MRR as an Opportunity - Are you Serious?

  

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From the desk of Michael Klotz, President and CEO of Health Data Vision, Inc.

Almost everyone in the healthcare industry I talk to, well actually, each and every one I talk to tells me the same thing: MRR is a pain, it’s laborious, painful, expensive, annoying – pick an adjective, I’ve probably heard it. And, listening to the stories and explanations behind those feelings, I think I get it: MRR is a drag.

So, then, why in the world would anyone possibly think of collecting and analyzing medical records as an opportunity? Call me crazy if you like. I’m not going to try to convince anyone to completely change their mind. However, everyone can agree that MRR is here to stay and it addresses some needs or at least mandates and regulations. In other words, it won’t go away.

Having come to that conclusion, it seems pragmatic to ‘make the best of it.’ When probing deeper, and our team has done that for a number of years, we find that there is a list of very common pain-points underlying the current state of MRR. Easy enough, right? Apparently not. Many before us have identified those pains, some have attempted to address them, others have promised to fix them. Largely, customers have been left with disappointment, surprises and lost faith in anyone’s ability to address the issues for real. Sarcasm and vendor fatigue follow.

At this point, everyone clearly expects me tell them that our company has figured out a perfect solution to all MRR pains and issues and that we’ll all live happily ever after (which, of course, our biz dev team does extremely well !). Seriously, we haven’t figured it all out, at least not yet. What we have done is taken a new approach to MRR. And what I want to share with you is not so much what we have done, but what factors we considered, what good or best practices we are aiming to implement, what principles we find of value.

Here are some of them:

• Process Centric Approach: Most data lives in databases, transactional systems and data warehouses. Dealing with that type of data is fundamentally different from MRR. It is the end result. Once the data is obtained, the MRR task is complete. However, looking at it from another perspective, MRR is a sequence of successive steps in a process. Each subsequent step can be performed easily, successfully and efficiently as long as the previous steps accomplished their objectives.
• Provider Data: One of the first things in the process is to verify, fix, enrich, update, group, and re-verify provider information. Sometimes provider data is already very accurate from the get-go. In most cases it is not. The important thing is, it can be fixed.
• MR Collection – Efficiency & PHI: we have concluded that the best way to handle medical records is to obtain them first, then centrally review and overread them. Many out there agree with this approach, others don’t. We all agree that for most organizations, this approach is a significant change, which in many cases needs time. Now, assuming we are collecting medical records, there are many ways to make it inefficient, cause pain downstream, including potential PHI violations. MR collection can be done very efficiently, however. It requires technology, process and discipline, but it can be done and even the possibility of a PHI violation can virtually be eliminated.
• Audit Readiness: Another common pain point is getting medical records and review results ready for audits. Depending on the approach used, this is typically somewhere between inconvenient and almost impossible. By using an approach that permanently ties electronic copies of the MR together with the review results, however, this can easily be addressed.
• Vendor Accountability: I know, everyone is doing that, or trying, at least. So why state the obvious? While most contracts attempt to define the what and when and even how, the most important things are usually overlooked or assumed not feasible: clear metrics, even down to weekly benchmark numbers and the ability for a vendor and their systems to provide objective, timely reporting. And, maybe most importantly, incentives for the vendor that unambiguously align their financial success with their customers’ goals.

If you agree that these items can be accomplished, and others can be tackled, we may find ourselves entertaining the possibility of a process that works, even works well. And if we take that step, it’s not a big leap to consider that the mechanics of MRR can be taken care of, so we can focus on what these efforts were about in the first place: measure quality, effectiveness, understanding your populations, providers and areas that need improving; finding additional sources for reimbursements, and many more. And that, you may agree, are opportunities. Opportunities to turn Medical records into the value they were meant to provide in the first place.

Download the slide deck with additional ideas on best practices (including maximizing MR yield through pursuits, abstraction and coding best practices, IRR tracking and reporting).