The Baby Boomer Effect on Medical Record Retention

Nametag Baby Boomer

Baby boomers, those born between 1946 and 1964, are driving an unprecedented shift in America’s older population, with the 65+ age group expected to capture 23% of the total population within the next 40 years – an astounding 7% increase.

Consistent with this trend in aging, in 2006 Medicaid paid $9.2 billion dollars for fewer than 1 million hospice patient beneficiaries – in 2017, 1.49 million Medicare beneficiaries were enrolled in hospice care, a 4.5% increase from 2016.

Currently, there are over 4,300 Medicare-certified hospice care agencies in the United States providing medical care for patients with a life-limiting diagnosis or condition and given a prognosis of six months or less to live. Hospice care can include pain management as well as emotional and spiritual support for the patient and their family. More than 42% of hospice patients elect to receive services in their own homes, while approximately 40% receive inpatient care at a freestanding hospice facility, hospital, nursing home or other long-term care facility.

As mentioned above, the number of Americans 65 and older is expected to nearly double from 52 million in 2018 to 95 million by 2060, which means there’s an immediate need for providers to address this demographic changeover and ensure that medical record retention requirements are being met within the home healthcare and hospice settings.

There are medical record retention requirements at the federal and state levels mandating a clinical record of past and current findings must be maintained for each hospice patient. Numerous requirements for the information must be included in the record as well as the requirement that the record must be readily available by request of an appropriate authority.

Furthermore, Medicare requires providers to maintain clinical records for five years after it files the cost report when there isn’t a defined state record retention requirement, with a recommendation of maintaining copies of the cost report and related working papers permanently.

Beyond federal and state regulatory directives, clinical and billing records are subject to the federal False Claims Act (FCA), which allows a plaintiff to bring an action within six years of the alleged false claim. The FCA permits a longer time period, often ten years, in which the government can file if it was unaware of the possible misconduct. For this reason, providers should consider keeping clinical records and related claims records longer, as an action under the FCA could be filed under seal. This means that it could be months, or even years, after the ten-year statute of limitations expires before the provider is served.

As hospice providers evaluate their EHR systems – such as Careficient, HEALTHCARE first, Hummingbird, Netsmart, and McKesson Homecare – and whether their needs are better served by a different system, legacy data management considerations should also be made.

System replacement provides an ideal opportunity to archive legacy patient and operational records stored within the outgoing system to maintain compliance and access to the information without keeping the cost and technical burden on the books.

Our HealthData Archiver®, is a long-term data storage solution that delivers a single point of access to historical patient, employee or business data for healthcare delivery organizations. The solution consolidates data stores, reduces out-of-production system maintenance costs, mitigates technical risk, complies with record retention mandates, and offers both interoperability and data analytics capabilities.

Eager to ensure record retention of the ever-expanding baby boomer population? Let’s connect.

Nov 13 2019

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