HCN provides network members access to centrally administered applications for practice management and accounting. The two primary applications selected by HCN include Platinum and WebMD’s Medical Manager. Kearns has implemented the Platinum financial system successfully at Family Health Centers in Fort Meyers prior to that health center joining the network. The Medical Manager application was selected by the HCN MIS Committee and had not been running previously in any of the centers. Medical Manager is currently owned and operated by WebMD, and provides health centers with typical practice management functionality including patient scheduling, resource management and billing.
Data management and reporting. Data downloaded nightly to HCN’s SQL Server database from Medical Manager is available to health centers for query using InfoPoint or Crystal reports. Platinum data is directly accessible via Crystal. In addition, HCN itself employs programmers and regularly provides standard center- and network-level accounting and practice management reports to the health centers.
Medicaid billing formats. HCN has worked extensively with Medical Manager and their corporate parent, WebMD, to accommodate health center needs around Medicaid billing. Member health centers successfully bill to numerous Medicaid managed care organizations (including through direct billing) and other payers, each of which typically require a different format for billing. Respondents indicated some difficulty in using Medical Manager to efficiently produce billing formats consistent with HIPAA requirements for electronic data interchange.
This limitation posed an immediate problem when Utah and New Mexico health centers began using the Medical Manager product as the Medicaid offices in these States, unlike Florida’s, has moved to requiring HIPAA-compliant formats. Although these problems have largely been addressed, Kearns indicated that the introduction of a new managed care organization or other type of payer will often require special effort to further customize billing templates.
Relationship with WebMD. HCN, which administers Medical Manager to support over 1 million encounters over a wide geographic range, enjoys an atypical level of responsiveness from Medical Manager’s parent company, WebMD. While health centers from other site visits using Medical Manager reported inconsistent customer service from WebMD, Kearns indicated that he can relatively easily convene senior executives from WebMD to negotiate around functionality and price and is generally able to get a swift response from the vendor when problems arise.
Although there have been some reported problems with Medical Manager, the stability the network has achieved using the system exceeds the typical health center experience with this product. HCN respondents indicated that they have worked extensively with WebMD to customize the application for health center uses and that the relationship has helped WebMD’s efforts to increase market share among health centers.
As the network’s experience with WebMD has developed, the likelihood of the consortium changing vendors has decreased — particularly because there is high overall health center satisfaction with the tool. Additional findings related to health center experience with using Medical Manager are provided in the section discussing health center experiences below.