Mide-week update

Today, the President promoted the Healthcare Payment Learning and Action Network, a private – public partnership intended to facilitate the tranistion to quality based payments for healthcare. 

The bipartisan sustainable rate of growth repeal and replace bill appears to be percolating right along in Congress according to this Hill article. The Hill also reports that the President is willing to sign the bill.

Fierce Healthcare reports from the World Health  Care Congress about how insurers are trying to improve member engagement. Here’s a catchy idea:

Engage providers. The average consumer would much rather talk to the doctor than the insurance company, the executives said. Edelson [from United Healthcare] took the point one step further: Consumers would rather talk to nurses or office staff. Offer training and support to anyone in a physician office who interacts with members so they can address questions about consumers’ insurance plans or at the very least point members in the right direction.

Fierce Healthpayer reports from a recent AHIP conference about how insurers are building member trust in their big data practices.

The obstacle of protecting big data lingers. “We’re not quite there yet,” said Jim Routh, chief information security officer of Aetna. “Right now, we have the encryption capability to encrypt certain fields that are searchable. Where we’re headed is total search based on encrypted data. Hopefully, technology is almost there for searching on encrypted data.”

In the meantime, insurer are focusing on guarding against phishing attacks and patrolling inside their firewalls as experts have suggested.

CAQH CORE is seeking to whip up use of its handy electronic transaction tools.

Average adoption rates of fully electronic transactions varied widely, from a high of 92 percent for claim submission to a low of 7 percent for prior authorization. About half of all claim payments and remittance advice transactions remain manual. Health plans continued to process about 1 billion transactions manually, and healthcare providers handled over 2.4 billion.

The potential for significant cost savings is due to the large volume of transactions, as well as the dramatic cost difference between manual and electronic transactions. For health plans, costs for each manual transaction averaged $2 for the six transactions studied, while electronic transaction costs ranged from only 5 to 10 cents. Healthcare providers’ estimated costs averaged more than $5 for manual versus $1.60 per electronic transaction.

Good luck to them.

Leave a Reply

Your email address will not be published.