Payers Making I.T. Moves After Reform Ruling

Payers Making I.T. Moves After Reform Ruling Payers Making I.T. Moves After Reform Ruling

A survey of more than 100 payer organizations conducted by HealthEdge, a vendor of enterprise platform software for health insurers, indicates that payers are ready to make some I.T. moves as a result of health reform. Following are highlights of the findings.

State Insurance Exchanges State Insurance Exchanges

Asked if they plan to participate in the state insurance exchanges authorized under health reform, 46.7% of payers said they plan to be on the exchanges; 33.3% said “maybe,” and a sizable chunk, 20%, said they won’t.

Interested in ACOs? Interested in ACOs?

Asked it they’re interested in participating or exploring participation in emerging accountable care organization models, 41.2% of payers said yes, 35.3% said maybe, and 23.5% said they don’t plan on it.

How Ready are Payers for New Business Models? How Ready are Payers for New Business Models?

When asked if they’re ready for new business models such as value-based purchasing, pay-for-performance, ACOs, etc., 12.3% of respondents said their organizations are “completely ready” for a new era; 69.1% said they were somewhat ready, while 11.1% said they’re not ready and 7.4% just don’t know.

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ICD-10 Timelines ICD-10 Timelines

While the ICD-10 compliance deadline has now pushed back to at least October 2014 (after multiple timeline revisions), not all payers are sure they’ll be ready. While 61.4% said they will “definitely” be ready to meet the new deadline, 30.1% said they are likely to, and 8.4% said they are unsure or won’t be ready.

Financial Repercussions of ICD-10 Delay Financial Repercussions of ICD-10 Delay

While 11% of payer representatives said the delay will have a significant financial impact on their organizations, 86.5% said any financial hits will be moderate or limited.

I.T. and Meeting Financial Goals I.T. and Meeting Financial Goals

When asked if their current information systems will enable them to meet their goals to cut costs and reduce their administrative spend, 48.4% of respondents said their current systems can make it happen, 30.5% said their current technology won’t do it, and 21.1% are unsure.

 

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