Grove Medical Associates, P.C., (GMA), is an internal medicine practice serving Worcester County in Massachusetts and is affiliated with the Central Massachusetts Independent Physicians Association (CMIPA). GMAs four Board Certified Internal Medicine physicians, a Physician’s Assistant, a Certified Nutritionist, registered nurses, medical assistants and administrative support staff serves a diverse patient population of over 6,500 people. Thanks to the implementation of workflows enabled by health information technology interventions, GMA was able to successfully apply to Meaningful Use and achieve Level III Patient Centered Medical Home certification. Amazingly, the practice now consistently maintains the highest level of individual PCP Quality Performance scores through CMIPA which consists of 250 physicians.
Grove Medical Associates
Since implementing the EHR, GMA has demonstrated an improvement in quality of care in preventative measures, which is demonstrated in the graphs below. These graphs are displayed at each nurse station and are discussed at weekly staff meetings. Discussing this monthly is vital to maintain the desired level of care. The medical assistants are trained to utilize the EHR preventative measure alert and structured data to ensure all testing is captured for each patient at all visits. The linked case study highlights how Grove Medical utilized dashboards, a hospital interface, and patient engagement technology to reach Stage 3 Patient Centered Medical Home Level III designation.
With the adoption of the EHR, Grove Medical Associates was able to increase the level of service billing due to proper E&M coding. Overall our Physician Providers were coding only 20% of their office visits as a 99214 in 2004. After the implementation of the EHR in 2005, our Physician Providers are properly coding 80% of the office visits as a 99214 (versus a 99213). The difference in additional revenue is approximately $35.00 per office visit.
GMA did experience an increase in insurance collections with the adoption of the EHR. The providers were able to increase the number of office visits per day. The average number of office visits per day in 2004 was 17, and is now 20-22. Annually, this translates to approximately 3,000 additional office visits. Average insurance collections doubled since 2004 with the adoption of the EHR.
GMA was able to maximize, in most cases, the amount of incentive money offered by the insurance carriers and CMIPA. We were also able to participate in two incentive programs; MCMP (Medicare Care Management Program) and BTE (Bridges to Excellence) when offered.
With the implementation of the a patient portal, patients had the ability to track care plan progress and communicate directly with providers. Improved adherence to care plans correlated with significant improvement in adherence to care plans and a corresponding improvement on patient outcomes.
Grove Medical Associates utilizes a Chronic Care Management Record (CCMR) module. This module has an algorithm to predict future costs and improve patient outcomes. The EHR has allowed GMA to make great progress in quality improvement measures, such as breast cancer screenings, cervical cancer screenings, colon cancer screenings, and diabetic retinopathy eye exam screenings. In preparing for the Patient Centered Medical Home Initiative (PCMHI) the adoption of a Transition of Care measure to workflow allows GMA to closely monitor our high risk patients recently discharged from an outside health facility.