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Implementing Electronic Health Care Transactions Could Save Billions

January 13, 2017

Despite the growing adoption of electronic business transactions in health care settings, a opportunity for approximately $9.4 billion in savings still exists, according to a recent data report in the 2016 CAQH Index.

“Our organization understands the value of conducting business electronically and the greater efficiencies and cost savings realized through seamless data exchange,” Joseph M D’Allaird, director of revenue cycle at Cortland Regional Medical Center, a data contributor to the 2016 CAQH Index, said in a press release. “When we can reduce the amount of paperwork for our physicians and staff, more time and resources can be spent caring for patients.”

The fourth annual CAQH Index analyzes adoption, costs, and provider labor time associated with the most common administrative transactions between health plans and providers. This is the first year the CAQH Index measured provider labor time.

According to the analysis, providers could save roughly 1.1 million labor hours per week by adopting electronic transactions. Providers are currently spending eight minutes on average, and up to 30 minutes performing manual tasks, including making phone calls, sending faxes, and mailing correspondence. It is estimated that prior authorization offers the greatest time savings potential if it is conducted electronically. Provider labor would reduce time per transaction from 20 minutes to 6 minutes, and reduce the cost from $7.50 to $1.89.

Compared to last year’s CAQH Index, the potential savings from full industry adoption of electronic transactions grew by approximately $1 billion. The growth is reportedly due to additional transactions and claims that weren’t tracked in the past. Claims are used to send extra information that is required for some health care claims like discharge summaries. Notably, 94% of claim attachments are submitted manually, and each cost nearly $6 more to process compared to electronic attachments.

Top health insurers, like Cigna, are showing their support to participate in the 2016 CAQH Index.

“Cigna is deeply committed to the efficient exchange of administrative healthcare data as a CORE-certified organization and participant in the 2016 CAQH Index,” Julie Vayer, vice president for total health and network operations at Cigna, said in a press release. “By working together to standardize the way health plans process transactions, and by identifying industry best practices, we can help create a fully electronic healthcare system that will benefit consumers, providers and payers.”

The report also recommends industry stakeholders share best practices, look for ways to reduce barriers to adoption, and review existing standards, codes, operating rules, and policies around business transactions.

Julie Gould (Mazurkiewicz)

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