Published: 2009-10-15 12:53:25
Author: Chris Seper | MedCity News | October 5, 2009
COLUMBUS, Ohio — An insurance-driven plan will try to unite doctors around one online portal to submit patient claims information: cutting down on administrative time, quickly providing details on how patients are insured, and (hopefully) trimming costs from health care.
The one-year pilot is being run in Ohio and New Jersey. Advocates call it an ATM approach for health insurance: several insurers agree to one method of information delivery. It has the initial backing of state physicians groups as well as insurance companies that represent more than 90 percent of Ohio’s privately insured population. America’s Health Insurance Plans, the national trade association for insurers, wants to develop a service for every region of the country.
But rallying around one system may be thorny. Many doctors have an electronic method to manage and submit records — as do many insurance companies. So, using the banking comparison, this pilot will try to create an ATM system after hundreds of banks that already have their own money machines. Will they be ready to use something new?
Insurers say a streamlined system will attract physicians because more patients have high deductibles and many aren’t paying. Plus, there is waste. Physicians spend the equivalent of nearly three workweeks every year interacting with insurance companies, according to a May report in Health Affairs.
“That interaction has no value to the patients — it’s administrivia,” said Mark Jarvis, senior director of practice economics at the Ohio State Medical Association, one of five state doctors groups that joined in an announcement Monday morning welcoming the initiative.
And making that interaction an automated exchange of information through technology — rather than a manual transaction by phone or Internet — can reduce cost by up to 90 percent, said Julie Klapstein, chief executive of Availity, which is providing the online claims and health transaction platform for the pilot, during a noon conference call with reporters. “It takes $4 to $8 per manual transaction,” Klapstein said. “Automating these transactions moves that cost down to less than $1.”
If the “administrative simplification” envisioned by the pilot were to succeed and go nationwide, it could save the U.S. health care system hundreds of billions of dollars over 10 years, said Karen Ignagni, president and CEO of America’s Health Insurance Plans, the national membership organization for health insurers, during the press teleconference.
Starting in November, physicians can enter patient data into a Web site provided by electronic claims manager Availity, which can connect with multiple insurance companies. Participating insurers are: Aetna, Anthem Blue Cross and Blue Shield, CIGNA, Humana, Kaiser Permanente, Medical Mutual of Ohio, UnitedHealthcare and WellCare Health Plans.