Page 35 - Delaware Medical Journal - May/June 2018
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payment made it hard to correct the behavior of poorly compliant patients. Previously, when we complained about a three-month wait for data, I would say, “A lot of patients can slip through the cracks and die in three months.”
In the HealthEC model, the data comes from multiple current sources and is closer to real time. This allows a physician high-risk patient sooner. This allows earlier intervention to help a patient make better choices. Fewer patients will slip through the cracks.
In the old claims data approach, BMI
payment linked to it. In this old system,
if it was not billed, it did not happen. The only way to document the BMI discussion was to submit a bill that was not going to be paid. Now, HealthEC should be able to in the EMR and submit this data to the
TRANSFORMATION IN HEALTH CARE
we have robust software available that the hospitals and insurance companies lack!
Hopefully, the AmeriHealth Caritas
many contracts brought to Delaware physicians by MedNet and HealthEC.
CONTRIBUTING AUTHOR
■ ANDREW DAHLKE, MD is a Neuroradiologist working in Lewes, Delaware and currently serves as President-Elect of the Medical Society of Delaware.
REFERENCES
1. KLAS 2017 Population Health Part 1 - Validating Adoption of Population Health Management Functionality - September 2017, Performance Report
2. KLAS 2017 Population Health Part 2 - Validating Adoption of Population Health Management Functionality - January 2018, Performance Report
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insurer. The data can be electronically pulled out of an EMR without wasting quality metrics calculations!
on the claims data and got credit for compliance, and the family practice doctor who was not on the claims data would get dinged for failure to meet a quality measure. The HealthEC EMR data calculates compliance per patient in a clinically integrated network, ensuring that the whole network is credited for it. Hence, all doctors seeing the patient will get credit.
The track record of prior ACOs in Delaware has been abysmal. These
ACOs have been controlled by hospitals and insurance companies. The MedNet/ HealthEC clinically integrated network is a true change. Now the physicians will be
