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Greater Houston Healthconnect Expands Network

Greater Houston Healthconnect Expands Network | Healthcare and Technology news | Scoop.it

GreaterHouston Healthconnect, a regional health information exchange (HIE) in Houston, has just added CHI St. Luke’s Health, a major health player in Texas, to its network.


Houston’s CHI St. Luke’s earlier announced its intention to build a broad network of primary care and specialty physicians to complement its six hospitals, three emergency centers, and other service locations. With population health as a key goal, the CHI St Luke’s network will utilize access to patient health information from any of the participating Healthconnect facilities in order to achieve clinical integration, manage transitions of care, and improve long term health outcomes, its officials say.


“CHI St. Luke’s and our network of partner physicians are endeavoring to reach patients where they are in the community by offering them flexibility of care options and smart information systems to help them stay healthy,” Michael Covert, the organization’s president and CEO, said in a statement. “As part of Greater Houston Healthconnect we’re letting our patients know that we care about them no matter where they had or will receive care in the future. Their medical information should follow them wherever they go―seamlessly. We need a neutral, community-based organization to accomplish that.”


Healthconnect partners with the Texas Health Services Authority (THSA), the statewide body responsible for connecting regional HIEs throughout Texas. Greater Houston Healthconnect currently has agreements with 284 healthcare organizations, representing over 50 percent of area hospital beds and 40 percent of physicians. Millions of patient records are available for query through the exchange and almost all major Texas medical center institutions participate, officials say.


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$8 Billion Annual Savings Opportunity for U.S. Healthcare With Adoption of Electronic Business Transactions

$8 Billion Annual Savings Opportunity for U.S. Healthcare With Adoption of Electronic Business Transactions | Healthcare and Technology news | Scoop.it

U.S. healthcare could save $8 billion annually by transitioning six routine business transactions from manual to electronic, according to the newly published 2014 CAQH Index™. The CAQH Index tracks progress from manual (e.g., via phone, fax or mail) to industry standardized (HIPAA) electronic administrative transactions between health plans and healthcare providers. This annual report, the second from CAQH, details adoption rates and potential savings.

“Hospitals should be focusing on patients, not paperwork. By expanding automated electronic communications between providers and health plans, we can reduce health care costs, ease administrative burdens, and ensure that key stakeholders in our health care system communicate with each other more effectively,” says Joel Perlman, Executive Vice President, Finance, and Chief Financial Officer, Montefiore Medical Center.

Based on data from 2013, the 2014 CAQH Index represents a collaboration between healthcare providers and health plans. Data submitted includes administrative transactions and cost estimates for analysis. The report reflects data from participating health plans representing 112 million enrollees – almost 45 percent of the privately insured U.S. population – on more than four billion transactions. In addition, a range of healthcare facilities and provider practices participated in a data collection process conducted on behalf of CAQH by Milliman, Inc.

Both this and the prior year’s CAQH Index studied six transactions — claim submission, eligibility and benefit verification, prior authorization, claim status inquiries, claim payment, and remittance advice transactions. This enabled year-over-year comparisons between health plans providing data counts for both reports. CAQH also measured two transactions for the first time: claims attachments and prior authorization attachments.

While overall adoption rates of fully electronic transactions (those automated for both health plans and healthcare providers) rose only slightly during this period, the volume of fully electronic transactions grew by double-digit rates for eligibility and benefit verifications, claim status inquiries and claim payments.

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.

“The CAQH Index shows that additional progress to realize the full potential of electronic transactions requires an ongoing commitment by all healthcare stakeholders, including health plans, providers, vendors and government,” says Robin Thomashauer, Executive Director, CAQH. “Findings can inform industry initiatives such as CAQH CORE and CAQH Solutions that support the move towards greater use of electronic transactions.”

Health plans and providers can estimate their potential cost savings by using an interactive savings calculator available at www.caqh.org. The complete 2014 CAQH Index report and highlights are also available for download.

The 2015 CAQH Index is underway, and is seeking additional participants. Health plans and providers that participate will receive a confidential, independent assessment of how they compare to their industry peers.

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