PPACA (Patient Protection and Affordable Care Act) passes to do one of two things….first to reduce cost
And secondly to improve quality
So I ask to consider – what would you do with an extra $30 billion dollars a year?There is a lot you could do – first and foremost help pay for the other things we need to do to address quality – and ensure greater focus on patient care.The first phase of the Index looked at industry data. Now we are gathering numbers in real time from payers, providers and clearinghouses to tell an even more accurate story – and document progress – and savings.I urge you to join our effort – get involved in the Index – and raising awareness of the opportunity to get immediate savings.And help us work together to overcome the few remaining barriers. Today we’re releasing a whitepaper – with the Center for Health Transformation – that looks at these opportunities – and provides a clear roadmap for collaboration.
PPACA (Patient Protection and Affordable Care Act) passes to do one of two things….
Welcome to the new healthcare system…pretty easy to navigate, eh?
And on top of that we have to keep in mind what is going on with HIT over the next 5 years. How do companies try to manage meeting these mandates as well as improving quality and reducing cost through PPACA?
Light in the Darkness: How Information Will Create Transparency in Healthcare
August 26, 2010<br />Transparency in Healthcare Miriam Paramore, SVP Strategy & Government Affairs<br />
Emdeon: A Leader inToday’s National Health Information Network<br />2<br />155 million<br />Patients<br />350,000<br />1,200<br />5 billion<br />Providers<br />Payers<br />RCM & Payment<br />Distribution<br />Healthcare<br />Information<br />PBM Services<br />ePrescribing<br />Pharmacies<br />55,000<br />Emdeon – We make healthcare efficient.<br />
efficient healthcare<br />Emdeon – We make healthcare efficient.<br />
Emdeon – We make healthcare efficient.<br />What is Transparency Hard?<br />Price<br />Healthcare is not retail – there is no price at the point of service<br />What a hospital charges is not the “price”<br />What an insurance company pays is the “price”<br />But the consumer can’t buy at that “price”<br />Quality<br />Data is not digital<br />Lack of standards means even digital data is meaningless<br />There is no good clinical information exchange<br />Consumer-friendly communication of medical terms is difficult<br />
Everybody is asking the same question…<br />HIMSS Financial Systems Steering Committee<br />6 Public-Private Collaborations<br />7 State & Local Initiatives<br />5 Value Driven Healthcare Initiatives<br />3 Business Coalitions<br />Total = 21 separate initiatives<br />
Biopsy 11000 Average Rates by State<br />Key rounded to nearest $10<br />Analysis data metrics<br />ERAs from 31 payers, Dec2007-Feb 2008<br /> 36 million claims <br /> $23 billion in charges<br /><ul><li>146,841providers
13.5 million insured</li></ul> 101,450 procedure / modifier combinations <br /> 725 average good estimates per state<br />