There’s another, complementary track to take to reform American health care that will streamline workflow, cut down on paperwork and save money: administrative simplification.
While not a sexy phrase, it’s a very attractive option that will help to contain costs. The UnitedHealth Center for Health Reform & Modernization (UHC), part of UnitedHealth Group, issued its report into this topic, Health Care Cost Containment – How Technology Can Cut Red Tape and Simplify Health Care Administration.
UHC found $332 billion in medical cost savings through 12 proposals that group into the following themes:
1. For patients, go electronic: use automated cards for patient eligibility and benefits, create a monthly online personalized health statement for patients, eliminate paper checks for electronic funds transfer.
2. For providers, expand use of electronic data interchange (EDI), implement multi-payer transactional capability for practice management systems, and integrating practice management systems with payer systems.
3. Integrating electronic medical records with personal health records to promote coordination of patient care.
4. Improve payment speed and accuracy through using predictive modeling to ‘pre-score’ claims for better medical management as well as fraud detection.
These approaches are all founded on rapidly deploying and adopting data and transaction standards, and applying what UHC calls “modern management techniques” — that is first and foremost information technology that can track fraud and flows of money to providers and payers.
Health Populi’s Hot Points: “Bending the health cost curve” is the Holy Grail for health reform; if we don’t stem the cost increases in health care, the long-term challenge of the U.S. deficit won’t get cured.
Administrative simplification has been a target of health reform since the passage of HIPAA. Remember that “HIPAA” is the acronym for “Health Insurance Portability and Accountability Act of 1996.” It’s the “Accountability” portion of the law that included the administrative simplification components regarding the adoption of electronic data standards as a basis for streamlining bureaucracy and saving costs.
We’re still getting ‘there,’ and it’s slow-going. But administrative simplification and the long slog toward building and sustaining an electronic infrastructure in health care is an integral part of reforming U.S. health care and bending the cost curve, as the UnitedHealth report quantifies.
For more on the opportunity to save money through investing in the electronic infrastructure of U.S. health care, visit the U.S. Healthcare Efficiency Index project at http://www.ushealthcareindex.com/.