The Cost Savings Opportunities on the Business Side of Healthcare – #HITsm Chat Topic

Posted on August 14, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 8/17 at Noon ET (9 AM PT). This week’s chat will be hosted by Don Lee (@dflee30) and @CAQH on the topic of “The Cost Savings Opportunities on the Business Side of Healthcare“.

Progress on the Journey to Automate the Business of Healthcare

Next time you’re in the doctor’s office, take note of what the administrative staff is doing behind the reception desk.

For every patient, the staff needs to know if he or she has an active health insurance policy, if it will reimburse for the specific services the doctor provides and the deductibles or copays to determine the patient’s bill. After the patient leaves, the staff submits the claim and may continue to follow up to make sure it gets paid.

Complicating their job, not every patient has the same insurance plan, let alone the same insurance company. That makes it easy to imagine how the doctor’s office could become a chaotic logjam without some uniformity in how all these processes are accomplished from one health plan to another. But, all in all, this system works pretty well, doesn’t it?

This is because leaders on the business side of healthcare began collaborating more than 10 years ago to crack the code on interoperability. They hammered out rules of the road that, in combination with other efforts, have accelerated the use of automation and brought uniformity to routine processes — like figuring out if you owe a copay.

But the journey from slower and costlier manual processes – like phone, fax and mail – to interoperable, or automated, machine-to-machine processes is far from complete. We know this because our co-host, @CAQH, tracks the progress of this journey through the CAQH Index.

The most recent CAQH Index found that progress has not only slowed, but on some important measures the industry has actually lost ground and a savings opportunity of $11.1 billion remains. Since healthcare providers have historically been slower to implement and use automated processes than health plans, the vast majority of the savings is available to medical providers ($7.5 billion) and dentists ($2 billion).

The CAQH Index takes into account the cost of common business processes for each stakeholder and the number they conduct each year to determine the greatest savings opportunities for medical and dental health plans and providers. We’ll be talking about that in the #HITsm chat with co-host @dflee30, a Health IT expert who recently interviewed CAQH researchers about the report.

For a short time, there’s still time to participate in the 2018 CAQH Index study. Every data contribution helps to make the Index more complete. Email explorations@caqh.org for information on how your organization can help.

Download a complimentary copy of the 2017 CAQH Index or use the savings calculator to estimate your organization’s savings at www.caqhindex.org and check out Don’s recent podcast.

So, without further ado, here are the various topics and questions we’ll be discussing for this week’s #HITsm chat.

Topics for this week’s #HITsm Chat:
T1: #Healthcare administrative costs have been projected to reach $315 billion by this year. What are some of the sources of these excessive admin costs? #hitsm

T2: Why is it important to track progress related to admin costs? #hitsm

T3: What are some barriers the #healthcare industry faces in reducing admin costs? #hitsm

T4: What can the #healthcare industry do to overcome these barriers and achieve significant cost savings? #hitsm

T5: How is the emerging #valuebased payment model impacting #healthcare administration and operations? #hitsm

Bonus: What are other growing #healthcare administration and operations trends and how might they impact healthcare admin costs? #hitsm

Upcoming #HITsm Chat Schedule
8/24 – The Role of Technology in Chronic Disease Management
Hosted by Colton Ortolf (@ColtonOrtolf)

8/31 – Will Big Media Spoil HealthIT for the Little Guy?
Hosted by ShereeseM, MS/MBA (@ShereesePubHlth)

9/7 – TBD
Hosted by Jessica Maxine Selby (@JessMSelby)

9/14 – TBD
Hosted by TBD

9/21 – Human Centered Design in Healthcare #PatientsMatter
Hosted by Jen Horonjeff (@jhoronjeff) from @Savvy_Coop

9/28 – How Does Interoperability Affect Technology Adoption in Healthcare?
Hosted by Niko Skievaski @niko_ski from @redox

10/5 – TBD
Hosted by TBD

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.