Monitoring the healthcare industry’s progress towards business efficiency

Pat Blewitt, EmdeonMaryland AHAAM

June 2009

Top 4 Issues - Legislative Day

1. Issue - National Payer Identification Number2. Issue - CMS Should Require the Adoption of a

National Patient Health Insurance ID Card3. Issue – Electronic Funds Transfer4. Issue – Claim Acknowledgement Transaction

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AAHAM Requested Action

AAHAM requests that Congress encourage & CMS/HHS take action towards a rule requiring all payers required to use the HIPAA 835 transaction also be required to pay providers using electronic Funds transfers (EFT).

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Why the Recommendation?

Mandated use of electronic funds transfers could cut $11 Billion per year from healthcare costs in the United States.

http://www.ushealthcareindex.com/index.php

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New Industry Forum Launched in December 2008:U.S. Healthcare Efficiency Index™

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Purpose • Create an industry forum for monitoring

business efficiency in healthcareVision • Raise awareness of potential savings and

reframe the national dialogue on health reform

Goals• Establish single national reference• Track progress across the industry• Remove barriers• Take costs out of healthcare

ushealthcareindex.com

Potential Savings: $30 Billion per Year

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Independent Advisory CouncilFritz Scheuren, Ph.DPatrick Baier, D.Phil.StatisticiansScheuren - Ruffner Andrew L. Naugle, MBAJohn L. Phelan, Ph.DMilliman, Inc. Jane Sarasohn-KahnHealthcare economist and author The Hon. Newt GingrichFormer House Speaker, and Founder, Center for Health Transformation The Hon. Phil JohnstonChair, Massachusetts DNC, former State Senator and former regional director at HHS Dave GaretsHIMSS Analytics Stanley Nachimson

Nachimson Advisors, LLC Erik SwansonWellpoint Fred Horowitz, DMDCooperative Exchange & Chief Executive Officer of Affiliated Network Services Richard NelliCooperative Exchange & Chief Technology Officer of CareMedic

Robin ThomashauerCouncil for Affordable Quality Healthcare (CAQH)

Eric WallaceLinxus / Greater NY Hospital Association Miriam ParamoreEmdeon

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Data collection, extrapolation, and publication

Every quarter contributors enter data at the secure,

password protected Index website

EDI Savings

Avg. Monthly Volumes

% of Volumes

in EDI

Payers Providers Clearinghouses

Publicly Available National Efficiency Metrics

Data goes directly to independe

nt statistician

s

Data is scrubbed and de-identifie

d

Aggregated metrics

are extrapolat

ed

Independent, 3rd Party Statisticians

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Secure Website & Login

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Index Phases

Phase 1: Industry Data – 5 Basic Medical Transactions

Phase 2: Direct Data Collection and Reporting

Phase 3: Expansion – Pharmacy Index

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what would u do w/ $30 B?

ushealthcareindex.com

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