Whitepaper Exposes Healthcare Administrative Waste

Practical Steps for Cutting Healthcare Costs through Existing Infrastructure & Collaboration

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The U.S. economy transmits over 18 billion electronic payments each year, yet approximately half of all healthcare financial transactions are still paper-based. Costs of paper, printing, postage and labor for manual processes in healthcare are estimated to add up to nearly $30 billion a year in waste. As healthcare reforms are considered in Washington and in all 50 states, administrative savings represent a bright spot—low-hanging fruit—that could help pay for longer-term reforms. To help inform this dialogue, Emdeon, in cooperation with the Center for Health Transformation, unveiled an important whitepaper at the HIMSS 2009 Annual Conference in April. The whitepaper, "Taking the Paper Out of Paperwork: How Electronic Administration Can Save The U.S. Health System Billions", looks at the gaps in the industry that keep it dependent on manual processing—and offers practical steps for breaking this costly and inefficient cycle. "In these trying economic times, combined with the specter of unsustainable spending, Medicare insolvency and runaway growth in Medicaid, we must find those IT solutions that can not only save lives but can also lower costs," said Former House Speaker Newt Gingrich, founder of the Center for Health Transformation. For more of the Speaker's message, view the video foreword to the whitepaper. The whitepaper provides a step-by-step roadmap for both payers and providers and highlights best practices that are delivering tangible results today. This pragmatic approach leverages technology and infrastructure that already exist—and provides a vision for a new kind of industry collaboration. Recommendations outlined in the whitepaper include:

For Payers
* Develop and pilot reimbursement programs that reward quality healthcare practice and results, including electronic information exchange.
* Ensure all future information technology development is done according to industry standards.
* Collaborate around multi-payer functionality, understanding that providers want a single resource for interacting with health plans.

For Providers
* Keep abreast of federal funding opportunities for health information technology.
* Include process re-engineering for an electronic end-to-end eligibility, claims and payment process in electronic medical record (EMR) implementation strategies.
* Work with medical societies and specialty groups to advance national standardization goals.

Download the whitepaper.

New Payers On-Board



Emdeon is pleased to announce the following payers as part of our constantly expanding network:


• American Behavioral
• AmeriChoice of New Jersey, Inc. (Medicaid NJ)-Claims
• Automated Group Administration, Inc.-Claims
• Benefit Management, Inc. of KS-Claims
• Blue Cross of Oregon-ERA
• Blue Shield of Idaho-ERA
• CAHABA HomeHealth-ERA
• Cenpatico-FL-Claims
• Children First Medical Group-Claims
• DeltaCare USA Claims-Claims
• DeltaCare USA Encounters-Claims
• Employers Health Network, LLC-Claims
• Entrust-Claims
• Freedom Blue Medicare Advantage Claims-ERA
• Hawaii Medical Service Association (HMSA)-ERA
• Health Choice Generations-Claims
• Health Net of California and Oregon-Claims-Rosters
• Health Network One-Claims
• InterCare Health Plans Inc.-Claims
• Kaiser Individual and Families-KPIC-Claims
• Metro Plus Health Plan-Claims
• Midwest Security of WI-ERA
• Multiplan-Savility-Claims & ERA
• Municipal Health Benefit Fund-Claims
• North American Benefits Network (Cleveland, OH)-Claims
• Northstar Advantage-Claims
• Regence Blue Shield-ERA
• Reserve National Insurance-Claims
• Select Health-Claims
• Sunshine State Health Plan-Claims
• Tall Tree Administrators-Claims
• Tennessee Medicaid-ERA
• United Security Life & Health Ins Co-Claims

For a complete list of the payers in our network, visit our website.



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Emdeon Asks the $30 Billion Question

The $30Billion Question
Introducing the U.S. Healthcare Efficiency Index
“What would you do with $30 billion?” This question sparked a groundswell of intrigue at the recent Healthcare 2.0 conference in San Diego. Purveyed on buttons and business cards at the event, this hypothetical inquiry alludes to the dollar value assigned to the cost of the healthcare industry’s voluminous inefficiencies as it lumbers toward becoming electronically-based. A guerrilla website—www.save30billion.com—supplemented the messaging, concurrently touting the $30 billion question to curious participants and putting a spotlight on a must-address issue for the industry.

For those of us who’ve worked in healthcare any length of time, it may be hard to fathom there’s $30 billion (with a “b”!) of business inefficiencies in our industry. Of course, we know the transition is far from complete, and there’s always room for improvement...but $30 billion worth? Aren’t we ceaselessly implementing technology or upgrading systems to accommodate a new mandate, fulfill a market demand or streamline revenue cycles?

And if there’s still a $30 billion chasm—even after all the electronic evolutions, solutions and changes, how can we ever be sure we’re making real progress?

Enter the U.S. Healthcare Efficiency Index™.

The U.S. Healthcare Efficiency Index is “an industry forum for monitoring the business efficiency in healthcare.” The Index, already online at www.ushealthcareindex.com, is poised to be the singular source for tracking the transition of our system from paper to electronic transactions.

This innovative forum—and the intriguing $30 billion question that was its precursor—are the brainchildren of Emdeon’s leadership team. Though the Index was born of Emdeon’s unwavering commitment to electronic efficiency, it is established, guided and advised by some of the nation’s most respected, authoritative experts from the healthcare industry and beyond. The charter advisory council includes the likes of Former House Speaker Newt Gingrich, founder of the Center for Health Transformation. Renowned statisticians Dr. Fritz Scheuren and Dr. Patrick Baier are creating processes for data gathering, analysis and reporting for the Index.

Emdeon’s Senior Vice President of Corporate Strategy Miriam Paramore serves on the Index’s advisory council and is a passionate advocate of the need for awareness and action.

“So many business leaders and policy makers assume that billing and payment related transactions have been ‘fixed’ and are fully automated, but that’s not so.” Paramore explains. “For example, when we tell people that medical payment transactions alone could create $11 billion in annual savings through direct deposit, they’re blown away. They had no idea there was such need for improvement.”

The Index is launching in phases to accommodate increased specificity over time. Phase 1 is focused on the potential savings for medical claims-related transactions. Future phases will address pharmacy, dental, vision and Worker’s Compensation. In addition to the tracking of financial data, the Index also follows environmental impact as the industry moves away from paper usage to electronic transactions. Information will be updated quarterly.

Log on and sign up. Visit the "Get Involved" page of the website to sign up for regular updates and opportunities to participate.


Advisory Council Roster (to date)
Fritz Scheuren, Ph.D.
Scheuren–Ruffner

Patrick Baier, D.Phil.
Milliman, Inc.

John L. Phelan, Ph.D.
Milliman, Inc.

Andrew Naugle, MBA
Milliman, Inc.

Jane Sarasohn-Kahn, MA, MHSA
THINK-Health
Health Economist and Author

Newt Gingrich
Center for Health Transformation

Miriam Paramore
Emdeon



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New Payers On-board



Emdeon Business Services is pleased to announce the following payers as part of our constantly expanding network:


• 360 Alliance- Gilsbar- Hospital Claims
• 360 Alliance- Gilsbar- Medical Claims
• Aetna- Hospital Rosters
• Aetna Better Health Connecticut Medicaid- Medical Claims
• AmeriChoice of New Jersey, Inc. (Medicaid NJ)- Hospital Claims
• AmeriChoice of New Jersey, Inc. (Medicaid NJ)- Medical Claims
• Arkansas Managed Care Organization Inc- Hospital Claims
• Arkansas Managed Care Organization Inc- Medical Claims
• Atlantic Dental Inc. (ADI)- Commercial- Dental Claims
• Automated Group Administration, Inc.- Dental Claims
• Blue Cross Blue Shield of South Dakota (Sioux Falls)- Medical ERA
• Blue Cross of Alabama- Hospital ERA
• Blue Cross of Idaho Health Services, Inc- Hospital ERA
• Blue Cross of Oregon- Dental ERA
• Blue Grass Family Health/SRRIPA- Medical Claims
• Blue Shield of Idaho- Dental ERA
• CBH-Florida- Hospital Claims
• CBH-Florida- Medical Claims
• Cincinnati Financial Corporation- Hospital Claims
• Cincinnati Financial Corporation- Medical Claims
• Community Claims Administration- Dental Claims
• Community Claims Administration- Hospital Claims
• Community Claims Administration- Medical Claims
• Coventry Health Care- Nevada- Hospital Claims
• Coventry Health Care- Nevada- Medical Claims
• DeltaCare USA Claims- Dental Claims
• DeltaCare USA Encounters- Dental Claims
• Health Net of California and Oregon- Claims- Hospital Rosters
• Health Net of California and Oregon- Claims- Medical Rosters
• HealthSpring- Hospital Claims
• HealthSpring- Medical Claims
• InterCare Health Plans Inc.- Hospital Claims
• InterCare Health Plans Inc.- Medical Claims
• Midwest Security of WI- Dental Claims
• Midwest Security of WI- Hospital ERA
• Midwest Security of WI- Medical ERA
• Molina Healthcare of Florida- Hospital Claims
• Molina Healthcare of Florida- Medical Claims
• National Health Benefits Corportation-NHBC02- Hospital Claims
• National Health Benefits Corportation-NHBC02- Medical Claims
• National Health Benefits Corportation-NHBC03- Hospital Claims
• National Health Benefits Corportation-NHBC03- Medical Claims
• National Health Benefits Corportation-NHBC04- Hospital Claims
• National Health Benefits Corportation-NHBC04- Medical Claims
• Network Health Insurance Corp-Medicare- Hospital Claims
• Network Health Insurance Corp-Medicare- Medical Claims
• North American Benefits Network (Cleveland, OH)- Dental Claims
• North Suburban Associated Physicians- Hospital Claims
• North Suburban Associated Physicians- Medical Claims
• Northern Illinois Health Plan- Dental Claims
• OK State Employees & Educators (EDS)- Dental Claims
• OK State Employees & Educators (EDS)- Hospital Claims
• OK State Employees & Educators (EDS)- Medical Claims
• Phoenix Health Plan- Hospital Claims
• Physician Associates of the Greater San Gabriel Valley- Medical Claims
• Piedmont Behavioral Health- Claims
• Prestige Health Choice- Hospital Claims
• Regence Blue Shield- Dental ERA
• Sunshine State Health Plan- Hospital Claims
• TRLHN/AU- Hospital Claims
• TRLHN/AU- Medical Claims
• TRLHN/EB- Hospital Claims
• TRLHN/EB- Medical Claims
• Upper Peninsula Health Plan- Hospital Claims
• Upper Peninsula Health Plan- Medical Claims
• Virginia Premier Gold- Medical Claims
• Washington Labor & Industry- Hospital ERA
• Washington Labor & Industry- Medical ERA
• Wellmark Blue Cross and Blue Shield of Iowa (IASD)- Hospital ERA
• WellPath- Hospital Claims
• Western Health Advantage- Hospital Claims
• Western Health Advantage- Medical Claims
• WestLake Financial Group, Inc.- Claims

For a complete list of the payers in our network, visit our website.



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