Healthcare IT News - December 2007 - (Page 30)

30 Healthcare IT News December 2007 ■ www.HealthcareITNews.com NEWSBRIEFS Rocky MouNtaIN autoMatES coNtRact MaNagEMENt Colorado-based Rocky Mountain Health Plans has deployed technology to help manage and track the performance of its contracts. The plan rolled out the Choreo Suite, developed by Portland, Ore.-based Kryptiq, to automate manual workflows. Rocky Mountain Health Plans provides medical benefit plans and services to more than 176,000 enrollees. The technology has helped Rocky Mountain better compete, said Dale Renzi, director of network and business system development at Rocky Mountain Health Plans. Real-time top trend in claims Payers advised to focus on multi-payer solutions to impact provider adoption. ■ Physicians spend more than $8 per patient to send out statements. ■ Providers write off approximately 7 percent of their revenues to bad debt, according By PaTTy ENrado, Contributing Editor to a 2006 ARM Report. ■ Many coinsurance plans ask that private NEW ROCHELLE, NY – The growth of consumerism, health savings accounts and self-paying pay balances are collected after the payer patients is making real-time claims adjudica- adjudicates the claim. tion at the point of service increasingHumana’s 2005 research revealed ly critical to payers and their network that payer-developed real-time claims providers. adjudication technology has to be inteThe financial impact is acute, said grated into a provider’s practice manKenneth Willman, national direcagement system to avoid duplicated tor of provider interface at Humana. efforts and accept multiple payers. Speaking at a Corporate Research Through Availity, a joint venture Group Web seminar titled Moving Kenneth Willman formed by Humana and Blue Cross Blue Ahead with Real-Time Claims Adjudication, Shield of Florida, Humana launched pilots in Willman noted: 2006 to accept claims in real-time. ■ Physicians only collect a small percentage Provider adoption rate at the pilot sites of a patient’s responsibility after the patient has been “overwhelming,” with some sites leaves the office. rEalTImE see page 31 MaSSachuSEttS BluES pRovIdE NEW WEB SERvIcES Blue Cross Blue Shield of Massachusetts has tapped Mountain View, Calif.-based eHealth, Inc. the parent company of eHealthInsurance, to provide the health plan with an e-commerce platform. The licensing agreement between the insurer and eHealth provides individuals and families in Massachusetts with access to eHealth’s proprietary health insurance shopping technology, enabling them to review quotes, compare plans side by side and apply for coverage through the Blue Cross Blue Shield of Massachusetts Web site. Your personal coach calling with key advice HEalTHCarE IT NEws sTaff Diabetic pilot shows how it’s done Horizon BCBS, collaborates with physician group. By PaTTy ENrado, Contributing Editor Humana’s 2005 research revealed that payerdeveloped real-time claims adjudication technology has to be integrated into a provider’s practice management system aEtNa.coM EN ESpañol taRgEtS hISpaNIc coNSuMERS A new Spanish-language Web site from Hartford, Conn.-based Aetna is designed to make it easier for Hispanic consumers to learn about Aetna products, services and network of providers. Aetna.com en Español also provides information and tips about health benefits to help Hispanics choose benefits plans that best serve them and their families. “More than 32 million U.S. residents speak Spanish at home, and many Hispanics prefer to receive information about health benefits in Spanish,” said Raymond Arroyo, Aetna’s chief diversity officer. – Healthcare insurer Humana has launched a weight and health management program that uses mobile phones as “personal digital coaches.” Boca Raton, Fla.-based Sensei, owned in part by Humana, sends multimedia weight-loss advice to cell phone users for a weekly fee beginning at $5.75. The service is currently available to Sprint and AT&T mobile phone users. The program delivers customized meal and fitness recommendations, shopping lists, and motivational messages. ■ LOUISVILLE, KY More at HealthcareITNews.com e Connect: coacH 1207 ● – A pilot program begun a year ago to aid diabetic patients enrolled in New Jersey’s State Health Benefits Program has delivered successful clinical and financial outcomes. Collaboration and the technology to enable care coordination among payer, physician organization and individual physicians were critical components, said Andrew Schuyler, MD, executive medical director of Horizon Blue Cross Blue Shield of New Jersey. Horizon Blues deployed MED-ecision’s platform to proNEWARK, NJ vide Partners In Care, a physi- said O’Brien. “ The trend cian organization, and individ- appears to have been mitigatual physicians involved in the ed, if not neutralized.” patient’s care management with While 1,400 patients were inirelevant data in real-time. tially identified as diabetics, 900 The comprehensive care were diagnosed as true diabetcoordination pilot ics, with the remaining resulted in an improve500 redirected for addiment of HEDIS complitional coordination. ance from 43 percent to James Barr, MD, med80 percent within nine ical director of Partners months, said Kevin in Care, said one of O’Brien, CEO of PIC. his patients, whom he The number of pa- David St. Clair hadn’t seen in more tients documented as having than a year, had been identitheir diabetes “under control” fied as diabetic. Data revealed grew from 32 percent to 56 multiple acute conditions that percent within nine months. would have resulted in poor and And physician participation in high-cost outcomes if no interthe program has grown from vention had occurred. 10 to 350 practices. Instead, Barr was viewed by “Costs are better controlled,” dIaBETIC see page 31 NEW haMpShIRE MEdIcaId ExtENdS dM coNtRact The New Hampshire Department of Health and Human Services has extended its Medicaid disease management program with McKesson Health Solutions for another year. The original program began during the State’s 2005 fiscal year. The one-year renewal began Oct. 1, 2007 and lasts through Sept. 30, 2008. The statewide service helps more than 4,400 eligible Medicaid clients who have asthma, diabetes, heart failure, coronary artery disease, COPD (chronic obstructive pulmonary disease), end stage renal disease and chronic kidney disease. More at HealthcareITNews.com e Connect: PaYerS 1207 chaNgES IN tEchNolgy adoptIoN coME IN tWo FactoRS Boomers and seniors have different online health research habits REAL GROWTH: The change in ownership due to new adoption of technology. AGING SHIFT: The apparent change in ownership due to consumers’ change in age. Healthways deploys portal for 27M By BErNIE moNEgaIN, Editor ● 2001 e ● Connect: GraPHS 1207 SOURCE: FORRESTER RESEARCH – Healthways, a disease management company that works with health plans to keep costs in check, has deployed a multi-million patient health and wellness portal for its members. Healthways’ new self-service site makes it possible for its 27 million members to download personalized documentation designed to promote wellness among healthy individuals; slow the progressions of disease associated with family or lifestyle risk factors; and promote the best possible health for those already affected by disease. IBM and business partner Mainsoft Corp. will provide interoperabilARMONK, NY ity between proprietary and open standards-based software systems, helping Healthways “cross the .NET-Java EE software standards divide,” as they put it. Using WebSphere Portal and Mainsoft software, Healthways completed a security-rich electronic fulfillment site, with personalization based on the members’ plans and individual health needs. “We knew we needed a portal solution simply because an enterprise portal makes the most sense for how we do business,” said David Jarmoluk, director of enterprise architecture for Healthways. ■ More at HealthcareITNews.com e Connect: Portal 1207 ● http://www.HealthcareITNews.com http://www.Aetna.com http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8198 http://www.HealthcareITNews.com http://www.HealthcareITNews.com http://www.healthcareitnews.com/story.cms?id=8201 http://www.healthcareitnews.com/story.cms?id=8200

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Healthcare IT News - December 2007 Contents Paying Docs Seal of Approval Key to Success Stage 4 Stark Payoff New Kids on the Block Real-time Trend On the Block Picture Perfect Head of the Class

Healthcare IT News - December 2007

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