| 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.
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