New Phase for EDI Measurement Effort

The U.S. Healthcare Efficiency Index, an industry consortium founded in 2008, has launched the second phase of an initiative to measure industry progress in adopting electronic financial and administrative transactions.


The U.S. Healthcare Efficiency Index, an industry consortium founded in 2008, has launched the second phase of an initiative to measure industry progress in adopting electronic financial and administrative transactions.

Emdeon Business Services, a Nashville, Tenn.-based claims clearinghouse and revenue cycle management vendor, founded the initiative. The U.S. Healthcare Efficiency Index is a national reference for tracking and measuring the transition from paper-based and phone-based transactions to electronic transactions.

Through an extensive search of literature Emdeon employees estimated the current rate of adoption during 2008 for electronic medical claims and related transactions. To a degree, the initiative sought to restart and greatly expand the annual research on EDI growth that Health Data Management did in the 1990s through its Health Data Directory.

Based on their research, Emdeon employees in 2008 estimated 75% of claims were electronically submitted, as were 40% of eligibility and claim status transactions. Only 10% of claim payments were electronic, as were 26% of claim remittance advice transactions. Emdeon estimated use of electronic data interchange for these five transactions presently saved $23.6 billion annually. But $53.3 billion could be saved each year if all of these transactions were electronic.

Now, the second phase will start primary data collection to get hard numbers. The phase with begin with some large national payers and Blues plans submitting non-identifiable data to a new National Data Collection Center through a secure Web portal. Statisticians at Scheuren-Ruffner Consultants will aggregate and analyze the data. Milliman Inc., a consulting and actuarial firm, will validate the findings based on a methodology developed by the initiative's advisory council.

The process later will be opened to other insurers, as well as providers and clearinghouses. Later phases of the index include development of a Pharmacy Safety and Adherence Index.

More information is available at ushealthcareindex.com.

--Joseph Goedert

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