Providers seek data analysis

Physicians adjust to Medicare task

When James Zini opened his medical practice in Mountain View 36 years ago, electronic health records and data analysis weren't part of the practice.

Next year, electronic health records will be a requirement for providers who don't want to incur a financial penalty from Medicare. Medicare has begun offering programs that financially reward physicians if they cut costs primarily through the use of data analysis.

"It is so much different now to figure out how to survive in an increasingly technology-driven field," Zini said. "I know how to take care of patients. I am not a computer guru."

Zini said implementing electronic health records at his business was costly, and implementing data analysis would be, too.

"It is impossible for me as an independent primary care doctor," Zini said.

Zini said this is why he has decided to work with a national company that assists with tasks like data collection. He said that through the company, he will be able to save costs and provide higher-quality care.

Farzad Mostashari, the former National Coordinator for Health Information Technology, said he founded the company, Aledade, because he saw independent physicians, like Zini, were struggling to keep up with other physicians who were often working with corporate hospital networks.

"We want to make it simple for doctors to do this," Mostashari said.

Aledade launched in June and is working with doctors in Arkansas, Delaware, Maryland and New York City. The company is partnering with the Arkansas Foundation for Medical Care to provide the service in Arkansas.

"There is really a tradition of independent practices in Arkansas," Mostashari said. "There are other parts of the country where that is essentially gone, where every doctor has been employed by some hospital system."

What Aledade does is help doctors form Accountable Care Organizations through Medicare.

The Medicare program has individual doctors pool together to share resources and data to reduce costs while increasing quality care. If the doctors lower costs they receive bonuses from Medicare.

For example, primary care doctors can use electronic health records to make sure they aren't ordering a test for their patient that a specialist has already completed.

"Analysis is needed to improve communication with patients and between different providers," Mostashari said.

Primary care physicians also need to know if their patients are admitted to hospitals, Mostashari said. He said electronic health records can be used to find that information.

"When a patient gets discharged from the hospital, it is a very dangerous period," Mostashari said. "Maybe they were on a pill, but now they are on injections. Maybe they are frail from laying in bed."

It is important for patients to visit with their primary care physicians after a hospital stay, Mostashari said. If doctors are alerted of their patients having a hospital stay, they can make the effort to follow-up with patients, he said.

Zini is mostly interested in what the data will say about specialists he sends his patients to.

"Over the years I have picked specialists that I think are the best," Zini said. "It was done through trial and error. With data you can tell pretty quick. Aledade can help me make that decision."

In most cases physicians have to pay an outside company up front to provide data analysis services, Mostashari said. He said this is the most difficult part for independent doctors.

"They make a good living, but they don't have a huge amount of capital laying around," Mostashari said. "We thought it was important to do this without up-front fees."

Mostashari said the company raised money from private capital to cover the start-up costs of the business. This way doctors didn't have to pay up-front.

He said that his company provides the service with the agreement that 40 percent of any savings the doctor receives from Medicare will be given to Aledade.

"They are willing to take this risk with us," Zini said. "I couldn't do this otherwise."

The company is in the process of finalizing the Accountable Care Organization in the state, Mostashari said. He said about 10,000 Arkansas Medicare patients will be affected by the plan. He said he couldn't put an exact number on how many doctors would be in the organization.

Mostashari said that he wants to expand the company in the future.

"Our plans are to help these ACOs succeed and then to bottle it up and make it something we can use in other parts of the country," Mostashari said.

Arkansas had two Accountable Care Organizations in the state as of January 2013, according to data released by Medicare.

There were 428 organizations throughout the U.S. at that time. The Kaiser Family Foundation estimates that 14 percent of the U.S. population is being served by an Accountable Care Organization.

NW News on 09/02/2014

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