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December 2004
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EHI, December 2004; Volume 5; Number 12
No clearinghouse fees for some...2 Blues invest in RealMed...BCBS-SC e-claims hit 87%...Regence alters systems strategy...ValueAct takes 14% of Trizetto...ProxyMed splits CEO, chair roles...eHealth stocks strong in ‘04...Chart: ’04 stock performance...eHealth, services stocks rise 2%...Humana in clearinghouse talks...Anthem offers online enrollment...Gateway is WebMD exclusive...BCBS-MA backs EMR effort...and more.
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SOME MCOs AVOID CLEARINGHOUSE FEES
Blue Cross Blue Shield of South Carolina (Columbia, SC), one of the nation’s most savvy health plans when it comes to information technology (see story, this issue), refuses to pay any transaction fees to clearinghouses for electronic claims.
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BCBS-NC, BCBS-IL INVEST IN REALMED
Blue Cross Blue Shield of North Carolina and Blue Cross Blue Shield of Illinois have each taken a 30% stake in RealMed (Indianapolis), EHI has learned.
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BCBS-SC E-CLAIMS VOLUME HITS 87%
Blue Cross Blue Shield of South Carolina (Columbia, SC) is currently receiving 87% of its total claims volume electronically either through electronic data interchange or through direct connections with providers, according to Tom Faulds, president of the company’s Blue Cross division.
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REGENCE ALTERS SYSTEMS STRATEGY
After realizing that a prior effort to convert to a single administrative system was a mistake, Regence Group (Portland, OR) has embarked on another approach—tying information systems development directly to the company’s product strategies around consumer-directed healthcare.
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HUMANA EYES CLEARINGHOUSE VENTURES IN MORE MARKETS
Encouraged by the success of its Availity clearinghouse joint venture with Blue Cross Blue Shield of Florida, Humana Inc. (Louisville, KY) is talks with other payers to form similar ventures in other parts of the nation, Michael McCallister, chief executive, told EHI.
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ANTHEM ROLES OUT ONLINE ENROLLMENT IN OH, KY, IN
Anthem Blue Cross Blue Shield, a unit of WellPoint, has rolled out online enrollment for new groups with more than 51 employees and for individuals in Ohio, Kentucky and Indiana, the company announced. Comparative hospital and drug information is provided by Subimo (Chicago).
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VALUEACT TAKES 14% STAKE IN TRIZETTO
Trizetto Group (Newport Beach, CA) has placed 6.6 million shares of its own common stock formerly held by IMS Corp. with ValueAct Capital (San Francisco).
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BCBS-MA TO SINK $50 MM IN EMR EFFORT
“The way to manage the affordability of healthcare is to eliminate waste in the system,” said Tim O’Brien, senior vice president of sales, Blue Cross Blue Shield of Massachusetts (Boston) in discussing the company’s $50 million pledge to a newly formed not-for-profit state collaborative aimed at increasing adoption of electronic medical records.
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