Purpose
The national dialogue on the role of information in healthcare reform has been dominated by electronic medical records and the promise of clinical savings. The business side of healthcare offers significant potential savings that are frequently overlooked. The U.S. Healthcare Efficiency Index™ provides a way to measure that potential and monitor what is actually saved.
Since the 1980s, the healthcare industry has struggled to get rid of paper processing and move into the age of information technology and electronic commerce. Twelve years after enacting the Health Insurance Portability and Accountability Act (HIPAA), the savings promised from administrative simplification have not been fully realized. Few outside of healthcare are aware of the lack of progress and the potential benefit if we work together to address it.
Vision
Our vision is to change that. We want to raise awareness of potential savings (in dollars and in paper) and facilitate public-private sector collaboration and problem solving among payers, providers, vendors, banks and others. And we want to measure the outcome of that work.
Too many claims are still being filed on paper, too many payments are still being made by check and too many notifications are still sent by mail – all wasting billions of dollars and sheets of paper each year.
Phase 1 of the Index estimates the total annual savings potential to be nearly $30 billion for medical claims-related transactions. Medical payment transactions alone could bring an estimated $11 billion in savings through direct deposit. Addressing this issue can bring immediate relief – within existing policy –for both payers and providers.
Through the Index, we want to foster engagement, dialogue and transparency to help get our healthcare system on a more sensible path -- so we can save $30 billion each year and spend it on something more beneficial than paper.
Are We There Yet?
The industry needs a mechanism for raising awareness, identifying barriers, solving problems, and monitoring progress towards efficient business practices. Absent a measurement, we will never know how far we have come or how far we need to go.
Relatively little industry data exists today to measure the impact of manual processing. Through the Index, we want to highlight what is known about the issue and engage the industry in gathering better data and establishing consistent measures of key business transactions. The goal is to create a single national indicator that measures progress across the entire healthcare industry.
Phased Approach
The launch of the Index is being undertaken carefully using a thoughtful, deliberate approach. Phase 1 takes a very broad-based industry view. Current findings are derived based on estimates from trusted industry sources.
The Index will become more specific over time. In Phase 2, a methodology will be established and specific data will be gathered to provide a more in-depth view of the industry’s progress. Third-party statisticians will assist in developing transparent processes for data gathering, analysis, and reporting. All statistics will be submitted confidentially, and all data will be reported in the aggregate. The outside auditor will verify the results prior to publication. Results will be updated and published on a regular basis.
Future phases will extend to additional business transaction types, such as pre-authorization, pre-certification, and referrals. The Index also plans to expand into healthcare areas beyond the medical sector, to include dental, vision, and Workers Compensation. As electronic processing takes hold in the clinical arena, the Index expects to evolve into a reference for the utilization of clinical transactions such as electronic prescribing.
Ultimately, the Index intends to report on results across multiple dimensions, including by payer type, by provider type and by transaction type. It will also serve as a platform for promoting excellence in business efficiency in the healthcare industry through recognition and awards.
Join the Conversation
Get involved and help us start the dialogue that leads to more efficient and affordable healthcare for all. Argue with us, identify problems, share new information. Together, we can lower the cost of healthcare.
The national dialogue on the role of information in healthcare reform has been dominated by electronic medical records and the promise of clinical savings. The business side of healthcare offers significant potential savings that are frequently overlooked. The U.S. Healthcare Efficiency Index™ provides a way to measure that potential and monitor what is actually saved.
Since the 1980s, the healthcare industry has struggled to get rid of paper processing and move into the age of information technology and electronic commerce. Twelve years after enacting the Health Insurance Portability and Accountability Act (HIPAA), the savings promised from administrative simplification have not been fully realized. Few outside of healthcare are aware of the lack of progress and the potential benefit if we work together to address it.
Vision
Our vision is to change that. We want to raise awareness of potential savings (in dollars and in paper) and facilitate public-private sector collaboration and problem solving among payers, providers, vendors, banks and others. And we want to measure the outcome of that work.
Too many claims are still being filed on paper, too many payments are still being made by check and too many notifications are still sent by mail – all wasting billions of dollars and sheets of paper each year.
Phase 1 of the Index estimates the total annual savings potential to be nearly $30 billion for medical claims-related transactions. Medical payment transactions alone could bring an estimated $11 billion in savings through direct deposit. Addressing this issue can bring immediate relief – within existing policy –for both payers and providers.
Through the Index, we want to foster engagement, dialogue and transparency to help get our healthcare system on a more sensible path -- so we can save $30 billion each year and spend it on something more beneficial than paper.
Are We There Yet?
The industry needs a mechanism for raising awareness, identifying barriers, solving problems, and monitoring progress towards efficient business practices. Absent a measurement, we will never know how far we have come or how far we need to go.
Relatively little industry data exists today to measure the impact of manual processing. Through the Index, we want to highlight what is known about the issue and engage the industry in gathering better data and establishing consistent measures of key business transactions. The goal is to create a single national indicator that measures progress across the entire healthcare industry.
Phased Approach
The launch of the Index is being undertaken carefully using a thoughtful, deliberate approach. Phase 1 takes a very broad-based industry view. Current findings are derived based on estimates from trusted industry sources.
The Index will become more specific over time. In Phase 2, a methodology will be established and specific data will be gathered to provide a more in-depth view of the industry’s progress. Third-party statisticians will assist in developing transparent processes for data gathering, analysis, and reporting. All statistics will be submitted confidentially, and all data will be reported in the aggregate. The outside auditor will verify the results prior to publication. Results will be updated and published on a regular basis.
Future phases will extend to additional business transaction types, such as pre-authorization, pre-certification, and referrals. The Index also plans to expand into healthcare areas beyond the medical sector, to include dental, vision, and Workers Compensation. As electronic processing takes hold in the clinical arena, the Index expects to evolve into a reference for the utilization of clinical transactions such as electronic prescribing.
Ultimately, the Index intends to report on results across multiple dimensions, including by payer type, by provider type and by transaction type. It will also serve as a platform for promoting excellence in business efficiency in the healthcare industry through recognition and awards.
Join the Conversation
Get involved and help us start the dialogue that leads to more efficient and affordable healthcare for all. Argue with us, identify problems, share new information. Together, we can lower the cost of healthcare.
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