the Grace Report Provides Important Private Intelligence, Gathered Exclusively
for OBs & GYNs, Their Practice CEOs, and Key Administrators.

Headlines- November 28, 2005
THE GRACE REPORT

Headlines- November 28, 2005

Commentary and Opinion by Robert L. Michel:
Ob-Gyn Success Story Teaches How to Boost Quality and Revenue

TODAY I WOULD LIKE TO CALL YOUR ATTENTION to a most unusual
ob-gyn business success story. On pages 2-9 in this GRACE REPORT,
you will read about an ob-gyn who is prospering in the same tough
healthcare environment that is draining money and resources away from
ob-gyn group practices throughout the country.

Let me summarize the business victories of this savvy physician. In the 12 months following the installation of an electronic health record (EHR)
system in his office, he more than doubled the monthly volume of patients seen, from 311 (15.55 patients per day) in 2003 to 735 (36.75 a day)! More astonishing, he did this without any additional physician hours in the office. Of course, many of you can do the arithmetic.More patients per day and per month means more revenue—and more physician income.

Next, this ob-gyn built clinical templates into his EHR system to help
him practice medicine that, with great consistency, follows guidelines and clinical best practices. This is generating more financial benefits. One result is lower malpractice costs, because of the liability insurer’s confidence in his clinical practice patterns. The other benefit is immediate. By closely following clinical guidelines, he is capturing and coding for more of the clinical services that are often missed (or not provided at all) in many obgyn offices working from paper health records. Certainly this adds more revenue to the practice, and this additional revenue comes with a highconfidence factor. That’s because the EHR documents, in great detail, the answer to every question asked of the patient and every step taken in the patient’s care. Simply put, this ob-gyn has the audit evidence needed to support the coding behind every claim.

You will have the opportunity to read for yourself about the many
different successes now enjoyed by this ob-gyn practice. I draw two
messages from this ob-gyn’s experience. First, he demonstrates that obgyn groups, large and small, should view the all-digital medical practice from a different perspective. They should view this business strategy with the conviction that, once implemented, EHRs can generate a host of benefits, ranging from more income and higher clinical quality, to reduced liability risk. Second, the GRACE REPORT is your best source to identify these ob-gyn management success stories.

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Going Totally Digital Helps Ob-Gyn Increase Dollars

Solo practice enjoys higher patient volume, better coding, and more time off for the doctor!

CEO Summary: How many ob-gyns wish they could see more patients in less time, accurately and confidently capture the perfect coding for their procedures, and increase their free time away from the practice? Answer yes to any or all three of these benefits and you’ll want to learn the business secrets of ob-gyn Jeffrey, L. Harris, M.D., of Jesup, Georgia. He built a new office specifically designed to support an all-electronic ob-gyn practice. His successful use of digital systems earned him a national award from the Healthcare Information and Management Systems Society last month.

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How Electronic Medical Records Transform Practice Patterns

Key is understanding how EHRs & EMRs change and improve how docs deliver care

CEO Summary: How many ob-gyn group practices could increase their
monthly patient volume by 136% without any increase in physician office
hours? Yet solo ob-gyn Jeffrey Harris, M.D., accomplished this and more
when he implemented an electronic health record (EHR) system and a new practice management system into his office. He found that his coding was now more accurate, more complete, fully-documented—and generating additional revenue per patient. It’s an impressive EHR success story.

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Blue Cross in Kansas City Offers Pay-for-Performance to Ob-Gyns

P4P PLAN FOR OB-GYNS IS NOW IN ITS FOURTH YEAR

CEO Summary: Here’s another surprising example of a physician pay-for-performance program initiated in 2001 by ob-gyns in Kansas City, Missouri. Armed with documentation of bettter-than-average health outcomes within their group practice, these ob-gyns approached the region’s major health insurer and asked if it would agree to increase reimbursement for improved outcomes. Blue Cross Blue Shield of Kansas City already offered a physician pay-for-performance program to 450 primary care providers in Kansas City. Having seen the benefits of improved outcomes and increased patient satisfaction, the health insurer
worked with the ob-gyns to design a program that fit the needs of both groups. Now in its fourth year, this pay-for-performance program pays an additional 10% for specific procedures when the ob-gyns achieve goals in five specific measures.

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Managing OB Liability Risk Can Save Significant Dollars

Opting to self-insure with a captive, MaternOhio proactively manages risk

CEO Summary: Faced with the same rising malpractice insurance premiums as most of the ob-gyn profession, MaternOhio of Dublin, Ohio adopted a proactive—even aggressive—business strategy to control and reduce its liability costs. One strategy was to form a captive insurance company and self-insure. But this alone was not enough. The 64 ob-gyns of MaternOhio support a detailed risk assessment program. They are willing to actively engage patients and hospitals in their efforts to improve clinical quality and communications, both of which are known to help control liability costs.

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INTELLIGENCE: Late and Latent

SURVEY REVEALS EXTENT OF UNDIAGNOSED MENORRHAGIA

ADD To: Undiagnosed Menorrhagia

Look for the next briefing on Monday, December 19, 2005.

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