Survey: Payers not Technologically Ready for New Payment Methods

A semi-annual survey of health insurers finds large percentages of payers expect to participate in new payment programs, yet acknowledge they don’t yet have the information technologies to support the programs.


A semi-annual survey of health insurers from software vendor HealthEdge finds large percentages of payers expect to participate in new payment programs, yet acknowledge they don’t yet have the information technologies to support the programs.

More than 170 payer executives responded to the vendor’s State of the Payer survey, with 69 percent planning to be in accountable care organizations, nearly 66 percent in pay-for-performance initiatives and 59 percent in valued-based payment models. But, 41 percent aren’t ready for ACOs, nor are 34 percent for P4P and 47 percent for value-based programs. In particular, a quarter of responding insurers still manually process 40 percent or more of their claims, and the cost of manually processing is less than $6 per claim for only 35 percent of them. Ray Desrochers, executive vice president at HealthEdge, expects payers to focus on boosting their I.T. capabilities during 2013.

Asked if they will make the October 2014 ICD-10 deadline, 130 payers answered the question with 117 saying yes, none saying no and 13 unsure. Another 42 respondents did not answer. One third of payers who answered ICD-10 questions believe the compliance date likely will slip again.

Health care reform initiatives top the list of hottest discussion topics for 2013, followed by health information exchanges and ACOs. Far behind were ICD-10 and ICD-11. More information is available at healthedge.com/survey, registration is required.

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