We are excited to post a press release from Prime Care Technologies about the launching of Healthline, the latest in the fast-growing primeFORCE portfolio of solutions and services. Healthline can be a tremendous resource to help LTPAC providers in the highly competitive world of talent recruitment and retention to reduce call-offs, healthcare claims, and turnover. Please read on.

24/7 service puts healthcare professionals, advocates, and even physicians a phone call away
with no per-call consult fees.

DULUTH, GA, August 25, 2015 – Prime Care Technologies, Inc., the nation’s leader in technology-powered business solutions for providers of long-term/post-acute care (LTPAC), today announced the launch of Healthline, the latest in the fast-growing primeFORCE portfolio of solutions and services.    

An ideal offering for employers in labor-intensive industries where staffing is mission critical to operations, the service includes 24/7 telephone and/or video access to teams of healthcare professionals, without per-call consult fees.  Calls are answered in an average of 16 minutes and can include getting a prescription, when appropriate, from a physician for a common ailment. Other benefits include advice from a nurse practitioner on how to ease pain, help from a billing expert with negotiating discounts to lower out-of-pocket costs, a referral from a vision professional on the right specialist, assistance from a health navigation expert on where to get an inexpensive MRI, and much more. 

“Employees constantly face tough choices, like calling off of work to take sick kids to the doctor, spending hours in crowded urgent care centers, and absorbing high fees towards high deductibles,” explained Joe Stone, Executive Vice President for primeFORCE. “With primeFORCE Healthline, help is just a call away, round the clock, from home, easing fears of lost pay and postponed care. Medications and treatments can start faster, reducing trips to the doctor and call-offs,” explained Stone. 

The benefits to employers are equally significant. On average, Americans visit a physician, hospital outpatient, or emergency department four times per year, at a cost of $104 per office visit and $1,318 per ER trip.[1]  “If employers can eliminate just one of each per employee per year the savings on claims alone add up quickly,” said Stone.  With primeFORCE Healthline, employers experience an average of 3.6X annual ROI, resulting from reduced call-offs, higher productivity, lower turnover, and lower expenses on claims.  “Healthline is a pressure relief valve for busy families, and welcome relief for employers looking for creative ways to keep talent.  Everyone wins,” summarized Stone.

About Prime Care Technologies, Inc.
Headquartered in Duluth, GA.; and with offices in Eustis, FL; and Brookfield, WI; Prime Care Technologies, Inc. is the nation’s leading provider of technology-powered business solutions for providers of long-term/post-acute care.  Clients rely on these technologies and experts to optimize financial performance for procurement, claims, workforce, cloud-IT, connectivity, business intelligence, and more. Having the right information, to make the right decisions, right now—results in tens of thousands of dollars in dividends per location per year.  For more information, visit www.PrimeCareTech.com.  

primeFORCE Healthline is NOT insurance. The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under the Affordable Care Act or Massachusetts M.G.L. c. 111M and 956 CMR 5.00. This discount card program contains a 30 day cancellation period. Discount Medical Plan Organization: New Benefits, Ltd., Attn: Compliance Department, PO Box 671309, Dallas, TX 75367-1309, 800-800-7616. Website to obtain participating providers: MyMemberPortal.com. Not available to WA, VT, KS, UT & FL residents. Telehealth operates subject to state regulation and may not be available in certain states. Consults are not available outside of the U.S.

[1] Centers for Disease Control, American Medical Association, and Agency for Healthcare Research and Quality (AHRQ); respectively.

 

PRIME CARE TECHNOLOGIES launches the long-term/Post-Acute CARE industry’s MOST COMPREHENSIVE SOLUTIONS PLATFORM

For growth and performance-focused organizations, innovations accelerate results

DULUTH, GA, May 4, 2015 – Prime Care Technologies, Inc., the nation’s leader in technology-powered business solutions for providers of long-term/post-acute care (LTPAC), today announced the launch of a comprehensive solutions platform.

Packed with innovations for LTPAC providers to take financial and operational performance to new heights, the breadth and depth of the platform marks an industry first. Providers can now optimize the right mix of strategic applications, answers, and experts—all running securely in primeCLOUD—to solve some of the industry’s toughest challenges. The lineup is accessed at www.PrimeCareTech.com and includes innovations to:

Reduce costs - primeCOMMERCE, powered by Procurement Partners, provides significant cost cutting through formulary management, invoice automation, central contract compliance, business logic and approval workflows; and more.

Improve cash flow - primeCLAIMS cuts claims processing time up to 35-50% and collects cash faster with an enterprise-class claims solution connected to 3000+ payers.

Optimize a workforce - primeFORCE saves time and money by managing a talent universe in one place.

Drive performance and security - primeCLOUD boosts uptime, performance, and security for the software applications, networks, and devices on which business rely.

Simplify interoperability - primeCONNECT enhances application data sharing within and between healthcare partners to reduce information technology costs, coordinate care, improve quality outcomes, and capitalize on financial incentives.

Measure results - primeVIEW business intelligence provides executives information at their fingertips to make decisions in a centralized dashboard. primeVIEW rolls up key performance data from over twenty-five popular applications under a single login.

“Having the right blend of technology is mission critical for today’s operator,” commented Jim Hoey, CEO of Prime Care Technologies. “Prime Care Technologies suite of solutions is supported by a team of business performance experts who help clients streamline people, processes and technologies to maximize quality of life for patients and residents as well as professional satisfaction for the teams responsible for their experience.”

About Prime Care Technologies, Inc.
Headquartered in Duluth, GA.; and with offices in Eustis, FL; and Brookfield, WI; Prime Care Technologies, Inc. is the nation’s leading provider of technology-powered business solutions for providers of long-term/post-acute care. Clients rely on these technologies and experts to optimize financial performance for procurement, claims, workforce, cloud-IT, connectivity, business intelligence, and more. Having the right information, to make the right decisions, right now—results in tens of thousands of dollars in dividends per location per year. For more information, visit www.PrimeCareTech.com.  

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Likely you read the article in the November 14, 2014 McKnight’s Daily Update entitled, SNF staffing data will be submitted quarterly, payroll vendors might be responsible, CMS officials say, which reported that CMS has launched a pilot to solicit information directly from providers’ payroll systems. The crux of the matter is the lack of confidence in the accuracy of the information providers are reporting to CMS annually to comply with Five Star Rating information requests.

Further, in a previous McKnight’s article, dated November 13, 2014, entitled 80% of nursing homes report misleadingly high staffing levels, Center for Public Integrity claims, the Center for Public Integrity claims that “more than 80% of skilled nursing facilities might have inflated registered nurse staffing levels on the Nursing Home Compare website.” I have a hard time believing that reported registered nurse staffing levels were double that which Medicare cost reports reveal. If that is the case, some providers must be extremely short sighted. Or the investigative journalists at CPI don't know how to read cost reports. The New York Times further fanned the flames of controversy by claiming that providers “ramp up” their staffing levels before a known inspection, allegedly using that time period as the sample for reporting purposes. These two articles seem to indicate that providers have two issues to deal with when it comes to reporting labor information, e.g., accuracy and integrity.

Technology can ensure reporting accuracy and timeliness

So what’s a provider to do? Assuming providers have integrity, let’s discuss accuracy. In the past, when I was running buildings, I had to collect the data and create the reports manually, cross-checking multiple times to make sure the reports were accurate - a laborious, tedious, and time-consuming task. Providers today, however, have a much easier and time-saving alternative - automated data mining and business intelligence (BI). Retrieving, compiling, and repurposing the data into useful, relevant, timely, accurate, and actionable information is fully automated through data mining and BI technologies. The data comes directly from the provider’s time and attendance and payroll systems, combined with its clinical and financial software. The BI tool retrieves that data and stores it in a data warehouse from which it creates reports usually viewable in a dashboard. Further, the reports can be as “real time” as the provider needs them to be. As soon as an employee punches in or out that data is stored and therefore information can be retrieved and reported throughout the day.

Business Intelligence can be a tool to use to take action, to make sure that labor is compliant with budgetary and regulatory requirements. It can also be a reporting tool readily disseminating accurate reports to stake holders, managers, and even to regulatory agencies. Even better, such BI tools already exist, such as our primeVIEW dashboard. With it providers throughout the day are able to view staffing levels, observe overtime, identify who’s on the clock and who’s not, review part-time employee hours, and assess labor trending. It can also generate the CMS 671 report for the Long Term Care Facility Application for Medicare and Medicaid. This kind of rich reporting goes beyond CMS requirements and has proven useful to providers across the country to help them save money and improve business processes.

If you haven’t already, I encourage you to look into Business Intelligence to not only run your business, but to comply with such reporting requirements as CMS will mandate for all providers. Through business intelligence, such information is accessible, accurate, and painless…well, at least the process is; the results may not be. But that is why you want BI in the first place. Address the pain before it gets out of hand. But that is for another blog posting.

CMS Says Skilled Nursing Will Face Negative Margins By 2040,” so read the headline in last Wednesday’s AHCA/NCAL Gazette. In fact, it was the top story. Yep. It grabbed my attention really quick. Now granted, I may likely not be around by 2040, but judging by my parent’s longevity, I could. I’ve been affiliated with LTC since 1978 and it’s in my blood. I care. And, yes, to be frank, the article somewhat spooked me when I read the following, “By 2040, two-thirds of skilled nursing facilities will be operating in the red, signaling more consolidations, partnerships and accountable care organizations (ACOs) on the horizon, according to a recent memo issued by the Centers for Medicare & Medicaid Services’ (CMS) Office of the Actuary.”

Here are a couple of reasons why I am spooked. First of all, I have seen projections of the future, especially those going further out than 10 years, either flat out ignored or at least not effectively addressed. Perhaps, we hope the projections are wrong or that someone someday may do something about the issue at hand. It never ceases to amaze me that the future eventually becomes the present. Have you noticed that too? Rephrased, have you acknowledged that truism as well?

Secondly, I am spooked because I’ve noticed that when it comes to health care policy, government at the federal and state levels feels that it will have the answers. Their track record has not convinced me that government is or should be the problem solver. So what can LTC providers do today to meet the challenges the years leading up to 2040 will pose? Well, they can start today to embrace and implement available practices and technologies to build a solid financial footing by quickly collecting claims processed.

Ensign Services did just that. A recently-published ProClaim Partners case study revealed that Ensign Services faced several challenges:

• Ensign Services needed to replace a legacy clinical and financial software application which included a basic claims submission automation feature.
• The new software Ensign Services implemented met its EMR requirements, but lacked automated claims submission to Medicare. This also became the catalyst for consideration and conversation about clearinghouse services to all payers.
• To compensate, Ensign Services selected a widely-used clearinghouse. The new clearinghouse was unwilling and unable to support Long Term Care-specific claims submission and management requirements.

To overcome these challenges, company executives arrived at the following conclusions:

• Ensign Services needed a responsive and easy-to-use enterprise-class claims clearinghouse designed specifically for Long Term Care to help its clients meet their respective cash flow objectives, save money, reduce unnecessary claims processing and collections tasks, increase user satisfaction, and streamline business workflows.
• Because of its relationship with Prime Care Technologies, Inc. for IT hosting services, Ensign Services investigated PCT’s affiliate, ProClaim Partners, LLC, and discovered that it could assist them in managing client claims.

The results? Since fully implementing the ProClaim Partners solution, Ensign Services has been able to:

• Decrease claims turn-around time
• Significantly improve claims management-related business processes
• Reduce frustrations related to new client on-boarding
• Experience quicker special requests and support issues response times

Is this THE answer to the spooky negative margins providers may experience by 2040? Not entirely. But as margins get tighter, a quicker turnaround of claims processed will be critical. The fact is it is critical today. Those providers who take steps today to improve cash flow through claims automation will not only have the advantage in the future, but also right now. At least with a better cash flow position, providers can focus on the factors influencing the bottom line.

At least those are my “thunks”.

Have you fully automated the claims management process? If so, what advantages are you seeing today?

Most large employers are aware of the potential “Pay or Play”1 penalties of the Affordable Care Act (ACA) that they will be facing starting January 1, 2015, assuming no postponement in the current timetable.  However, are these employers also aware of the many other pitfalls and penalties that they will face if they fail to be completely ACA compliant?  Chances are that whatever methods, systems, or software an employer is using, it won’t be able to easily attain all of the data necessary for ACA compliance requirements. To avoid penalties, large employers will need systems that are capable of tracking employee hours, benefit eligibility, dependents, waiting periods, health care coverage offerings, and enrollment by lines of coverage.  Even employers electing NOT to offer medical coverage will be required to send notices and reports to employees and the IRS. For employers with fluctuating work schedules, such as restaurants and health care providers, gathering this information can be difficult, time consuming, and expensive. 

To successfully comply, information gathering and accurate reporting automation will be critical to assimilating all such vital information and to dispensing it to employees and required reporting agencies. The challenge facing employers is that they may not have immediate access to the data required to be compliant. Further, the data may be unavailable, unusable, or of questionable accuracy. Even with the right data, employers’ data gathering and compilation systems face new challenges to conduct proper analyses and to satisfy stringent ACA reporting requirements. The new systems will need to have the capacity to deliver actionable information, track, forecast, and manage costs and trends, and still meet reporting requirements. For public firms auditability is also important under Sarbanes-Oxley requirements. An automated system that accurately provides all of the required information is essential to ACA compliance. Non-compliance, even unintentional, can be expensive, trigger audits, and disrupt business operations. A system that provides centralized data and communicates changes instantaneously and accurately between HR, payroll, benefits, carriers, and third party administrators is essential in this new world dictated by the ACA. 

What challenges do you face in meeting the 2015 ACA reporting requirements? What steps have you taken?

[1] U.S. employers under the Affordable Care Act (ACA) must make many decisions. Most importantly, at this time, is to decide whether it is financially and competitively advantageous to offer health coverage? This decision is called “Pay or Play”.