Doug Magenheim, M.D., is the owner and medical director of My Doctor LLC, a concierge practice in Cincinnati, Ohio. We talked with him about how athenaOne supports real-time visibility into care gaps through Aledade and Aledade Assist™, their EHR overlay tool that is directly integrated within athenaOne. Dr. Magenheim explains how Aledade Assist fits into existing workflows with little interruption and how the combination of athenahealth and Aledade can help independent practices improve quality and shared savings.
Q: What kind of practice have you built at My Doctor LLC, and what pressures are shaping care delivery today?
A: We have a varying population — from young individuals who are looking for more access and quality care to Medicare patients who are older and have multiple medical problems that need attention.
I think, for sure, the issue is going to be how many patients you can take care of and how much focus you can have on each individual. That's why we started our practice a number of years ago. We aim to take care of patients when they need it, how they need it, and hopefully in ways they don't know they need it.
We probably feel most pressured by the amount of work that comes in from the outside. It's not just patient care, but also the number of documents, communications, prescription refills, and calls from specialists that we manage. It's like drinking from a firehose.
Q: What led your practice to pursue value-based care through Aledade?
A: Our group as a whole feels that we do excellent work and [provide] high-quality care. But the managed care companies don't share those savings with us. Joining Aledade allowed us to become part of a risk-sharing orientation and recover some of what we think we saved through our quality systems.
I've also gotten to work with our area medical director, who has walked us through the hows, whats, whens, wheres, and whys that we need to change to improve not only the quality of care but also capture those things we may have [missed] to improve our quality reporting.
Q: How has the integration between Aledade and athenaOne gone so far?
A: The integration has been very seamless. We have an overlay [Aledade Assist], and the Aledade app runs right inside our software. So, we're looking at our patients’ data, in addition to quality data, in real time.
The athenahealth part has been [almost] invisible to us. We were in contact once when we were partnering. Other than that, we've really only had educational meetings to understand how it works together, and we've had no problems with the integration.
Overall, there has been little interruption in the workflow, and it has allowed us to step up and capture shared savings that weren't previously available to us.
Q: How is your team using athenaOne in the workflow to improve coding specificity and close care gaps?
A: With the changes in the ICD (International Classification of Diseases) coding inside the software, we've used the Aledade/athenahealth program integration to help increase the specificity of our coding.
It allows us to see when we have unspecified or not specific enough diagnostic codes that we can change, or when there are care gaps we have not met. It has identified some of them while patients are still in the office.
The Aledade Overlay tool [Aledade Assist] helps us understand where those care gaps are in real time while we're using the chart, as opposed to getting a list of things we need to go back and do when patients aren't there.
It's a lot of playing catch-up to fix the coding, so there has been a little extra work. But it has been minimal at most.
Q: What value do real-time data and embedded insights from the integration bring to the practice?
A: It's providing data for us — actionable data in real time, in real space — so we can take care of our patients better.
Our practice already had some data available at CMS, and it was able to identify that we were pretty high performing when it came to doing annual exams. However, when we went back and audited a few things, a couple of topics needed to be filled in, so we did that.
Also, it's helped us identify where to do some care management programs, and even step up to further improve our activities. For example, we used to not bill transition to care management charges. Even though it was available, it was something none of us had focused on. athenaOne provided us with the templates and the information to do it correctly and showed everyone that there are significant cost savings in being able to do those transition to care visits.
Q: How do athenahealth and Aledade help your practice remain independent and thrive?
A: In two ways. First, they're providing us with data that will allow us to practice even better care than we do now. Second, I think financially it will be rewarding because we're doing the things we need to do. The shared revenue that comes back to us will help us be more profitable and probably recruit more physicians to a process we think works really well.
We're looking forward to being reimbursed for good care and closing the quality gaps we identify as we go forward. And I think that's part of what this partnership will allow us to do.
shared savings VBCfee for valuevalue-based contractspay for performanceinteroperability and EHRimplementing VBCclosing care gapsmedical coding & billingdata & interoperabilityreducing admin burdengrowing my practiceinternal medicineindependent medical practice
