Determining ROI for Behavioral Health EHR Solutions
by Core Solutions on November 10, 2022
EHR solutions represent a significant initial investment for healthcare organizations, whether making an initial purchase or transitioning from one system to another. The good news is that the purchase of the right behavioral health EHR can provide a significant return on investment (ROI).
Identify technology competencies that will best serve your behavioral health organization with our guide, The Ultimate Guide to Behavioral Health EHR Selection.
That raises a question: How can a behavioral health organization determine the ROI of the solutions it’s considering? This can prove challenging for a number of reasons, including a lack of financial incentives for EHR adoption and stringent requirements around clinical data use that necessitate specialized solutions. The financial considerations of a behavioral health EHR investment also extend beyond the initial purchase. An EHR's total cost of ownership can include maintenance, staff training and support, data migration, and more — all-important expenses to note when calculating the cost of EMR for private practice.
Although you certainly want to make sure you get the most bang for your buck when investing in a behavioral health EHR solution, ROI isn’t just limited to an organization’s bottom line. The right solution can save your organization time and resources, improve processes, and help with staff and clinician recruitment and retention.
How to Determine the ROI of Behavioral Health EHR Solutions
As your organization evaluates different EHR solutions, consider the following areas when working to determine the ROI of the new system.
Billing and collections
Behavioral health medical billing can be complex, due in part to the variety of billable services and the qualities of those services. For example, the types of treatments, length of sessions, and coordinating care across multiple partners generally make behavioral health services more difficult to standardize than physical healthcare. This means patients’ behavioral health needs may exceed what an insurance company is willing to cover, leaving behavioral health providers to balance an effective treatment plan with adequate reimbursement.
Unfortunately, due to all the rules and regulations surrounding behavioral health medical billing, many providers fail to collect all that’s owed to them, with some estimates putting the percentage of successful collections for services rendered between 75% and 85%. Leaving dollars on the table could make the difference between an organization being in the red or the black.
Inefficient or incorrect documentation can further complicate matters concerning. If services are not coded and documented properly, this can lead to denials and time spent on appeals and claim corrections. Delays in correcting and appealing the claim can lead to delays in payment as patients wait to learn what they owe. Often, the more time that passes, the less likely patients are to pay their bills, which can affect the practice’s revenue. Furthermore, missing a payer’s timely filing deadline can lead to loss of payment.
The right behavioral health EHR can improve the billing and collections process in a few ways. One is that it reduces the risk of human error that can occur with manual coding. There are more than 68,000 codes in the ICD-10-CM — much more than one person can be expected to memorize. Use of an EHR better ensures the right code is entered for the right service and the claim is as accurate as possible. Submitting a clean claim expedites the payment process and ensures that the insurance company and the patient pay the correct amount.
Clinical efficiency and workflows
One of the benefits of an EHR is that it can automate existing manual processes, such as intake forms and patient histories. The time spent collecting this information can eat into the amount of time a provider can spend with patients and the number of patients a provider can treat. The ability to submit forms digitally allows the patient to fill them out ahead of time and that information is updated automatically in the EHR. EHRs with behavioral health templates can also allow providers to document common symptoms more quickly than filling them in manually.
Healthcare organizations generate a lot of data. Nearly 30% of the world’s data volume is generated by healthcare organizations, and a single patient generates almost 80 megabytes of imaging and EMR data each year. This data can be mined for valuable insights that can improve patient care and business operations. Integrating business intelligence (BI) into an EHR enables better care coordination and risk stratification, including identifying patients who are likely to be no-show or who will require follow-up care due to being high risk or having a gap in care. BI can also alert providers to potential medication interactions and aid in the development of treatment plans.
Value-based care and reimbursement
With the healthcare industry’s steady transition to value-based payments, providers must be able to prove that they are improving patients’ outcomes and experience to collect as much value-based payment as possible. Value-based care has six key elements:
EHRs can help providers meet each of these elements. EHRs make accurate patient information more readily available to providers. A comprehensive view of a patient’s health allows providers to achieve early identification of possible mental illness and intervene as quickly as possible. Screening and assessment tools built into EHR solutions allow providers to effectively document and track any changes to a patient’s health status during the course of treatment.
One of the most significant benefits of cloud-based EHR solutions is that they eliminate the need to manage on-premises servers and hire IT staff to support this technology. Depending on the size of the practice and its patient load, staffing and hardware costs can quickly add up and possibly grow significantly year over year. With cloud-based solutions, the EHR is managed remotely by the vendor. Freeing up the money that would have been spent on managing in-house servers and staff means those resources can be used elsewhere.
Better Understanding the ROI of a Behavioral Health EHR
An EHR's total cost of ownership may look daunting at first, and you may question whether the cost of EMR for private practice is justified. However, it’s important to know that adding EHR and EMR capabilities is a worthwhile investment that will help your clinical, financial, and administrative operations run as efficiently and effectively as possible. For a custom look at the ROI potential for your behavioral health EHR use, reach out to Core Solutions today.
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