Healthcare IT News - April 2008 - (Page 30)

30 Healthcare IT News April 2008 ■ payERS care and solidifies patient-provider relationships. He said the reduction in hospitalizations achieved by the Billings Clinic has not been achieved by payer-based interventions, but payers can play an important role by incentivizing physicians. CMS spokeswoman Ellen Griffith said the pilot was designed to determine the effectiveness of pay for performance for physician groups to achieve quality and cost efficiencies, and incentives to better coordinate inpatient care. CMS hopes to identify commonalities and differences in www.HealthcareITNews.com successful providerperformance year, based care manageof which $7.3 milment programs. lion was given to At the end of the two groups for first performance achieving quality year, all groups and cost efficiency improved the clini- The Billings Clinic has achieved key goals,” she said. cal management of goals in a CMS pilot. CMS expects diabetes patients, Griffith said. Two other groups to share in savings in groups achieved all 10 quality subsequent performance years as measure targets, and eight groups their initiatives evolve, she said. CMS improved scores on six or more dia- extended the demonstration for a fourth year. ■ betes quality measures. “A total of $9.5 million in savings More at HealthcareITnews.com was generated at the end of the first ●Connect: MoNtaNa 0408 e MonTana Continued from page 1 mostly older and living in remote, rural communities, using Pharos Innovations’ telephony and Internet-based program. Enrolled members called in health status data, and Pharos Innovations’ application triggered prompts to case managers if clinical intervention was required. F. Douglas Carr, MD, medical director at the Billings Clinic, said the cost of managing the patients is approximately $700,000 per year. “We can add 100 to 200 more patients without adding nurses because we can leverage the technology,” he said. Carr noted that documentation in electronic medical records and the Pharos Innovations’ tool let physicians manage their chronically ill patients themselves, achieving higher patient compliance and better outcomes. Randy Williams, CEO of Pharos Innovations, said the Pharos model engages patients to participate in self- Sometimes you just want a little more. Our award-winning editorial staff writes Healthcare IT News in a timely, concise manner to serve today’s busy executives. But occasionally you’ll read something that best leaves you wanting more. aETna Continued from page 28 That’s why we created Find the eConnect code below the article you’re reading, visit www.HealthcareITNews.com, and type in the code. You’ll get a list of relevant links that dig deeper into the topic. . Healthcare IT News’ : Another way we serve our readers best. < FIND Visit www.HealthcareITNews.com and you’ll ﬁnd the eConnect box in the upper right hand corner. 71 Pineland Drive, Suite 203 • New Gloucester, ME 04260 • (207) 688-6270 • www.medtechpublishing.com to provider satisfaction. A single sign-on will enable physicians to perform multiple transactions for all their payers. “We’re always looking for new ways for physicians to do business with us,” he said. Aetna will benefit through transactional efficiencies. By driving physician adoption of electronic transactions, call center activity and costs will decrease. The payer will be able to automate and enhance its content to educate its providers and deliver transparency. Marchetti said Aetna was impressed with NaviMedix’s innovation in automated provider communications, content management, security and broad reach – more than 390,000 providers use the multi-payer portal. Tom Morrison, executive vice president of marketing and product management for NaviMedix, noted the doubling of consumerdirected health plans from 2006 to 2007 is increasing the administrative complexity for both members and physician offices. “ There’s a growing sense among analysts and health plans that independent payer Web sites are not the way to go,” he said. In her perspective Lynne Dunbrack, program manager for Health Industry Insights, an IDC company, pointed out that HighMark, a Blue Cross Blue Shield plan in western Pennsylvania, was an early adopter of NaviNet. Within three years, the payer was able to move all referral and claims status inquiries through NaviNet instead of its call center. With an approximate cost of $8 per call versus 50 cents per e-transaction, HighMark achieved significant ROI. “Aetna has recognized that having a multi-payer tool is an effective way for providers to use the technology,” she said. She likens NaviNet to Amazon. com in that both allow a high volume of multiple transactions, and aggregate data and the marketplace under one portal. “It’s a powerful model from the consumer standpoint,” she said. ■ More at HealthcareITnews.com e Connect: aetNa 0408 ● HITNeConnect_TAB.indd 1 5/29/07 12:36:05 PM http://www.HealthcareITNews.com http://www.HealthcareITnews.com http://www.healthcareitnews.com/story.cms?id=8971 http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.medtechpublishing.com http://www.medtechpublishing.com http://www.HealthcareITnews.com http://www.healthcareitnews.com/story.cms?id=9007

Table of Contents Feed for the Digital Edition of Healthcare IT News - April 2008

Healthcare IT News - April 2008 Contents New Media Push Stepping Down BI Headaches Decision Grants Safety Alerts Summit 08 Growing an EHR Year 24

Healthcare IT News - April 2008

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