Bending the Cost Curve Could Also Reduce Physicians' Headaches

Les Masterson, for HealthLeaders Media , October 7, 2009

Jarvis said the project will reduce claim denials because physicians will be able to quickly find eligibility information. This is much easier than having to make phone calls to health insurers or search for that information on the insurers' sites, he added.

Given the timing of this pilot project, many cynics will ask: If physicians want administrative simplification, why has it taken so long for health insurers to develop this pilot? And are health insurers developing this pilot in response to healthcare reform?

Ignagni said the reason the pilot is happening now is not because of health reform, but because the technology is now available and AHIP has been focused on creating the pilot program for "a number of months."

Ignagni added that a similar project in New Jersey is also in the works, and the collaboration could spread to other parts of the country.

This pilot program has the potential to serve as a trailblazing project that could change healthcare administration processes. These aren't small, regional health insurers that we're talking about. It's Aetna, Anthem Blue Cross and Blue Shield, CIGNA, Humana, Kaiser Permanente, Medical Mutual of Ohio, UnitedHealthcare, and WellCare Health Plans, Inc. These are some of the largest and most influential health insurers in the country.

If they find successes and cost savings through this pilot, these insurers will likely look to expand the program to other states.

Administrative simplification is not an exciting topic, but it could serve as a way to reduce health costs, improve physician/health plan relations, and remove some of the complexity in a healthcare system that so many Americans don't understand.

Les Masterson is an editor for HealthLeaders Media.

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