Health insurers’ focus on administrative cost reduction has been intensified by the economic recession and Washington’s healthcare reform agenda.
More focused spending for healthcare IT solutions that demonstrate the ability to take cost out has spiked as a result – at least for NaviNet.
Payers are helping their provider networks be more efficient and effective, both administratively and clinically, said Kendra Obrist, chief marketing officer. Giving user-friendly tools and relevant data to physician offices also drives up satisfaction.
AmeriHealth Mercy, which serves the Medicaid population in 15 counties in Pennsylvania, was challenged with delivering clinical summaries to its network physicians without disrupting their workflow, said Ed Malinowski, associate vice president, Information Solutions, AmeriHealth Mercy Family of Companies. The health plan was able to “find the right place in the cycle to introduce clinical information” by deploying NaviNet’s portal in April 2009, he said.
AmeriHealth Mercy fielded approximately 2.5 million eligibility inquiries in 2008. When the physician office makes a query via the portal, the health plan can deliver critical patient data, which can then be delivered to the physician, he said.
Additionally, providing one platform for all payer communications improves AmeriHealth Mercy’s network provider satisfaction, he said.
With Neighborhood Health Plan of Rhode Island facing state and federal funding reductions, the not-for-profit health maintenance organization renewed its focus on technology to reduce cost, said COO Nancy Coburn.
The health plan is looking to move 80 percent to 85 percent of its two highest call center transactions – eligibility of benefits and claims status – to NaviNet’s provider communications portal, which it deployed in July.
The portal will also give physicians administrative efficiencies, which will help them handle the increase in patient volume they have been experiencing, Coburn said.
For payers, core activities related to IT are critical, said Vi Shaffer, research vice president of Gartner. NaviNet is helpful to the insurance industry because the company leverages technology, its shared assets and “elegance of process” to get rid of waste, she said.
“Payers are really coming together to collaborate with providers,” Obrist said. “The climate to work together is stronger.”
