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December 2003
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HEALTH NET MOVING TO ONE PLATFORM
Health Net (Woodland Hills, CA) is finding that an ongoing migration to a single technology platform for administrative functions is already yielding reductions in claims inventory and days claims payable along with increases in electronic claims submissions and auto adjudication, chief executive Jay Gellet tells EHI.
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December 2003; Volume 4, Number 12
Health Net platform conversion...Coding shift could cost $14 BB...Harvard increases direct claims...Oxford cuts claims staff 20%...MERCURIO ON eHEALTH: Good news from MCOs...Fidelity, Vanguard join forum...Chart: HNT efficiency measures...Chart: ICD-10 code shift costs...BCBS-NC online enrollment...Tufts to use HealthShare...Quovadx buys Rogue Wave...Neoforma pays off debt...Sloan sticks with Eclipsys...eHealth, info services stocks fall...and more...
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SLOAN-KETTERING TO UPGRADE TO SUNRISEXA
Sloan-Kettering Cancer Center (New York) said it will upgrade its clinical information and workflow technology to the SunriseXA system from Eclipsys Corp. (Boca Raton, FL).
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NEOFORMA PAYS OFF REMAINING $14 MILLION IN DEBT
Neoforma Inc. (San Jose, CA) will enter 2004 debt-free, having paid off the remaining $14 million of outstanding loads under a credit line with one of its two principal owners VHA Inc. (Irving, TX).
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QUOVADX COMPLETES ROGUE WAVE ACQUISITION
Quovadx (Englewood, CO) has completed its acquisition of Rogue Wave Software (EHI, November). Quovadx acquired 9.7 million Rogue Wave shares in a tender offer of $4.09 in cash and 0.53 shares of Quovadx stock for each Rogue Wave share.
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TUFTS TO USE HEALTHSHARE FOR HOSPITAL QUALITY DATA
Tufts Health Plans (Waltham, MA) will provide its members with online access to hospital quality data supplied by HealthShare (Acton, MA), according to Kevin Counihan, senior vice president of sales and marketing services.
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BCBS-NC TO PUSH ONLINE ENROLLMENT
Blue Cross Blue Shield of North Carolina (Durham, NC) hopes to make significant headway in moving clients toward electronic enrollment of members in 2004, according to Robert Greczyn, chief executive.
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NUMBERS ARE IN, AND THEY LOOK GOOD FOR ELECTRONIC
This issue of EHI—the last of 2003—offers several promising stories about how information technology is making a major dent in costs while dramatically improving efficiency and productivity at leading managed care organizations.
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OXFORD CUTS CLAIMS STAFF 20% IN 2003
Oxford Health Plans (Trumbull, CT) was able to reduce claims and customer service staff by 20% in 2003, largely because of the implementation of electronic technology for claims submission and adjudication, referrals and renewals, according to Charles Berg, chief executive.
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HARVARD TO GET 50% OF ’04 CLAIMS DIRECT
Harvard Pilgrim (Wellesley, MA) expects to receive about 50% of its 11 million annual hospital and physicians’ office claims (not including pharmacy claims) to come through direct connections with the health plan, Charles Baker, chief executive, tells EHI.
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CODING SHIFT COST PUT AT $6-14 BILLION
A study commissioned by the Blue Cross Blue Shield Assn. (Washington) estimated that the cost to the healthcare industry of abandoning the ICD-9 diagnostic and inpatient procedure code system in favor of a new ICD-10 system would be $6 billion to $14 billion in technology, training, lost productivity, rework and contract renegotiations.
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