The Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 establishes programs under Medicare and Medicaid to provide incentive payments for the use of certified electronic health records technology. Though these Meaningful Use Rules (MUR) were designed to improve healthcare outcomes by utilizing Electronic Health Records (ERH) and documentation, there’s an ugly side of the program that has left many healthcare providers scrambling to adhere to the documenting standards of MUR. The good news is, small-cap innovator MIT Holding, Inc. (OTC: MITD) has the solution providers need to comply.
As of January 2014, 20 different rules for doctors and 19 different rules for hospitals became mandatory under stage two of MUR. Medicare and Medicaid providers are now required to document a patient’s recovery after they are released from care. Gathering this information can be tricky. Some documentation, such as age, weight and gender, is easy to obtain. In-depth follow-up such as checking that the patient is properly taking their medication and following doctor’s orders for and rehabilitation, however, can be time intensive, hard to fill, and is at mercy of the patient’s truthfulness.
If the patient does not recover or the healthcare provider fails to properly document the recovery, the provider will be penalized in that Medicaid/Medicare will pay all of those same procedures billed for the next year at a lower payout. For example, if a hospital bills Medicare/Medicaid $10,000 for a procedure and the hospital does not provide the proper after-care documentation, the hospital is subject to penalty by Medicare/Medicaid. So if the penalty is 10%, the hospital would only receive $9,000 for that procedure over the course of the next 12 months.
This structure can have a dramatic impact on doctors and hospitals that lack the means, resources or the know-how to meet standard reporting. While healthcare providers can easily purchase the software and information technology (IT) needed to report the documentation, they still haven’t found a fully efficient way to gather the information. In fact, Frost & Sullivan reports that more than 50% of healthcare providers lack a plan of action to implement the health IT needed to improve care efficiency.
Managed Healthcare Executive recently published an article discussing the strategies and struggles of some of today’s leading care companies as they work to meet the new requirements. According to the article, Cigna Corp. (NYSE: CI), Aetna, Inc. (NYSE: AET), and Humana, Inc. (NYSE: HUM) utilize accountable care organizations (ACOs).
Cigna’s strategy, for example, is to execute patient outreach through the use of an “embedded care coordinator” with an ACO provider group. The company trains nurses, provides information on at-risk patients, and then informs nurses of which patients are being discharged from the hospital. The nurses then calls the patients at their home the day after their discharge to answer medical questions, confirm additional appointments, and keep patients educated on what to expect during recovery.
MIT Holdings’ solution offers doctors and hospitals the ability to refer their patients to the company’s comprehensive, one-source recovery service built on face-to-face patient contact. This first-of-its-kind service starts as soon as the patient is discharged from the hospital, at which time MIT assumes the responsibility of the recovery period. By building a personal relationship with the patient in the comfort of their own home, MIT has the unique ability to gather important information to meet MUR mandates.
If Cigna were to employ MIT’s solution, here’s how it would look: Cigna would be able to eliminate the expense and bureaucracy of the embedded care coordinator by eliminating the role altogether. Instead, MIT would meet with the patient at the time of discharge and if necessary would even accompany the patient home and help them determine each and every recovery need. MIT would also meet with other members in the household, and for the patient as well as those members would price pharmaceutical needs through the MIT pharmacy. Through this process, MIT, on behalf of Cigna, would establish a relationship with the patient that would promote clear and accurate communication, feedback and documentation. MIT is even capable of handling billing and insurance issues.
“We handle all the billing and all of the medical needs that an individual will need, and our record keeping will be through in-home interaction with the patient and will contain all of the information that Cigna, Aetna or Humana would need to report for the MUR,” explains William Nalley, IR representative for MIT Holding.
From the time of patient discharge from the medical facility, MIT’s services handle everything pertaining to the at-home recovery phase, including in-home medical equipment, infusion services, medications, follow-up appointments, organize therapy sessions, wound dressings, transportation, insurance inquires and professional insurance claim billing.
The goal is to make the patient feel like their care provider went home with them – there is no lapse in patient care or communication. All the patient needs to do is follow the MIT professional health caregiver’s instructions and recover while MIT documents the recovery of the patient, interacting with them one-on-one to help them properly, efficiently and quickly heal.
The digital paperwork MIT maintains in order to monitor the patients recovery contains all the information the hospital and doctors need to comply with the new rules. By recognizing the steep implications hospitals may face under the new requirements and developing a tested and sound solution, MIT has the potential to revolutionize the way doctors and hospitals gather and report patient recovery progress.
As more healthcare providers become aware of these services, MIT is catching wind in its sail, and recently reported first-quarter revenues of $489,854, more than double prior-year first-quarter revenues of $279,872. The company attributes this growth of 133.3% to an increase in customer referrals and subcontractor services. The first-quarter net loss of $9,654 represents a drastic cut from a loss of $105,726 a year ago. This resulted in a gross profit for the first quarter of $277,922, or 56.7%, as compared to gross profit for the same quarter in 2014 of $127,790, or 60.9%.
Moving forward, MIT will continue to market its comprehensive at-home recovery solutions and services as a viable solution to the healthcare industry’s growing demands.
For more information visit http://mitholdinginc.com/investors.html or contact William Nalley at 305-515-8077
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