Though HIPAA (Health Insurance Portability and Accountability Act) was adopted 10 years ago, its potential to address and push forward change in healthcare is still evolving. It’s original focus was on patient privacy and security, but now long-term benefits – such as lower healthcare costs, reduction of medical errors, and the development of wide area healthcare information networks – is emerging as another part of its scope, according to results of the twice-yearly U.S. Healthcare Industry HIPAA Survey. The survey is sponsored by HIMSS and Phoenix Health Systems.

"Although there is still progress to be made on implementing HIPAA privacy, security, and transactions standards, we see a fairly high degree of compliance among providers and payers," said Darin LeGrange, president and CEO of Phoenix Health Systems. "Now the industry is focusing on the original intent of the law, which looked to the long-term benefits that could be achieved through the safe electronic communication of healthcare transactions nationwide."

According to the survey, providers have begun implementing return on investment (ROI) initiatives, including:

• Adoption of computerized practitioner order entry (CPOE);
• Conversion paperless medical record; and
• Transacting directly with payers and not clearinghouses.

In related results, the survey found that 1 percent of providers have begun ROI implementation while 21 percent plan to in the future.

Unlike in previous studies, survey participants were asked about the specific benefits of HIPAA. According to results, providers and payers ranked "greater attention to patient privacy by staff" of top importance among the benefits they have seen. Also high on the list were better patient privacy, improved systems and processes, and bolstered consumer confidence. Less than 5 percent of participants saw no benefits at all.

Regarding the National Provider Identifier (NPI) Rule, which requires healthcare providers to use a unique identifier when filing electronic claims, 39 percent of providers claimed their organizations already have applied for their NPI.  

The National Patient Identifier remains controversial. According to results, 30 percent of providers and 45 percent of payers believe there would be more benefit than negatives, whereas 23 percent of providers and 28 percent of payers disagreed.

Other findings of the winter 2006 survey:

• Compliance with security standards remains an issue: 55 percent of healthcare providers report they are compliant with security standards (up from 43 percent in the summer 2005 survey) as do 72 percent of payers (down from 74 percent);
• A significant group or providers – one fifth – is either unable or unwilling to implement privacy requirements;
• Compliance with the Transactions and Code Sets (TCS) rule includes implementation of all necessary policies, procedures, processes and systems in order to test and then conduct the standard HIPAA transactions required for healthcare business functions. Of note is the fact that just 46 percent of providers and 67 percent of payers are actually conducting all the necessary standard transactions for their organizations.