Qualifacts is proud to announce that its comprehensive electronic health record (EHR), CareLogic Enterprise, has received Stage 2 meaningful use certification. As an Office of the National Coordinator (ONC) 2014 Ambulatory Complete EHR, CareLogic will support the efforts of eligible professionals working to meet the requirements for Stage 1 and Stage 2 of the Medicaid and Medicare EHR Incentive Programs.
According to the Certified Health IT Product List (CHPL) managed by the ONC only 2,008 EHR products achieved 2014 certification compared to the 5,034 that achieved certification for 2011, creating a recertification rate of less than 40% under the stricter requirements for 2014 certification.
“The meaningful use program is about improving care quality and coordination across the entire healthcare system and as such, it’s a big deal to our customers and speciality behavioral healthcare providers across the country,” said David Klements, President and CEO of Qualifacts. “We’re pleased to be amongst the select number of vendors that have met the more strenuous requirements, and look forward to working with our clients to ensure their successful implementation and use of these new capabilities.“
“As soon as new meaningful use functionality was added to CareLogic, our EP’s and clinical staff could immediately begin using the functionality to improve client care.”
This certification will allow Qualifacts to continue providing CareLogic users with the infrastructure necessary to reliably and efficiently meet meaningful use measures, more accurately leverage data to improve quality of care and support overall agency sustainability through EHR incentive payments. The company will continue to leverage significant financial and staff resources to ensure that CareLogic Enterprise surpasses the current Stage 1 and Stage 2 needs of its users, and is better prepared for Stage 3 certification.
“The best thing about having a single web-based platform is that as soon as Qualifacts became certified, our customers had immediate access to the 2014 version of our certified EHR,” said Mary Givens, Product Manager of Healthcare Reform with Qualifacts. “Unlike other EHRs, with CareLogic there was no need to wait for an upgraded version of the product or pay additional cost to access the meaningful use features, saving our customers time and money.”
“We have used CareLogic for three years and one of the reasons that we selected CareLogic is because the system’s SaaS based, single platform provides immediate access to new functionality unlike other EHRs,” explained Karen Ayala, Executive Director of the DuPage County Health Department. “As soon as new meaningful use functionality was added to CareLogic, our EP’s and clinical staff could immediately begin using the functionality to improve client care.”
“Our agency participates in a consortium with eight other agencies who use Qualifacts’ CareLogic. With more than 50 Eligible Providers, Qualifacts’ certification for meaningful use Stage 2 is a significant step forward,” added Tom Ford, CEO of Lookout Mountain Community Services. “Not only will agencies in the consortium be able to access additional revenues as a result of the certification, but the agencies will also collect information that will improve the lives of the individuals we serve.”
There is a seemingly constant stream of grabbing headlines revealing yet another behavioral health or human services agency being penalized under payer take-backs or even accused of fraud, but for many providers these horror stories have not been enough to drive them towards compliance action.
In this post, we’ll take a closer look at compliance for behavioral health and human services providers, and reveal the best practices to guarantee that your agency is compliance strong for 2015 and beyond.
The Rise of the Take-Back
Providers not yet prioritizing compliance should tread carefully, especially considering the prevalence of payment reform causing payers to ramp up their compliance efforts in the form of persistent audits. This combined with the advent of incentive programs, means that payers are looking to minimize costs by enforcing take-backs whenever possible.
These take-backs or the mandatory repayment of overpaid funds continue to hit the healthcare industry hard, but for behavioral health and human services providers, take-backs can mean the difference between agency stability and a funding crisis.
The impact of take-backs is further amplified by existing funding issues which contributing to the extreme likelihood that overpaid funds have already been spent. This leads many providers to resort to desperate measures including layoffs in order to secure funds for repayment.
7 Steps to Guarantee Compliance Excellence
Providers can move closer to effective compliance measures and audit safeguards by following these key steps:
- Adopting a Leading EHR
EHRs are one of the most effective compliance tools in a provider’s toolkit. The most effective EHRs make clinical documentation a part of the clinician’s workflow and require the completion of proper documentation for every service provided before a claim can be submitted. This level of checks and balances, makes documentation a natural part of the clinician’s day and integral to the billing process.
- Assigning a Point Person
For behavioral health and human services agencies of any size, compliance starts with a point person, the Compliance Officer. This person manages and oversees all agency compliance efforts.
Avoid: the Compliance Officer/Jack-of-All-Trades. Unfortunately, many agencies that already have Compliance Officers encourage them to priorities other responsibilities unrelated to compliance. These responsibilities usually take precedent over compliance and all compliance efforts are pushed further and further back. Avoid this common pitfall at all costs.
- Building Your Compliance Dream Team
Establish a committee of stakeholders from across the agency to ensure that the unique compliance concerns of each department are represented. Compliance teams create greater accountability, build staff buy-in and result in stronger compliance initiatives.
- Getting the Rest of Your Agency On-Board
Start with the message that prioritizing compliance is mandatory and essential to each person’s role. Incorporate this message into regular staff trainings on compliance and highlight how compliance will benefit the work they do on a daily basis. Educate the entire agency on the necessity of compliance, especially all members of the management, clinical and billing teams.
Avoid: Take-backs and repayment will be too abstract for the larger agency and should not be the primary message of your compliance training nor should it be the primary goal of your compliance efforts. Providers often forget that the most profound impact of compliance is not avoiding penalties, but positively impacting quality of care, efficiency and overall cost management.
- Creating a Compliance Roadmap
With help from the compliance committee, the Compliance Officer should create a compliance plan featuring the following components:
> Identification of compliance committee members and Compliance Officer
> Clearly defined compliance objectives and standards
> Internal staff training programs
> Enforcement standards for disciplinary action in response to instances of noncompliance
> Standard guidelines to respond to noncompliance and prevent repeat offenses
- Monitoring for Signs of Noncompliance
Continuously monitor for signs of noncompliance. High denial rates and incorrect billings are usually a dead give-away. Pay close attention to clinical documentation, which is consistently one of the highest contributors to noncompliance.
- Conducting Audits
Perform regular internal audits to prevent noncompliance surprises and address issues in a timely manner after they arise.
The Compliance Power of an Effective EHR
Qualifacts’ certified Complete EHR, CareLogic Enterprise, enforces the necessary checks and balances to simplify the compliance process and safeguard against failed audits.
With CareLogic, providers can rest easy knowing that…
- Proper and completed documentation is required for each specific service provided.
- Completion of certain document fields is required and signature validation is enforced to reduce “documentation errors.”
- Documentation forms can easily be adapted to changing regulations to ensure that providers are not using outdated forms.
- Only “clean claims” are sent out.
- The billing staff can mark services as “non-billable” if provided in error. Changing a service to “non-billable” no longer triggers a claim, but allows the documentation to remain in the client’s chart.
- Providers receive reliable alerts to notify them of unkept appointments and the need for document completion or signature verification.
- For convenience, documentation generates directly from the clinician’s schedule. This means that they do not have to recreate the information in multiple places which saves precious time and energy.
Qualifacts Systems, Inc., the leading cloud-based electronic health record (EHR) provider for the behavioral health and human services industries, is proud to announce that it has been named to the Inc. 5000 as the fastest growing behavioral health EHR in America. This announcement marks Qualifacts’ third consecutive year ranking in the Inc. 5000 and highlights the company’s commitment to continued growth.
“Our growth is a direct result of listening to our customers, understanding their needs, and hiring smart, passionate people who know how to execute. I’m extremely proud of what we’ve accomplished, but even more excited about our future.” says David Klements, President and CEO of Qualifacts.
Qualifacts provides integrated clinical, financial and administrative software solutions to the behavioral health market through its single platform EHR, CareLogic Enterprise. The company has significantly increased its profitability from year to year and more than doubled its revenue from 2011 to 2013. In the past five years, the company has grown its workforce by 650% and customer base by 1,000%. With plans for future growth strengthened by a recent majority investment from private equity firm, Great Hill Partners, the company is on track to increase its workforce by an additional 40% by the end of 2015.
Qualifacts will continue to invest in sales and product development to further reinforce its position as a market leader and continue to support the complex healthcare reform needs of behavioral health organizations.
“Qualifacts’ single platform approach is the best solution for behavioral healthcare providers that either don’t want or can’t afford major software upgrades every few years and rightly prefer to dedicate their resources to serving more clients and improving care quality,” states Klements. He also adds that “at a time of rapid change in the healthcare market, Qualifacts is focused on ensuring that our customers can access and leverage the information and technology they need to not only compete, but thrive.”
You may have heard that Qualifacts recently secured a private equity investment from Boston-based Great Hill Partners, which presents a valuable opportunity for Qualifacts to create additional value for behavioral health and human services providers and strengthen product quality, but also continue to support local community.
The investment will help Qualifacts strengthen its importance in behavioral health technology and, along with a collection of local technology leaders, kick-start a rising technology community in the heart of Music City, Nashville, Tennessee. “The investment helps Qualifacts grow, but at the same time, having those resources in Nashville promotes tech community growth,” says Bryan Huddleston, President and CEO of the Nashville Technology Council (NTC), an organization dedicated to fostering and advancing the technology community in Middle Tennessee.
“I want there to be a change.”
Helping to lead this community progress and economic development is Qualifacts’ CEO, David Klements. Huddleston weighs in on Klements’ role in the Nashville community, saying that “Klements, from both a career and community-give-back perspective, has been very intentional about saying, ‘I want there to be a change.’”
Qualifacts is looking to deliver this change by recognizing the importance of community and helping behavioral health and human services providers deliver a higher quality of care to communities everywhere.
NTC interview and post by Cassidy McHose and Michael Norco
Qualifacts Systems, Inc. today announced that it has secured a majority investment from Great Hill Partners, a Boston-based private equity firm with more than $3 billion under management. The recapitalization, which was led by Great Hill Partners and existing Qualifacts management, will allow the company to accelerate product development and continue growth. The investment will also help the company identify strategic partnership and acquisition opportunities.
“Qualifacts has emerged as a recognized leader in behavioral health software, but there’s more we want to do to ensure that our customers are successful for the long-term,” said David Klements, President & CEO of Qualifacts. “To help us maximize our full potential, Qualifacts management wanted a financial partner with the right experience and resources. Great Hill was a perfect fit and we’ve already hit the ground running.”
In the past five years, Qualifacts has grown its customer base by 1,000% and workforce by 650%, repeatedly earning the company a place among the Inc. 5000 as one of the fastest growing private companies in America. The company’s single platform EHR, CareLogic Enterprise, supports more than 50,000 behavioral health professionals in 30 states and has supported the delivery of more than 20 million services to one million consumers within the past year.
“We are delighted to partner with David and the entire Qualifacts team,” said Mark Taber, a Managing Partner with Great Hill Partners. “Qualifacts offers a unique and powerful platform for behavioral health organizations to drive operational efficiencies, improve access to patient information, and quickly adapt to changing billing and compliance regulations.”
The investment will accelerate existing product initiatives which support the healthcare reform needs of behavioral healthcare providers. These include demonstrating clinical outcomes, coordinating care with other healthcare systems, delivering integrated primary care services alongside behavioral healthcare and efficiently handling new payment models.
Rafael Cofiño, a Principal with Great Hill Partners, added, “We believe Qualifacts has tremendous growth potential as behavioral health providers seek ways to manage increasing patient volume along with highly dynamic state and federal funding requirements.” Great Hill Partner’s prior healthcare technology investments include bswift, Passport Health Communications and SterilMed.
About Great Hill Partners
Great Hill Partners is a Boston-based private equity firm that manages more than $3 billion in capital to finance the expansion, recapitalization or acquisition of growth companies in a wide range of sectors within the business and consumer services, healthcare, media, communications and software industries. Great Hill targets investments of $25 million to $150 million.
For more information, please see www.greathillpartners.com.
Recently, Generations/Gaither, a behavioral health service provider and Qualifacts customer, needed to build a particular report in Qualifacts’ report building system and wanted to learn more about the report building process. To address Generations’ reporting needs, a personalized one-on-one training was arranged through a statement of work.
Being so closely located to Qualifacts’ Nashville headquarters, we arranged for Generations to visit our office for the training day. Upon arrival Wayne Greer, Executive VP of Generations/Gaither’s Group, met one-on-one with Qualifacts’ reporting subject matter expert and gained invaluable answers to the questions hindering Generations’ essential reporting abilities.
The training day was tailored to target Generations’ specific needs and included discussion topics around methods of accomplishing a report detail and applying rules, and processes to accomplish reporting goals. In addition to tons of learning, the training also included a bit of fun and laughter for good measure.
Wayne ended the day with a fully functional report that he personally created and completed, and stated that the one-on-one training was well worth his time.
“Being able to sit down with Qualifacts staff in-person, I believe we were able to accomplish, in a very short time, work that would have taken much longer if we had tried to work over any kind of distance medium. Indeed, when I submitted the original request to have my report written, the estimated time to complete the report was 25 hours. Working together in person, we were able to complete the report in about 4 to 5 hours and spend additional time in general training. It was also nice to be able to see where the support staff worked and to meet the folks that I have been working with over the phone. It was a very productive and pleasant visit.”
- Wayne Greer, Executive Vice President of Generations/Gaither’s Group and Qualifacts Customer
As a leading SaaS provider, Qualifacts is constantly driving innovation and employing user informed data to build solutions to complex healthcare reform needs. One example of this is our recently launched pilot project; through which, the Qualifacts team is encouraging organizations to play a greater role in future improvements to CareLogic IMPACT, our fully integrated outcomes management tool. The project will help leverage comprehensive benchmarking data to gain insight into several key areas including unmet implementation needs, access to outcomes data and much more.
The project includes ten participating organizations and will focus on:
- Monitoring the implementation and use of CareLogic IMPACT in order to better identify strengths and opportunities for improvement
- Developing and piloting a benchmarking process that is scalable for the entire CareLogic IMPACT system
- Evaluating outcomes linked to CareLogic IMPACT for each participating organization
We look forward to sharing the project results with the CareLogic IMPACT family shortly and applying these findings to further streamline clinical outcomes measurement.
Want to learn more about the pilot project and CareLogic IMPACT? Contact Christy Winter for more information.