Monitoring the healthcare industry’s progress towards business efficiency
Pat Blewitt, EmdeonMaryland AHAAM
June 2009
Top 4 Issues - Legislative Day
1. Issue - National Payer Identification Number2. Issue - CMS Should Require the Adoption of a
National Patient Health Insurance ID Card3. Issue – Electronic Funds Transfer4. Issue – Claim Acknowledgement Transaction
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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).
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Why the Recommendation?
Mandated use of electronic funds transfers could cut $11 Billion per year from healthcare costs in the United States.
http://www.ushealthcareindex.com/index.php
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New Industry Forum Launched in December 2008:U.S. Healthcare Efficiency Index™
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Purpose • Create an industry forum for monitoring
business efficiency in healthcareVision • 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
Independent Advisory CouncilFritz Scheuren, Ph.DPatrick Baier, D.Phil.StatisticiansScheuren - Ruffner Andrew L. Naugle, MBAJohn L. Phelan, Ph.DMilliman, Inc. Jane Sarasohn-KahnHealthcare economist and author The Hon. Newt GingrichFormer House Speaker, and Founder, Center for Health Transformation The Hon. Phil JohnstonChair, Massachusetts DNC, former State Senator and former regional director at HHS Dave GaretsHIMSS Analytics Stanley Nachimson
Nachimson Advisors, LLC Erik SwansonWellpoint Fred Horowitz, DMDCooperative Exchange & Chief Executive Officer of Affiliated Network Services Richard NelliCooperative Exchange & Chief Technology Officer of CareMedic
Robin ThomashauerCouncil for Affordable Quality Healthcare (CAQH)
Eric WallaceLinxus / Greater NY Hospital Association Miriam ParamoreEmdeon
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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 independe
nt statistician
s
Data is scrubbed and de-identifie
d
Aggregated metrics
are extrapolat
ed
Independent, 3rd Party Statisticians
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Index Phases
Phase 1: Industry Data – 5 Basic Medical Transactions
Phase 2: Direct Data Collection and Reporting
Phase 3: Expansion – Pharmacy Index
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