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.
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 wont.
Asked it theyre 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 dont plan on it.
When asked if theyre 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 theyre not ready and 7.4% just dont know.
While the ICD-10 compliance deadline has now pushed back to at least October 2014 (after multiple timeline revisions), not all payers are sure theyll 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 wont be ready.
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.
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 wont do it, and 21.1% are unsure.
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