly digital world.

The Difference Between “Voice” and “Tone”

Before we dive into how you can build your own distinctive brand voice, let’s first clarify an important point. While the two terms are often used interchangeably, voice and tone are not the same thing.

Let’s break it down this way:

• Your voice is your brand’s character, your personality. It stays the same and consistent, no matter what message you’re conveying. This is how your brand speaks and acts.
• Your tone is the inflection you’re giving your voice in a particular piece of content. Tone will vary depending on the specific message and audience. It has to change in order to stay relevant to the people you’re trying to reach.

The Components of a Brand Voice

While you now know that a distinctive voice is important for your business, you may have no idea where to begin.

But there are some basic components involved in establishing and maintaining this voice. These components include:

Clarity

What do you stand for? What are your values? What is your mission?

These are the underlying questions behind determining your brand voice. You need to know what’s behind your brand in order to know how it speaks.

It may even be helpful to think of your brand as a person. After all, you’re determining its personality!

What type of words does your “person” use? Is your person laid-back or energetic? Warm or cool? Formal or irreverent?

This is your brand voice. Making it clear who are you are as a brand will help you carve out a niche with your customers and potential customers. That’s what sets you apart!

Consistency

We’ve talked about the importance of consistency many times before, but we usually discuss it in the context of maintaining frequent, regular social media posting.

Consistency also matters for your brand voice. You’ve carved out a distinctive voice. That’s step one. But step two is to carry that voice through everything you create.

This consistency should be maintained in all of our marketing materials, including your social media marketing. Keeping “on brand” can help ensure your target audience hears your voice loud and clear.

How can you make your voice shine on social media? It’s pretty simple, really!

Once you’ve nailed down what your brand voice is, you want to determine how it affects the various pieces of your strategy. This includes making sure that external pieces you’ll be sharing are still distinctively in your voice and ensuring that the posts themselves are crafted in the right voice and tone.

Because the only thing constant is change, it may also be beneficial to think through what your brand’s voice will be in times of chaos, turmoil or emergencies. While we don’t like to think of the worst case scenario, it’s still an important part of planning.

Style

Does your brand have an established style guide? Yes? OK, next question—do you stick with your style guide?

Be honest! Believe it or not, your style makes an impact when it comes to your brand’s voice. Carving out an established set of style, grammar and other guidelines is vitally important.

We talked above about why it’s important to remain consistent in your brand’s voicing. Your style guide—and adhering to that style guide—is key to ensuring you are giving your audiences a consistent voice.

What’s involved in a style guide? Well, it’s everything that makes your brand a brand! It’s all the little tiny components that give you a voice.

A style or branding guide (the two terms are essentially the same thing) helps provide clarity and guidelines around your brand voice. It should include basics such as logos and color palettes and more specific guidelines related to style and grammar.

This can get as granular as whether you use commas in a simple series or as simple as words you prefer. (Don’t worry if you don’t know what a simple series is or why it matters—we’ve got that base covered for you!)

Why is this type of guide important? Refer back to the items we just talked about, clarity and consistency.

You’ve clarified your voice by determining the personality of your brand, and you need to be consistent in the use of that voice across all your content. A style guide provides a set of specifics on how you do that.

In other words, it’s your user’s guide to raising your voice!

Whether you have a distinctive brand voice or need help putting one into action, we’re here to help! Let our Social Joey team go to work to transform your social media marketing.

Cary Orthopaedics Case Study

2021 Alliance sponsor feature article courtesy of rater8

Cary Orthopaedics has proudly served Raleigh and Southeast Wake County for over 30 years. When CEO, Brad Scheel, joined the team in January 2019, he knew he had to do something about their subpar online image. Brad states “My best doctors had only 2-3 online reviews after practicing for 10-20 years.”

Cary Orthopaedics struggled with the same problem many medical practices experience today: poor and too few online reviews. Most patients had exceptional experiences at the practice. However, the few outliers were inclined to vent their frustrations online. Having encountered this problem at his previous practice, Raleigh Endocrine Associates, Brad knew how to address this.

Click here to view the complete case study

Mean What You Say and Say What You Mean

By Janet Woodall, Owner/Operator, Rockingham Revenue Services, LLC

2021 Alliance Sponsor feature article courtesy of Rockingham Revenue Services, LLC

I am the oldest of four children. My parents were very strict on us. Of course, my dad was a Pastor, so we had to behave. The one thing I learned the most from my parents is “mean what you say and say what you mean.” If we went to a store and my dad said we were only purchasing certain items on a list, you can guarantee we would not be getting anything else. Even if we asked, he would say “I meant what I said.”

As managers, we struggle with our staff having issues with communication. Nine times out of ten when issues arise it is because of the lack of communication. Someone failed to give all the information, or someone did not mean what they said. In order for us to avoid communication issues, I have listed some ways that are helpful to me when communicating information:

Team Meeting – If there is an issue with your team as a whole, then you should meet with them all together. Make sure to lay some ground rules, such as being respectful to each other and allowing the other person to speak their mind. Team meetings can create a sense of unity. However, you do not want it to turn into a blaming session. Make sure to redirect negativity as much as possible.

One-On-One – Sometimes issues need to be dealt with directly with your staff. If there is an issue that continues to happen, I would avoid the team approach and go straight to the source. I feel much better approaching a staff member directly when something is wrong rather than making everyone else feel like it does not apply to them.

Listen – God gave us two ears and one mouth for a reason. We often want to solve people’s problems before they can even finish what they are saying. Listen to them carefully and make them feel like they have been heard.

Thankful and Grateful – Always let your staff know you are thankful and grateful for them bringing things to your attention that need to be addressed. If you do not know you cannot address it. They need to know that you care.

Five Myths Your Landlord Wants You to Believe

By Stephanie Daniels, CARR

2021 Alliance Sponsor feature article courtesy of CARR

It can be difficult to discern fact from fiction when dealing with landlords. A misunderstanding of these key issues can have serious consequences for your practice. The following information should help dispel some common myths and prevent costly mistakes in your next lease negotiation.

Myth #1: The landlord is on your side

Many landlords attempt to befriend their tenants, making it difficult for tenants to remember the landlord’s primary goal is financial gain. They are seeking to secure a lease with the tenant paying as much as possible. Even the friendliest landlord wants to make the maximum profit on his space, just like the nicest tenant seeks the lowest possible lease rate so his business can thrive. Financial burdens quickly arise for tenants who place undue trust in their landlord and fail to properly negotiate their lease. By having representation, you can learn how your lease compares to the market and ensure you are getting the best possible terms.

Myth #2: You are not entitled to representation

Some landlords employ intimidation, instead of friendliness, to achieve their goal. The intimidation tactics may include telling tenants they are not allowed to have representation. This is not true. Lease negotiations are different than negotiating the price of a car or trying to haggle for a better price at a flea market. They are complex transactions, layered with hidden opportunities for landlords to take advantage of anyone not represented by an expert. Landlords are professionals who are aware of these complexities. If a landlord says you are not allowed to have representation, that is a clear signal they do not respect your desire to be treated fairly.

Myth #3: You are already getting the best possible rate for your space

There are many conditions that factor into lease rates for a commercial space. Things such as current building vacancy, length of the lease, amount of tenant improvement allowance, building condition and many other considerations impact the appropriate rate for a particular space. Several of these considerations are specific to spaces for healthcare tenants, highlighting the need for a real estate professional who has expertise in healthcare. Healthcare practices are often told they are getting the best possible rate for their space, yet they can receive a much better offer from the landlord when an expert assesses these mitigating factors.

Myth #4: Your renewal is not negotiable

Most leases provide an option for the tenant to renew their lease when it expires, and may even detail the exact terms of the renewal. However, it is important to understand that your renewal is negotiable, even if you have renewal terms specified in your current lease. A landlord who says you cannot renegotiate the terms for your renewal is usually doing so because they can get you to pay more by exercising the option to renew instead of negotiating new terms. The only way to be certain you have the best possible terms for your renewal is to compare those terms with current market rates in the area, a vital step often missed by healthcare professionals entering this process alone.

Myth #5: You have no other options; the landlord has many

This common myth might be the most important to address, because it is fundamental to how landlords operate. The landlord wants you to believe that his property is the only suitable location for your practice. The truth is there are likely several other properties that would fit the needs of your practice, and the landlord should be competing to keep you in his building.

The landlord also wants you to believe he has several potential tenants ready to occupy your space if you don’t take it. This position is used to force a tenant to rush into signing an unfavorable lease, when, in fact, it usually takes months or years to fill a commercial space. Each leasing situation is unique, and a healthcare real estate professional who knows your strengths as a tenant can help you understand what type of leverage you have.

This information represents a few of the many misconceptions involving landlords in healthcare real estate transactions. Using a real estate professional with expertise in healthcare will help protect you from falling victim to these and other common landlord myths.

CARR is the nation’s leading provider of commercial real estate services for healthcare tenants and buyers. Every year, thousands of healthcare practices trust CARR to achieve the most favorable terms on their lease and purchase negotiations. CARR’s team of experts assist with start-ups, lease renewals, expansions, relocations, additional offices, purchases, and practice transitions. Healthcare practices choose CARR to save them a substantial amount of time and money; while ensuring their interests are always first.

Visit CARR.US to learn more and find an expert agent representing healthcare practices in your area.