Healthcare IT News - August 2007 - (Page 29)

www.HealthcareITNews.com August 2007 ■ Healthcare IT News 29 NEWSBRIEFS ChICago-BaSEd INSuRER to dEploy NEW tEChNology Destiny Health, a Chicago-based provider of wellness-based health insurance, will deploy technology to help the company monitor several health services, including disease management, utilization management, case management and maternity management. The technology suite, developed by New York-based ActiveHealth, is called CareEngine. Destiny Health has 50,000 members. Arthur Carlos, president and CEO of Destiny Health, said its members would benefit from the new technology, which engages members and their doctors with highly specific, targeted information. Payers central to Vermont pilot Project first step to health information exchange. By PaTTy ENrado, Contributing Editor RUTLAND, VT – Vermont is showing a high opt-in rate to its recently launched medication history project at two hospital emergency departments. Rutland Regional Medical Center and Northeastern Vermont Regional Hospital reported a 99 percent patient opt-in rate and retrieval of 74 percent of the medication history data for the 3,786 ED transactions that occurred in June 2007. of Vermont and MVP Health Inclusiveness among state “Everybody agencies, providers, payers, wants QualIty Plan – the latter three have held board member positions since consumers and businesses and EFFICIENCy VITL’s inception in July 2005. from the beginning was key The 26 percent of the transto the project’s success, said of care for actions in June 2007 that were Gregory Farnum, president vermont.” not retrieved comprised those of the Vermont Information – Gregory Farnum from self-pay plans, Medicare Technology Leaders. VITL, the nonprofit public-private partner- Part D and Cigna. VITL is working with Cigna to get its data ship tasked with establishing a statewide health consolidated and submitted. “Cigna has been information exchange, developed the project. Of the five payers in the state – Cigna, very positive,” Farnum said. Medicare, Medicaid, Blue Cross Blue Shield vErMoNT see page 31 MoNtaNa FaRMS out MoRE MEdICaId SERvICES The Montana Department of Public Health and Human Services has tapped Affiliated Computer Services (ACS) to provide managed care enrollment broker services for the state’s Medicaid Management Information System contract. ACS currently performs full fiscal agent functions for the Medicaid program, Mental Health Services Plan, Children’s Health Insurance Plan (CHIP) and Indian Health Services programs. ACS services include system development and maintenance and claims processing. S.C. Blues cultivate It talent Strategies run gamut from in-house to revenue generator. By PaTTy ENrado, Contributing Editor COLUMBIA, SC – Blue Cross Blue Shield of South Carolina’s computer training program, which marked its 10th anniversary recently, is going so strong that the company plans to expand it. A total of 245 people have completed the program, and BCBSSC plans to train 250 more within five years. The success of BCBSSC’s entry level training program exemplifies the health plan’s unique IT mission to grow its own talent and develop core IT competencies that bring in outside customers, thereby giving the insurer a competitive advantage. BCBSSC’s IBM data center is among the top 2 percent worldwide, according to Jack Canter, vice president and senior development officer. The health plan’s IT department processes por- Cigna to offer physicians new online service By PaTTy ENrado, Contributing Editor BLOOMSFIELD, CT – This fall, physicians in the Cigna HealthCare provider network will be able to obtain real-time precertifications on the Internet whenever they want. The online service will enable a more efficient workflow for the health plan’s 180,000-plus providers, said Lindsay Shearer, a spokesperson for Cigna. “Providers will no longer have to go through a series of telephone prompts or have the possibility of being put on hold,” she said. They will also be able to retrieve documentation of the transaction and response. “Providers will be able to do screen prints and have an audit trail of the transaction instead of just their own notes from the phone calls,” she said. Approximately 80 percent of Cigna’s provider offices have access to the Internet. CErTIfICaTIoN see page 31 BluES, othERS RECEIvE CoRE CERtIFICatIoN Blue Cross and Blue Shield of North Carolina, Blue Cross Blue Shield of Tennessee, the U.S. Department of Veterans Affairs and VisionShare, a provider of connectivity solutions, received certification to exchange or access consistent eligibility and benefits information required to verify patient health insurance coverage. The organizations recently completed a testing process that ensures their compliance with new standard business rules developed by the CAQH (The Council for Affordable Quality Healthcare) Committee on Operating Rules for Information Exchange (CORE). Lonnie Emard, an instructor with Blue Cross Blue Shield of South Carolina’s IT training program, helps a student during a recent class. aEtNa SIgNS CoNtRaCt WIth vEtERaNS aFFaIRS Aetna says it is the first national health plan to sign a participating provider agreement with the Department of Veterans Affairs for Aetna members who are also enrolled and receiving healthcare services from the VA. Healthcare providers participating with the VA now are recognized as in-network participating providers for all health plans administered by Aetna. The VA has 153 hospitals, 881 outpatient clinics and 135 nursing home care units. It is the largest integrated health care system in the United States. More at HealthcareITNews.com e Connect: PaYerS 0807 tions of eight Blues plans’ claims business, and supports processes of non-Blues health plans. Its subsidiary, Companion Data Services, won a Medicare enterprise data center contract to help the Centers for Medicare and Medicaid Services consolidate its claims processing. “By September of 2008, our data centers are projected to handle about 650 million Medicare claims per year and another 150 million per year for TRICARE and private insurance,” said Billy Quarles, BCBSSC spokesman. Whereas BCBSSC is known for its unique IT department, other Blues plans have taken a different approach. Each IT operation, however, reflects its own health plan’s business strategies. BCBS of North Carolina’s IT department comprises about BluEs see page 30 CMS proposes rule change By dIaNa MaNos, Senior Editor AGE of pay-for-performance programs Under one year One to under two years Two to under three years Three years or more Don’t know e ● Connect: GraPHS 0807 ● – The Centers for Medicare & Medicaid Services plans to change the rule for sending prescription orders via computer-generated facsimile. CMS is accepting comments, which may be submitted online, until Aug. 31, 2007. A final rule will be published later in the fall and will be effective for claims on or after WASHINGTON Jan. 1, 2008. The proposal promotes CMS’ strategy to encourage doctors to use digital data rather than computer-generated faxes. CMS has allowed an exemption for computer-generated faxes since the e-prescribing rule took effect Jan. 1, 2006. The rule change would eliminate the exemption. ■ More at HealthcareITNews.com e Connect: rule 0807 35% 21% 12% 25% 7% N = 57 Payer pay-for-performance survey, 2006. SOURCE: HEAlTH INDUSTRY INSIgHTS, AN IDC COMPANY ● http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=7594 http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=7524 http://www.healthcareitnews.com/story.cms?id=7523

Table of Contents Feed for the Digital Edition of Healthcare IT News - August 2007

Contents AHIC Redux IT Saving Lives IT, Wal-Mart Style OR Workflow Counting on Quality PHR Position Tapping Talent Slimming Down E-Prescribing Claims Processing

Healthcare IT News - August 2007

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