Emdeon: Use of electronic claims, remittance advice transactions rising

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With the current rate at 85 percent--a 10 percent increase over 2008 data--the healthcare industry is making progress on the adoption of electronic claims, according to a report on electronic transaction-adoption status in the U.S. by from revenue cycle management company Emdeon.

The U.S. Healthcare Efficiency Index (USHEI) was developed by Emdeon, of Nashville, Tenn., in 2008 to raise awareness of the potential cost savings associated with the adoption of basic electronic transactions in healthcare. The data in the compiled phase I study from December 2008 noted that the total unrealized industry savings was $29.7 billion per year for medical claims-related transactions and that the percentage of paper to electronic transactions was 57 to 43 percent, respectively.

Phase 2 data, which began collecting in the summer or 2009, is based on a sample of 113 payers, including two large national payers and over 100 medium and small regional payers which Emdeon estimated represents about 40 percent of the U.S. population. “To date, analysis has been completed on two of the five original data transactions: Claim Submission and Remittance Advice,” the company stated.

The first annual National Progress Report on Healthcare Efficiency reported that the current adoption of electronic remittance advice transactions is at a rate of 46 percent, compared with 26 percent from phase I data.

“While work continues to expand the data set and analysis, the findings are significant in a number of important ways,” the report stated. “[T]hey represent a new baseline for tracking progress...and confirm that electronic adoption is trending upward, however opportunities for significant savings still exist.”

According to Emdeon, phase 3 of the USHEI is focused on pharmacy-related data as prescription “medicine has an immense impact on the health of the population…By exploring efficiency within the pharmacy sector, we can not only quantify potential cost savings but also identify opportunities to enhance quality of care and patient safety.”

The development of the U.S. Pharmacy Efficiency and Adherence Index is scheduled to launch by early 2011, the report stated.

To read the full report, click here.