Blue Cross Blue Shield of Rhode Island, in an annual study of health insurer performance among ambulatory providers, scored highest out of 137 national, regional and government payers in 43 states. As in previous years, Medicaid plans litter the bottom third with Pennsylvania this year scoring last.

Overall, health insurers in 2009 paid physicians on average seven days faster and denied 12 percent to 18 percent fewer claims than in the previous year, according to the 2010 PayerView Rankings from athenahealth Inc., Watertown, Mass. The company offers outsourced billing/collections services bundled with practice management and electronic health records software. It has conducted the PayerView survey for five years based on data accumulated from clients. Data in the study totaled 41 million medical charge lines in 2009 from more than 23,000 providers.

Following BCBS of Rhode Island, the top 10 payer performance scores, in order, went to Humana Inc.; BCBS of Massachusetts; UnitedHealthcare; Tufts; BCBS of Ohio; Medicare B of Georgia; Medicare B of North Carolina; Medicare B of Oregon; and ODS Health Plan.

Scores for other notable commercial insurers include Aetna (12), Harvard Pilgrim (14), Cigna/Healthsource (38), PacifiCare (72), Presbyterian Health Plan (75), Great-West Healthcare (78), Group Health (79), Unicare (105), HIP of Greater New York (111), AVMED (118), Wellcare (120) and Amerigroup (123). Four regional Health Net plans scored between 82 and 116.  Blues plans and Medicare contractors were scattered across the best, middle and worst performance categories.

More information is available at athenahealth.com/payerview.

--Joseph Goedert

 

Register or login for access to this item and much more

All Health Data Management content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access