ATHENAHEALTH HELPS PHYSICIANS MAXIMIZE REVENUE UNDER NEW NATIONAL MEDICARE PAY-FOR-PERFORMANCE PROGRAM

Physicians nationwide can now leverage the power of the athenahealth network

WATERTOWN, MA (March 23, 2007) – athenahealth, Inc., the premier provider of web-based services, knowledge, and software for medical practices, today announced that its web-based athenaNet® practice management system now includes new physician quality measures and coding rules for its entire national client base as part of the new Tax Relief and Health Care Act of 2006 (TRHCA) that was signed into law in December 2006. Under the new law, the Centers for Medicare and Medicaid Services (CMS) has established a physician quality reporting system – the Physician Quality Reporting Initiative (PQRI). Providers who successfully report quality measure data on claims for services between July 1 and December 31, 2007, will be eligible for a single consolidated incentive payment in mid 2008. The bonus payment is the equivalent of 1.5 percent of total allowed charges for covered physician fee schedule services provided from July 1 through December 31, 2007.

PQRI is part of CMS’ overall quality improvement effort. Participating physicians benefit from capturing data about the quality-of-care provided to Medicare beneficiaries along a set of 74 distinct measures which were expanded from an original 16 “starter measures” based on Medicare’s former Physicians Voluntary Reporting Program (PVRP). These quality measures are typically based on a combination of diagnosis and procedure codes, but may also include other factors such as the patient’s age. athenahealth has built proactive “Medicare PQRI Rules” that are independent of each other, allowing medical practices to select the measures that are appropriate for the providers at their practice.

“Medicare’s new pay-for-performance (P4P) program is the latest in what will be many other national or regional programs requiring physicians to accurately report performance data for increased revenue,” said Jonathan Bush, Chairman and CEO of athenahealth. “The P4P trend in healthcare only reinforces the need for providers to leverage a flexible service offering like athenahealth’s that combines intuitive software, continuously updated payer knowledge, along with billing specialists to optimize practice management and revenue. Unlike traditional vendors, athenahealth is able to upload any new PQRI rules, send them out for free to thousands of physicians across the country, and then actually build them into the practice workflow in real-time so staff won’t forget them.”

Along with updating athenaNet with CMS measures already available, athenahealth is also adding measures related to ophthalmology and stroke/rehabilitation, with the remaining measures to follow as they become available. Administrative reports, displaying charge and amount information associated with PQRI claims, will be rolled out prior to the go live period in July. As the PQRI program is subject to updates and modifications by CMS, athenahealth’s flexible, web-based network will update various changes in the program as they happen to allow physicians to continue maximizing their reimbursement.

Source: ATHENAHEALTH