WATERTOWN, Mass. – A study released last week by AthenaHealth Inc. (NASDAQ: ATHN), a leading provider of Internet-based business services for doctors, and Physicians Practice, a practice management journal, ranks Blue Cross & Blue Shield of Rhode Island second in the Northeast in its business dealings with doctors, and best among private payers.
Only Medicare Part B in Connecticut was rated better in the Northeast; Blue Cross & Blue Shield of Massachusetts ranked sixth, UnitedHealthcare of New England was 11th, and Neighborhood Health Plan of Rhode Island was 30th among the 43 public and private payers covered by the study.
Among national payers, Aetna was No. 1, and UnitedHealth Group was fifth
The rankings, issued for the third year in a row, were based on performance data from more than 12,000 medical providers representing more than 30 million medical charge lines for all four quarters of 2007.
The data is derived from athenahealth’s national on-demand athenaNet system database, and ranks health insurers according to specific measures of financial, administrative performance, and medical policy complexity – such as the percentage of claims resolved on the initial submission (96.8 percent for BCBSRI, vs. 95.8 percent for UnitedHealthcare and 84.8 percent for Neighborhood), the denial rate, the “transparency” of denials, and patient liability.
The rankings are designed to quantify the “ease of doing business with the payer,” athenahealth said, and they aim to improve all doctors’ experience with the payers they deal with.
“In only its third year, the PayerView Ranking Initiative has allowed athenahealth to dramatically expand its advocacy on behalf of our national medical provider clients by addressing some of the current administrative breakdowns that medical groups face in their dealings with payers – a place where the health care industry badly needs greater process integrity,” said Jonathan Bush, chairman and CEO of athenahealth, in a news release.
“Athenahealth has been able to harness PayerView data to form strategic and operational initiatives with payers,” he added, “like our real-time adjudication platform that is aimed at creating better transparency in the transactions between payers and providers and that is designed to deliver better financial and operational outcomes for our provider clients.”
A news release on the rankings also quoted David Wichmann, president of UnitedHealth Group Operations, who noted that by collaborating with athenahealth, the insurer had made “significant service improvements,” such as reducing days in accounts receivable by 4.5 days in the first half of 2008 as a result of real-time adjudication.
Athenahealth is a leading provider of Internet-based business services for physician practices. For more information visit www.athenahealth.comThe complete 2008 PayerView Rankings, evaluating 137 national, regional and government payers, can be found at www.athenaPayerView.com.
Physicians Practice, a journal that helps physicians manage their businesses, is circulated to more than 276,000 physicians nationwide through partnerships with more than 60 hospitals and medical centers, including academic, community, faith-based and specialty hospitals. For more information, go to www.physicianspractice.com.
For Leaders Who Don't Have Time to Get Sick
Top performers guard their calendars, delegate relentlessly and optimize every hour of the day. Health,…
Learn More
