Think Medical Billing, Not “EMR First”

I have heard from our sales force (and at more than one cocktail party) that most hospitals and practices around the country are focused on Electronic Medical Records (EMR) these days and not so much on medical billing or Revenue Cycle Management (RCM) now because they want to “Do EMR first.”

But what if you are doing EMR first for revenue cycle reasons?

Isn’t the bonus money offered for “Meaningful Use” of an EMR the main driver behind the rush to implement them?  And isn’t the rush intensified by the threat of reduced Medicare rates for those who don’t “meaningfully use” health information???

Okay, so how will you get the incentive money?  My guess is that you will claim to the Feds—through the attestation process—that you are a meaningful user, right?  Claim it?  Like as in file a claim?

I don’t care if it’s MU, PQRI, BTE, or LFG for Do-Re-Mi, if you are going to be glad you moved to EMR, it’s going to be because you’re able to include clinical information in your medical billing system! If you don’t have this in mind from the get-go, you will lose LOTS and LOTS of money on your choice to do “EMR First.”

We used to not let practices do EMR with us without revenue cycle management first.  Heck, the single most powerful thing among the many powerful things that make up athenaClinicals (our EMR) is the fact that we make it easy to go after all available clinical information-driven bonus money and put it in our clients’ bank account.  We go get money!  That’s billing.  EMR—or EHR—is a Medical BILLING thing as much as it is anything else.

For those of you who are folding your arms and raising your noses babbling words like “quality” right now, my response is a similarly raised nose, but my babble is “sustainability.”  Quality, yes.  But if there is no MARKET for the exchange of clinical information, then this whole mini-revolution in health IT that we are enjoying will grow grass through it and disappear into the earth again before you know it.  Like in that book about what the earth will be like when we are gone from it, in a small number of years the health IT revolution could go the exact same way as the “eHealth” revolution of 1997.  Oh, you don’t remember that revolution?  Didn’t read with interest the postings of Caren Taylor at E*Offering?  Don’t remember the billions in market cap created (then evaporated) by WebMD and all the others?


Jonathan Bush, is CEO and President of athenahealth, a leading provider of internet-based business services to physicians since 1997. Prior to joining athenahealth, he served as an EMT for the City of New Orleans, was trained as a medic in the U.S. Army, and worked as a management consultant with Booz Allen & Hamilton.