Healthcare IT News - November 2007 - (Page 33) www.HealthcareITNews.com November 2007 ■ Healthcare IT News 33 NEWSBRIEFS AEtNA’S pIlot dRug pRogRAm to BE ExpANdEd to N.Y., CoNN. Health insurer Aetna, Inc. has announced plans to expand its pilot electronic prescription program after the program showed growth in the use of generic and formulary drugs. The pilot program was conducted in New Jersey, where doctors were given handheld devices through a collaboration with Zix Corp. Aetna officials say the program showed growth of 5 percent to 7 percent in the use of generic and formulary drugs, respectively, and will be tried next in New York and Connecticut. Payers urged to take collection role Assuming responsibility may be a tough sell. By PaTTy ENrado, Contributing Editor dIStRICt oF ColmBIA AWARdS mEdICAId CoNtRACt to ACS The District of Columbia’s Department of Health, Medical Assistance Administration has signed a seven-year, $111 million contract re-bid award with Affiliated Computer Services, Inc. of Dallas to continue operating the district’s Medicaid Management Information System. ACS has been the district’s Medicaid fiscal agent since February 2001, and the company received certification for the district’s current MMIS system from the Centers for Medicare & Medicaid Services in 2004. First Consulting Group has released a white paper with recommendations for health plans to help providers collect fees from self-pay patients. While many payers already have IT-based payment solutions in place, proactively collecting funds on behalf of the provider is the most radical recommendation. FCG highlighted UnitedHealth Group’s OnePay program, in which the health plan LONG BEACH, CA – pays the patient’s part of the bill to the provider after the claim is adjudicated. UnitedHealth Group either withdraws from the patient’s health savings account, or HSA, or charges the patient a credit line, which is refunded through direct payroll deductions. Providers agree to a discounted rate and the program is executed through UnitedHealth Group’s Exante Bank service. UnitedHealth Group, however, has discontinued this program after its one-year pilot. “There wasn’t a high adoption rate among physicians and hospitals,” said spokesman Daryl Richard. UnitedHealthcare is “going back to the lab,” taking what it has learned and applying it to new or existing programs. “The guiding principle is to make it simpler to pay for healthcare expenses,” he said. DeLeys Brandman, vice president at FCG, said payers are still better positioned to leverage their existing technology and processes to collect on behalf of their providers. “Health plans are still experimenting with new HSAs and HRAs, or health reimbursement accounts, which is easy and CollECT see page 35 Midwest HMO puts communication technology to work communications. Medica, a comWelcome calls, which were mercial and Medicaid HMO, limited to Medica’s large recently unveiled return on accounts because they were investment – fewer claims “healthcare denials, greater efficiency and customer retention communications – derived from its autois the key mated call programs. strategy for Medica implemented the programs, using retaining technology developed by members. this Silverlink in the spring of is a top five priority for 2005 to reach its 1.3 milmanaged care CEos.” lion members in the upper Midwest in more direct – Stan Nowak ways and through different channels. done manually, have now been Response time for notifica- expanded to a much larger poptions, typically done by mail, ulation. “We saw modest cost were reduced anywhere from savings,” he said. two weeks to a month to a couBussey said the orientaple of days, said Larry Bussey, tion of benefits provided in the director of Medica’s corporate CallINg see page 34 By PaTTy ENrado, Contributing Editor MINNEAPOLIS – WEllpoINt, ZAgAt joIN FoRCES to oFFER phYSICIAN RAtINgS Wellpoint Inc. is teaming up with Zagat Survey to launch a new online tool that will allow customers of the nation’s largest insurance company to share their physician experiences with others. The company will offer the online survey beginning in January 2008 to select members in its Blue Cross and/or Blue Shield licensed subsidiaries. The survey will allow customers to review their doctor visits based on four criteria: trust, communication, availability and environment. An available rating system will be based on a 30-point scale. The Scott & White Center for Diagnostic Medicine, part of the Scott & White Health Plan in Texas, saw increased efficiency and improved accountability when the HMO automated its contract management process in 2005. It helps texas plan manage its contracts implemented Kryptiq’s Choreo Contract Manager, which went live in April 2007. While the goal was to automate processes to handle the increase in contracting, the solution handled unique provisions and contract standardization, which helped improve cost structure. While a lot of payers have invested in such initiatives as auto-adjudication, network management systems are where the real cost savings are, said James Lawson, director of account management for Kryptiq. “It’s the backbone, the starting point, for how a health plan can manage contract portfolios and change the revenue picture,” he said. Although Lawson said the last decade has seen little change in manual processes, a competitive landscape is driving health plans CoNTraCTs see page 35 By PaTTy ENrado, Contributing Editor BCBS oF louISIANA to oFFER ACCESS to FREE oNlINE phRS Blue Cross and Blue Shield of Louisiana has announced that it will give many of its customers free access to its new personal health record service, where they can store and organize important health information in a secure, password-protected online record. Powered by MedMD, the PHR will store essential health history, current treatments and personal health habits and will remain accessible to the customer even after he/she leaves Blue Cross. Customers can also use the PHR to track lab test results and other measurements and identify potentially harmful interactions among medications, herbal supplements and vitamins. More at HealthcareITNews.com e ●Connect: PaYerS 1107 As a regional plan serving central Texas, Scott & White Health Plan’s medical delivery system comprised one large medical group and hospital. When it expanded its network dramatically in 2005 – increasing its provider contracts tenfold – the HMO automated its contract management process. Scott & White Health Plan saw the potential to use technology to help gain efficiency, reduce management effort and improve accountability for its contracting process, said CEO Allan Einboden. “Our value proposition is that we don’t spend as much on administration,” he said. “We have to operate efficiently, and technology has to play a big role.” Scott & White Health Plan TEMPLE, TX – Health plan products with pay-for-performance initiatives HMO All healthcare products Medicare Medicaid PPO e ● Connect: GraPHS 1107 41% 35% 28% 19% 18% 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=8051
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