Data collection center to start measuring payers' efficiency

By Molly Merrill
10:20 AM

A national data collection center has been launched to monitor business efficiency in healthcare by tracking electronic adoption and resulting cost savings.

Officials say primary data collection will begin with healthcare payers, but will later be opened up to providers and clearinghouses to provide a complete view of the industry.

The center was launched by the Advisory Council for the U.S. Healthcare Efficiency Index, an industry forum founded by Nashville, Tenn.-based revenue cycle management provider Emdeon, for monitoring business efficiency in healthcare and tracking the transition from a paper- and phone-based healthcare system to an electronic one.

The first phase of the index, launched in December 2008, focused on analyzing industry data available through research reports and other sources. It identified an estimated $300 billion in potential savings over 10 years for five basic medical claims-related transactions.

The second phase, launched this week, marks the beginning of primary data collection, beginning with major healthcare payers. Payers will submit data to the center through a Web portal. The non-identifiable data will be sent to statisticians at Scheuren-Ruffner Consultants of Alexandria, Va., where it will be aggregated and analyzed. Milliman, Inc., a global consulting and actuarial firm, will then validate the findings based on the methodology developed and approved by the advisory council.

The findings will be published as part of the first National Progress Report on Healthcare Efficiency, which is planned for release in early 2010.

The five transactions that are being tracked to measure electronic adoption and facilitate calculation of the associated cost savings are eligibility verification, claim submission, claim status, claim payment and claim remittance.

"This is a critical time as Congress struggles with how to design and fund healthcare reform. By serving as a central reference for tracking healthcare administrative efficiency, the index provides a roadmap for additional healthcare cost savings that can help pay for reform," said Miriam Paramore, senior vice president of corporate strategy for Emdeon.

Officials say plans are under way for later phases of the index, including development of a pharmacy safety and adherence index.

The advisory council also announced the addition of new members:

  • Phil Johnston, president and CEO of Johnston Associates, former regional administrator for the U.S. Department of Health and Human Services and former Massachusetts state representative;
  • Robin Thomashauer, executive director of the Council for Affordable Quality Healthcare (CAQH);
  • Tom Meyers, executive director of America's Health Insurance Plans (AHIP);
  • Eric Wallace, executive director of Linxus;
  • Fred Horowitz, a member of the board of directors of the Secure EDI Health Group (representing the Cooperative Exchange);
  • Richard Nelli, chief technology officer of CareMedic Systems (representing the Cooperative Exchange); and
  • Gregory Fisher, director of EDI Business Development for UnitedHealthcare.

"As the rhetoric on healthcare reform gets louder, it's important to find a common set of principles that address our most pressing needs,"  said Johnston. "Reducing waste is something we can all agree on. I am happy to join the index and shine light on the significant dollars that could be saved – to prevent cuts to programs or pay for other reforms."

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