New records, health focus seen as pluses at BVMA

FINDLAY — A new record system, and a focus on population health, are among the reasons Blanchard Valley Medical Associates was drawn to join NOMS Healthcare. NOMS uses the Epic and MyChart systems for its records. Dr. Kelly Koenig, a dermatologist and physician lead at BVMA, said switching to these platforms makes it easier to communicate with other systems and organizations. For example, as a dermatologist, she can now easily see records of her melanoma patients who have received care at The James Cancer Hospital and Solove Research Institute in Columbus. Koenig added that new medical school graduates are generally used to working with Epic, which makes her hopeful that switching to this system might help the practice recruit more physicians. She said BVMA has been trying to recruit a rheumatologist, and has been searching for an endocrinologist since the retirement of Dr. LeRoy Schroeder, one of BVMA's founding physicians. Nationwide shortages in both specialties have made these searches unsuccessful so far. Koenig said NOMS has been working on recruiting physicians throughout the region and may be able to help. "The physician shortage is real," said Rick Schneider, chief strategy officer for NOMS Healthcare. Across the country, many older physicians are retiring, and it's a challenge to replace them. Schneider said NOMS feels a responsibility to make sure the people in its communities can get care. If there is a specialty that one NOMS location offers but another does not, they occasionally arrange so those specialists can visit the other locations to lend their expertise. Over the last couple of years, insurance companies have been automatically downgrading the codes assigned to many patient visits. Koenig explained that, if she is caring for a complex patient who takes many medications for chronic illnesses, she will code the visit appropriately so insurers will reimburse for this care. However, insurers have been increasingly automatically downgrading the code so they don't have to pay as much. Koenig said Epic has tools to flag these discrepancies, making it more likely insurers will pay the practice what they owe. Under BVMA's previous system, finding these issues would have required an audit, itself an expensive process, she said. "Another big thing with NOMS is actually population health," Koenig said. She said it's through this model — which is being explored more nationwide — that they are more hopeful "we can actually thrive as an independent practice". The sickest patients, the ones who are regularly in and out of the hospital, are also the most expensive to care for. NOMS is "demonstrating better quality" in working with these patients and addressing issues earlier on. This includes making sure people get screenings like mammograms and colonoscopies, and that blood pressure, cholesterol and diabetes are managed effectively. This approach can help patients stay healthier overall. It also saves their insurance company money — and the insurers in exchange reimburse places like NOMS that are doing this successfully at a higher rate. BVMA's previous records system made it harder to track these things, Koenig said. The new system allows them to, for example, run a report to identify patients who may be overdue for a colonoscopy, and reach out to remind them. A population health nurse will be working with high-risk patients to help them schedule needed screenings or get care that they might need.