Managed Care Information Center
MCIC Home
E-Mail MCIC
Site Navigation:
E-mail a Friend
FREE E-Mail Newsletters
Subscribe to the leading management newsletters
Search
Search
Affiliates
Health Resources Online
* * *
Health Resources Publishing
* * *
Wellness Junction
* * *
Healthcare Intelligence Network
Contact MCIC
info@themcic.com

Managed Care Information Center
1913 Atlantic Ave., Suite F4
Manasquan, NJ  08736
(732) 292-1100
fax: (732) 292-1111

Home / News & IndustryManaged Care Insight and Analysis
Updated: September 15, 2009
Payerview Rankings Keep Tabs on Top National Health Insurers

An annual project of athenahealth and Physicians Practice journal, PayerView Rankings is an effort to provide objective data about our nation's health insurers.

Data from 2009's PayerView Rankings-evaluating 172 national, regional, and government payers in 40 states- supports current government and industry efforts to reduce administrative costs and expand access to healthcare through greater automation and transparency of information.

PayerView ranks health insurers according to specific measures of financial performance, administrative performance, and medical policy complexity, such as:

  • Days in accounts receivable;
  • Denial rates;
  • Payer payment speeds;
  • Adherence to Medicare standards, and others.

The PayerView Rankings are designed to look at payers' performance based on these categories which combine to provide an overall ranking aimed at quantifying the "ease of doing business with the payer."

All data used for the rankings come from actual claims performance data of athenahealth providers. The rankings include national payers with at least 12,000 charge lines of data and regional payers with a minimum of 20,000 charge lines.

This year's top ranking position among national payers was taken by Humana Inc., with Aetna in second, and CIGNA in third. The top eight are prominently listed on the athenahealth site.

"Receipt of fast, accurate payments is critical to effectively managing the business operations of physician practices," William F. Jessee, MD, FACMPE, president and CEO of the Medical group Management Association (MGMA) said. "While MGMA commends Humana for this important achievement there remains considerable room for improvement across the industry."

In the largest data set to date, using performance data from more than 18,000 medical providers representing over 41 million medical charge lines and $7 billion in charges billed to payers in 47 states (for all four quarters of 2008).

This year's rankings indicated national health insurers are paying physicians 5.3 percent faster and denying 9 percent fewer medical claims over the prior year.

This year's highlighted programs include automating various claim billing work conducted by physician practices in an effort to address growing healthcare administrative costs, and streamline claims processing to allow providers and their staff to focus more on delivery of care.

This comes after findings from The Commonwealth Fund and Robert Wood Johnson Foundation's Changes in Healthcare Financing and Organization (HCFO), which determined physicians on average are spending the equivalent of three work weeks annually on administrative and medical billing tasks.

"With much of the current attention and dialogue on healthcare reform focusing on driving greater use of electronic health records, our latest PayerView data and ongoing collaborative efforts with payers illustrate the tremendous challenges and opportunities that exist in addressing the billing and administrative breakdown in our care delivery system which represents the largest source of cost waste and burden for doctors and their patients," said Jonathan Bush, Chairman and CEO of athenahealth.

For more information on athenahealth, visit www.athenahealth.com.


  This article was taken from:
Pay-For-Performance Reporter

Free Trial Subscription

Become a Subscriber

    Back to This Week's List of Articles

"Managed Care Weekly Watch"
Subscribe Here

Email:

Name:

 
Top | Home


Resource of the Month | Database of MCOs | Publications | News & Industry | Surveys & Research | Free Products | Advertising Arena | Inside MCIC | Managed Care Archives | ManagedCareMarketplace.com | For Subscribers | Customer Service

©2009 The Managed Care Information Center