Technology Could Save $200 Million in Healthcare
Those savings shouldn’t end up paying for a fancy fountain in a hospital lobby, says Laura Etherton
An electronic health information exchange system modeled after Minnesota’s experience could reap such savings, and allow physicians to spend more time with patients instead of having to shuffle paperwork.
All the administrative and financial transactions between insurers and providers would be handled electronically in compliance with HIPAA regulations. No longer would a clinic have to verify a patient’s eligibility by calling an insurance company; payment would be transferred automatically into their bank account.
Although such a system is still several years away, the wheels are in motion. On Aug. 10, the Oregon Health Policy Board is expected to approve a set of recommendations from a work group led by Laura Etherton, healthcare advocate for OSPIRG and Dale Johnson, human resources director for Blount International who chairs the Oregon Coalition of Health Care Purchasers. Passage of a health reform law in Oregon known as House Bill 2009 mandated such an approach.
“Instead of everyone handling transactions in a different way, we’ve come up with one electronic method,” Etherton said. “This is exactly the kind of healthcare we like to focus on – saving money so providers can focus on taking care of people.”
Rather than start from scratch, the work group is using a system developed in Minnesota, which boasts about its 95 percent success rate in electronic claim submissions.
“We decided not to reinvent the wheel if another state had actually implemented such a system and make it as simple as possible,” Etherton said.
This approach follows what Medicare has done, letting physicians know they need to have an electronic system in place to process claims and eligibility, and setting a deadline, said Dan Stevens, regional director of provider networks for Providence Health Plans who participated in the work group.
But there’s a lingering question -- what’s going to happen to that multi-million dollars in savings? Will it actually result in lower insurance premiums, and, if so, how will it be measured?
OSPIRG, a consumer watchdog organization, intends to keep a watchful eye. “We want to make certain the money doesn’t end up funding a fancy fountain in a hospital lobby,” Etherton said. “Everyone would like to stop wasting all this money and get much more efficient system, but any time you change the system there are bumps on the road.”
Stevens is convinced this new system will have an impact on premiums because unnecessary administrative costs will be driven out of the system. “The hope is that insurers can save money and premiums will flatten with rates not going up as much.”
All providers – even those living in rural communities – need to be on board before such a system gets under way, said Sean Kolmer, deputy administrator of the Office of Oregon Health Policy and Research. Oregon is far ahead of the curve compared to other states; close to 60 percent of all medical practices have electronic medical systems in place.
”This should make the patient experience go a lot smoother and take the waste out of the system,” Kolmer said. “To make all this work everyone has to move at the same time, in the same direction.”
Yet many physicians in rural communities still rely on a leather bound book rather than a computer to keep track of their appointments, Stevens said. “There needs to be enough time for people to purchase, test and implement such a new system,” he said.
The Oregon Medical Association is talking with small practices in rural communities about challenges facing them, and helping with technical difficulties, along with the Oregon Association of Hospitals and Health Systems.
The planning process has been virtually without controversy, but Chris Apgar questions why officials decided to use a system from Minnesota rather than rely on standards developed in Oregon nearly eight years ago that also comply with HIPAA regulations.
“Why didn’t they consider what Oregon has already done and not waste peoples’ valuable time?” asked Apgar, who leads a healthcare privacy and security forum.
Etherton said the work group definitely appreciated Apgar’s work. “We were fortunate to have a couple of models to look at. But with the federal reform coming down, it helps to do something that another state has done, and have multiple states going in the same direction. We wanted to use a piece that was already in practice.”
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Comments
I agree cost savings shouldn't go to fountains or more likely million dollar fire places in hospitals designed to look like Mountain Lodges.
"“This is exactly the kind of healthcare we like to focus on – saving money so providers can focus on taking care of people.” and then "Yet many physicians in rural communities still rely on a leather bound book rather than a computer to keep track of their appointments". Let's do some math. Pencil and paper plus daily copies = $100/year max.
Scheduler program, computer, training, service, and annual updates: $750 min.
Is there some logic I am missing in all this?
DocWitt
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