Healthcare IT News - October 2007 - (Page 43)

www.HealthcareITNews.com October 2007 ■ Healthcare It News 43 NEWSBRIEFS CIGNA CAll CENtER pASSES CERtIFICAtIoN muStER CIGNA HealthCare has been recognized for call center customer satisfaction excellence for a second consecutive year under the J.D. Power and Associates Certified Call Center Program. Located in Bourbonnais, Ill.; Bristol, Conn.; Chattanooga, Tenn.; Phoenix; Scranton, Pa.; Denison, Texas; and Visalia, Calif., CIGNA HealthCare’s call center operations handle more than 18 million telephone calls and e-mails from customers annually. To become certified, the call center operations successfully passed a detailed audit of its recruiting, training, employee incentives, management roles and responsibilities and quality assurance capabilities. UPMC plan creates its own PHR Health insurer wanted to step beyond portability and data mining. strong focus on data analysis to determine illness risk and wellness benefit for our members,” she said. “Toward that end, one of our highest priorities was immediate and By Patty Enrado, Contributing Editor unfettered access to certain data elements.” PITTSBURGH, PA – Since UPMC Health Plan The PHR has built-in interfaces that perlaunched its personal health record, or PHR, mit data sharing between the health plan in July, 26,000 unique users have viewed and the University of Pittsburgh Medical their information. Center. Both health “the upmC Health plan plan and health sysUnlike many recent payer-led PHRs, UPMC tem are discussing has a StRoNG FoCuS on Health Plan developed data analysis to determine linking the latter’s its platform in-house patient portals to the illness risk and wellness PHR so members after reviews of commercial applications did benefit for our members.” who use the health not meet its vision. system can access – Sharon Hicks UPMC Health Plan information relevant wanted more than just portability and to their conditions. data mining. “We wanted an application Through its enterprise data warehouse, that had all that functionality and that we which serves as the PHR’s foundation, could build onto as desired,” said Sharon UPMC Health Plan runs health algorithms Hicks, vice president of Internet strategy. against a member’s data – including health The payer eschewed hosted applications risk assessment, claims data and selfas well. “The UPMC Health Plan has a UPMC see page 45 AEtNA to pRovIdE pHRS FoR FEdERAl ENRollEES Hartford, Conn.-based Aetna officials say every federal enrollee who selects an Aetna medical plan will gain access to a password-protected, online personal health record beginning in January 2008. The PHR will provide a centralized resource for health information and deliver personalized alerts to improve healthcare. More than 26,000 Aetna federal enrollees already have access to an Aetna PHR. “We are committed to helping simplify and improve our members’ interactions with the healthcare system,” said Tom Bernatavitz, Aetna’s vice president of federal plans. “It is a great help for busy families trying to keep track of immunizations on their children, as well as for federal enrollees that travel. They can access their personal health information 24 hours a day, seven days a week from anywhere in the world.” UPMC Health Plan’s PHR has built-in interfaces that permit data sharing between the health plan and the University of Pittsburgh Medical Center. N.D. Medicaid deploys Colorado plan reaps master patient index data exchange value Initiate Systems’ Identity – As part of Hub will replace the departits Medicaid Management ment’s in-house system with Information System proj- a more robust matching algoect, the North Dakota rithm that will take Department of Human demographic inforServices is implementmation and match ing a Master Client against existing data Index, or MCI. structures. With the MCI, the “The biggest benefit state will be able to we hope it will allow us Jennifer Witham reduce the number of to see is to better idenduplicate clients during the tify clients across programs Medicaid registration and eli- for the Department of Human gibility process, said Jennifer Services,” said Witham. “We Witham, director of the IT can leverage other eligibility services for the department. daKota see page 46 By Patty Enrado, Contributing Editor BISMARCK, ND Access to data saves plan money, boosts quality. By Patty Enrado, Contributing Editor GRAND JUNCTION, CO – pERFoRmRx REAdIES FoR uRAC pBm ACCREdItAtIoN PerformRx is preparing for the new URAC Pharmacy Benefit Management Accreditation. URAC recently announced the availability of the program to the commercial market, and PerformRx participated in the review of URAC’s program for health plans and stand alone PBM organizations. “With PerformRx providing the next generation of pharmacy benefit management services, it made sense for us to become a part of URAC’s push into the commercial market,” said Mesfin Tegenu, president of PerformRx. “The time has come for pharmacy benefit management services to be equipped with a measuring stick to promote the industry’s best practices, encourage quality improvement, and protect and empower consumers.” More at HealthcareItnews.com e Connect: PaYerS 1007 Share of total health plan budget devoted to pay for performance, 2006 and 2007 Percent of respondents ● e ● Connect: GraPHS 1007 SoURCe: HeALTH INDUSTRy INSIGHTS’ U,S. HeALTHCARe PAyeR PAy-foR-PeRfoRMANCe SURVey, 2006 As one of the founding partners and major funder of the Quality Health Network, or QHN, Rocky Mountain “ultimately, Health Plans saw from the begin- we’re doing this ning the benefit so we can pull of being part of data back.” a health information exchange, or – John Hopkins John Hopkins HIE. Less than three years since diabetic registry is not easily QHN first formed, Rocky scalable. Automating the proMountain Health Plans is work- cesses through Web-based data ing on projects that will contin- collection will make the program ue to reap benefits for all stake- even more valuable, he said. holders, said John Hopkins, Hopkins agreed. “It will be president and CEO of Rocky simpler for provider offices to Mountain Health Plans. administer the program and The health plans are provid- services and increase admining QHN with membership and istrative efficiencies,” he said. eligibility data that will enable “This will let us get more folks real-time verification of health involved through expanding the insurance when a member seeks program and expanding geohealthcare services. “Ultimately, graphically.” we’re doing this so we can pull The main focus remains getdata back,” he said. ting hospitals, physicians, labs Rocky Mountain Health Plans and clinics engaged in QHN’s won a 2006 AHIP Innovation CoLorado see page 45 and Excellence Award for its Improving Diabetes Outcomes in the Mesa County program. It is in the process of making the registry electronic. Dick Thompson, executive director of Quality Health Network, which covers Western Colorado, said the paper-based http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=7856

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Healthcare IT News - October 2007 Contents Global Harmony Telegrowth New Rules Keeping Tabs What's Free? PHR of Its Own Intelligent Closing Practice Management Paper Tiger

Healthcare IT News - October 2007

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