Healthcare IT News - March 2008 - (Page 30)

30 Healthcare IT News March 2008 ■ pAYERS www.HealthcareITNews.com BCBSMa calls for hospitals to use CPoe By Molly MErrIll, Associate Editor FraUd Continued from page 28 – Computerized physician order entry will soon be required for hospitals participating in Blue Cross Blue Shield of Massachusetts’ new incentive plan. BCBSMA officials said last month they would include the standards, to be established by the Massachusetts’ CPOE Initiative, as a threshold for participating in their quality and incentive programs after 2012. BCBSMA’s Primary Care Physician BOSTON Incentive Plan and Hospital Quality Improvement Plan allow both providers and hospitals to participate in an incentive program that rewards them for meeting certain nationally recognized quality standards and patient safety goals. “BCBSMA believes that the Massachusetts CPOE Initiative has made a compelling case for hospitals in Massachusetts to implement CPOE both from a quality and a financial perspective,” said Robert Mandel, MD, vice pres- ident of health care services for BCBSMA. “This is the quality of healthcare that our members should expect - and it is the quality of healthcare they deserve.” The Massachusetts CPOE Initiative projects that, 26 months after implementation, the system will provide annual savings of $2.7 million per hospital, with a total savings of $170 million per year throughout the state. More at HealthcareITNews.com e Connect: CPoe 0308 ● increasingly complex to implement and administer, said Wilson. McGinley noted that payers understand they can’t rid themselves of fraud. “Plans are becoming more receptive to managing risk through shared resources,” he said. Young said TriZetto Group’s acquisition of Plan Data Management back in 2006 was consistent with the company’s long-term strategy of integrating business-centric and critical applications, such as care management and network management, with its core data administration system. The bottom line, Young said, is having the ability to rapidly and easily access updated data. ■ More at HealthcareITNews.com e Connect: FrauD 0308 ● Towards the Electronic Patient Record Explore How IT is Revolutionizing Healthcare Learn how to prepare for future healthcare in all segments (providers, payers, and others) Identify the functions of the hospital of the future Explore how hospitals are saving money with health IT Discover how physicians can attract and keep patients with EMRs and health IT See how consumer activities will change healthcare Understand the legal aspects of EMRs and HIT New Ne cellphone applications for PHRs patient medication management and other care. roI Continued from page 28 24th Annual Conference & Exhibition May 17 - 21, 2008 Fort Lauderdale, Florida For more information visit www.TEPR.com or call (617) 964-3923 x 203 e for a copy of the full conference brochure. ● Connect: tePr 0308 savings from the year-long program, according to Dennis Sponer, president and CEO of ScripNet, a pharmacy benefits manager that works with workers’ compensation insurance carriers and pharmacies to streamline the prescription medication process for injured workers. An average of 76.4 percent of participants in the Call Ahead Program were prescribed generic drugs, as opposed to 70.4 percent of those not in the program. An average of 94.8 percent of claims was electronically adjudicated compared with 89.2 percent of claims for the non-participants. As a result, the Call Ahead Program produced an average of 21.2 percent savings over the average of 17 percent savings for non-participants, said Sponer. The Call Ahead Program sends an automated phone call to injured workers after they receive their workers’ compensation card, on behalf of their employer and health plan, to make sure they are aware of the medication process services. The goal is to keep injured workers from going out of network for their medications, Sponer said. The calls also allow injured workers to access a live person for questions. ScripNet’s interface with carriers for pre-authorization eliminates the paper process at the point of sale. Pharmacists access ScripNet’s database to determine in real-time such things as drug incompatibility, too-soon refills, drug utilization review, and other safety and cost information. John Aforismo, chairman and CEO of RJ Health Systems International and pharmacist consultant for ScripNet, said the ScripNet card ensures the pharmacist will be compensated by the health insurer and eliminates the need to file a claim. It makes pharmacy transactions efficient and in real-time. ■ More at HealthcareITNews.com e Connect: roI 0308 ● http://www.HealthcareITNews.com http://HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8885 http://www.TEPR.com http://HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8879 http://HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8880 http://www.TEPR.com

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Healthcare IT News - March 2008 Contents No. 1 E-prescribing ‘Quite Bright’ Bill Frist on IT Google Connection Poised for P4P ‘Smashing Success’ Tough On Fraud It's Analytics Getting Rid of the Pain Stuck In Neutral

Healthcare IT News - March 2008

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