We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 8/17 at Noon ET (9 AM PT). This week’s chat will be hosted by Don Lee (@dflee30) and @CAQH on the topic of “The Cost Savings Opportunities on the Business Side of Healthcare“.
Progress on the Journey to Automate the Business of Healthcare
Next time you’re in the doctor’s office, take note of what the administrative staff is doing behind the reception desk.
For every patient, the staff needs to know if he or she has an active health insurance policy, if it will reimburse for the specific services the doctor provides and the deductibles or copays to determine the patient’s bill. After the patient leaves, the staff submits the claim and may continue to follow up to make sure it gets paid.
Complicating their job, not every patient has the same insurance plan, let alone the same insurance company. That makes it easy to imagine how the doctor’s office could become a chaotic logjam without some uniformity in how all these processes are accomplished from one health plan to another. But, all in all, this system works pretty well, doesn’t it?
This is because leaders on the business side of healthcare began collaborating more than 10 years ago to crack the code on interoperability. They hammered out rules of the road that, in combination with other efforts, have accelerated the use of automation and brought uniformity to routine processes — like figuring out if you owe a copay.
But the journey from slower and costlier manual processes – like phone, fax and mail – to interoperable, or automated, machine-to-machine processes is far from complete. We know this because our co-host, @CAQH, tracks the progress of this journey through the CAQH Index.
The most recent CAQH Index found that progress has not only slowed, but on some important measures the industry has actually lost ground and a savings opportunity of $11.1 billion remains. Since healthcare providers have historically been slower to implement and use automated processes than health plans, the vast majority of the savings is available to medical providers ($7.5 billion) and dentists ($2 billion).
The CAQH Index takes into account the cost of common business processes for each stakeholder and the number they conduct each year to determine the greatest savings opportunities for medical and dental health plans and providers. We’ll be talking about that in the #HITsm chat with co-host @dflee30, a Health IT expert who recently interviewed CAQH researchers about the report.
For a short time, there’s still time to participate in the 2018 CAQH Index study. Every data contribution helps to make the Index more complete. Email firstname.lastname@example.org for information on how your organization can help.
So, without further ado, here are the various topics and questions we’ll be discussing for this week’s #HITsm chat.
Topics for this week’s #HITsm Chat:
T1: #Healthcare administrative costs have been projected to reach $315 billion by this year. What are some of the sources of these excessive admin costs? #hitsm
T2: Why is it important to track progress related to admin costs? #hitsm
T3: What are some barriers the #healthcare industry faces in reducing admin costs? #hitsm
T4: What can the #healthcare industry do to overcome these barriers and achieve significant cost savings? #hitsm
T5: How is the emerging #valuebased payment model impacting #healthcare administration and operations? #hitsm
Bonus: What are other growing #healthcare administration and operations trends and how might they impact healthcare admin costs? #hitsm
Upcoming #HITsm Chat Schedule
8/24 – The Role of Technology in Chronic Disease Management
Hosted by Colton Ortolf (@ColtonOrtolf)
8/31 – Will Big Media Spoil HealthIT for the Little Guy?
Hosted by ShereeseM, MS/MBA (@ShereesePubHlth)
9/7 – TBD
Hosted by Jessica Maxine Selby (@JessMSelby)
9/14 – TBD
Hosted by TBD
10/5 – TBD
Hosted by TBD
We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.
If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.