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athenahealth report raises red flag on Medicaid performance nationwide
e-Reports, June 16, 2014
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If you’re considering changing your payer mix, you’ll want to pay attention to athenahealth, Inc.’s 2014 PayerView® Report on health insurers. The technology firm annually conducts a study of health insurers’ performance on financial, administrative and transactional functions to assess how well they work with providers.

Humana ranked first in overall performance among 148 payers, but Blue Cross/Blue Shield plans pay most quickly. And with few exceptions, Medicaid programs across the nation delivered the worst performance on metrics like denial rates and days in accounts receivable.

Although Indiana’s governor has opted to not expand Medicaid under the Affordable Care Act, seeking to expand the Healthy Indiana Plan instead, this report sounds an alarm for states that are enrolling more in Medicaid. Nationwide, Medicaid enrollment is expected to top 85 million by 2021. (See related story in ISMA e-Reports.)

The athenahealth data is derived from the company’s athenaNet® database that now includes more than 52,000 providers across 20 states. PayerView® analyzes 108 million charge lines and $20 billion in health care services billed in 2013.

See the full PayerView Report here.

Copyright: Information written and displayed on www.ismanet.org is the property of ISMA and may not be reproduced without expressed written permission of the Indiana State Medical Association.

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