Monitoring the healthcare industry’s progress towards business efficiency Pat Blewitt, Emdeon Maryland AHAAM June 2009.

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Presentation transcript:

Monitoring the healthcare industry’s progress towards business efficiency Pat Blewitt, Emdeon Maryland AHAAM June 2009

Top 4 Issues - Legislative Day 1.Issue - National Payer Identification Number 2.Issue - CMS Should Require the Adoption of a National Patient Health Insurance ID Card 3.Issue – Electronic Funds Transfer 4.Issue – Claim Acknowledgement Transaction 2

AAHAM Requested Action AAHAM requests that Congress encourage & CMS/HHS take action towards a rule requiring all payers required to use the HIPAA 835 transaction also be required to pay providers using electronic Funds transfers (EFT). 3

Why the Recommendation? Mandated use of electronic funds transfers could cut $11 Billion per year from healthcare costs in the United States. 4

New Industry Forum Launched in December 2008: U.S. Healthcare Efficiency Index™ 5 Purpose Create an industry forum for monitoring business efficiency in healthcare Vision Raise awareness of potential savings and reframe the national dialogue on health reform Goals Establish single national reference Track progress across the industry Remove barriers Take costs out of healthcare ushealthcareindex.com Potential Savings: $30 Billion per Year

6

Independent Advisory Council Fritz Scheuren, Ph.D Patrick Baier, D.Phil. Statisticians Scheuren - Ruffner Andrew L. Naugle, MBA John L. Phelan, Ph.D Milliman, Inc. Jane Sarasohn-Kahn Healthcare economist and author The Hon. Newt Gingrich Former House Speaker, and Founder, Center for Health Transformation The Hon. Phil Johnston Chair, Massachusetts DNC, former State Senator and former regional director at HHS Dave Garets HIMSS Analytics Stanley Nachimson Nachimson Advisors, LLC Erik Swanson Wellpoint Fred Horowitz, DMD Cooperative Exchange & Chief Executive Officer of Affiliated Network Services Richard Nelli Cooperative Exchange & Chief Technology Officer of CareMedic Robin Thomashauer Council for Affordable Quality Healthcare (CAQH) Eric Wallace Linxus / Greater NY Hospital Association Miriam Paramore Emdeon 7

Data collection, extrapolation, and publication Every quarter contributors enter data at the secure, password protected Index website EDI Savings Avg. Monthly Volumes % of Volumes in EDI Payers Providers Clearinghouses Publicly Available National Efficiency Metrics Data goes directly to independent statisticians Data is scrubbed and de-identified Aggregated metrics are extrapolated Independent, 3 rd Party Statisticians 8

Secure Website & Login 9

Index Phases Phase 1: Industry Data – 5 Basic Medical Transactions Phase 2: Direct Data Collection and Reporting Phase 3: Expansion – Pharmacy Index 10

what would u do w/ $30 B? ushealthcareindex.com 11