The 2010 PayerView Rankings, distilled from 39 million charge lines and     $7 billion in services billed from 23,000 providers in 45 states, evaluate 137 regional, national and government payers for financial, administrative and transaction performance.

Check out the results and see who ranked where this year. And watch our Power of PayerView video below to get the full picture.

“PayerView was conceived with two ideas in mind,” says Bob Keaveney, Editorial Director of Physicians Practice which reports on the 5^th annual PayerView Rankings for its 200,000 readers. “First, to give physicians the only data-driven basis for judging their payers’ administrative performance along dimensions that matter to providers, such as speed and ease of payment collection. And, second, to shed a light on the inefficiencies of the payment process in hopes of spurring payers to improve, while simultaneously highlighting areas in which providers themselves can improve as well. Although there is still room for improvement, these latest results suggest that both objectives are being met.”

Stay tuned for more blog posts delving into this year’s trends and highlights and information on our PayerView webinar on June 16th. Register for the PayerView webinar here and receive a complimentary whitepaper.

We’re still between major announcements in federal HIT, so let’s look at a few reasons that things have been quiet for the past couple of weeks:

1. We are awaiting the confirmation of Donald Berwick for head of CMS.

2. ONC is currently working on compiling their review of the public comments for “Meaningful Use.” This will be followed in Q3 by the final rule.

3. ONC is also working on certification planning, but no big decisions have been made.

4. Many of the HITECH projects like Beacon, SHARP, workforce development and even the RECs are doing more ‘heads-down’ planning than announcement of findings or successes. None of the RECs, for instance, have had their operational plans accepted by ONC (or at least as far as we’ve heard).

5. Most of the HIEs are also working on their operational plans for ONC approval.

The one big announcement was that NIST released a solicitation for a consultant to develop a framework for understanding and assessing the usability of healthcare IT. Given that NIST is a body for standards, one could infer that they’re proposing to develop usability standards for EHRs. And given their integral role in certification, one might also infer that future EHR certifications will require EHRs to use certain design principles. It’s something to noodle on. But because of this slow period, your dedicated documenter of departmental derring-do is going to take a break from Gov’t Healthcare IT updates. But buckle your seatbelts for the June 4 update – it’s going to be thrilling!

This company is named for a goddess who typically conjures notions of compassionate wisdom. That’s certainly accurate—one of her totems is an owl. But there’s also an epithet invoked in times of battle: Athena Promachos or “She who fights in front.” Given the current state of health care, a cry to arms seems apt.

I come from the field of telehealth and if asked, I’d say complacency is our enemy. I know the never-ending slog keeps us slaved to the task at hand. But if we don’t look up and don’t act, I’d argue we risk a defeat of our own making.

In my first official outing as athenahealth’s Physician Advisor, I attended the Health 2.0 “In The Doctor’s Office” conference in late April in Jacksonville, Fla. Organized to help providers navigate the implications of the ARRA/HITECH Act, the agenda did a great job laying out some of the battlegrounds ahead.  Permit me to share a few dispatches

Penguins

More than the current fascination of my two-year-old son, it was suggested that a rookery of penguins is a helpful metaphor describing the inertia of health care, that is, no one moves unless we all move.  While perfectly reasonable, I would suggest closer examination to reveal the subtle dance of shared work as individuals rotate out to brace the collective against harsh conditions. It’s how penguins roll, and it could be an effective approach for us all to consider. 

The Cloud

One of many tech-oriented buzzwords captivating the Interweb, I was gratified to see every presenter and attendee in agreement that cloud computing will play a key role in future health care documentation and communication.  And though challenges remain in how to achieve this, I was left considering the true potential of the cloud.  Beyond resolving basic inefficiencies, the question is less about whether to use the cloud and more about how the cloud might enable some truly transformative benefit.

Meaningful Use

Perhaps the buzzword du jour, a Beltway insider characterized federal efforts very well confirming “Meaningful Use” as an ambitious plan of political will and investment toward EMR/EHR adoption.  Having focused primarily on the Regional Extension Center program and our “Meaningful Use” guarantee at athenahealth, the question remains of how high to set the bar.  Early opinion and evidence seems to highlight prolonged implementation and meager adoption rates as reason to lower the bar.  The recent award of $1.6 million to build a time-limited, web-based, Stage 1 attestation function for Centers for Medicare & Medicaid Services (CMS) is evidence of what I fear most.  Though welcome, the considerable federal investment into EHR adoption will serve to create or sustain solutions incapable of surviving past the incentive window.  Take the question posed by Matthew Holt, host of The HealthCareBlog: “What will the landscape look like in five years and what effect will that have on choices being made today?”  

Then there’s the phenomenon of “EHR second spouses.” After spending copious time and money implementing some EHR solution, practices will make the painful decision to change spouses (EHR) whether for cost, usability, or emergence of new technology. The transition will likely begin in the back half of the “Meaningful Use” window, through 2016. The feeling at Health2.0 in Jacksonville was that this could be very real and increasingly more common.

Stand by for more dispatches from the front—and maybe some inspiring hyperbole to spark discussion.

This post is called “In the News and in the Blogs” but this week we should just call it “In the Mix.”

To wit:

On May 11, CEO & President Jonathan Bush made an appearance on Fox Business Network to talk about the HITECH Act, electronic medical records and the athenahealth model. This follows an earlier piece from the Bits Blog on The New York Times website. The NYT story got some attention on The Health Care Blog in a comprehensive installment from Matthew Holt. That post looks at a piece about athenahealth on the Xconomy website, which sparked a bit of a brushfire on the HIStalk blog. The dialogue is ongoing. Feel free to post your comments here.

In response to a blog entry in HIStalk re: athenaCommunity’s impact on patient privacy, please see below….

First premise: Knowledge is power.

Second premise: HIPAA is intended to protect patient data that is generated in the course of healthcare operations

If you agree, you should read on.

Simple question: For the average US citizen, where do you think the majority of their clinical (and up-to-date insurance) information resides? If your answer is “in the primary care physician’s office”, you are correct. Follow-up question: If a particular ailment requires a patient to see another healthcare provider (e.g., a specialist), how does that patient’s clinical information get in the hands of this provider?

Today, your answer is likely (1) it doesn’t or (2) it involves you making copies of your chart and lugging them to your next visit. Either way, it is not efficient, reliable, or safe from a privacy or care quality perspective. Take your pick.

Over the last decade, the electronic medical record industry has been very focused on capturing data that formerly resided in a chart room at a physician’s office. Sure, EMR vendors provided connectivity with other participants in the healthcare supply chain (e.g., pharmacies), but only when access to those participants was consolidated by another organization (e.g., Surescripts)—in all cases, some other firm had to make it simple.

The EMR industry has not been focused on developing a practical and economically rational way of enabling key clinical data to be exchanged between physicians and other health care participants to better coordinate patient care. The federal government’s “meaningful use” regulations attempt to change the focus, but physician offices that have to meet these data exchange requirements will end up paying software vendors to develop point-to-point interfaces (potentially with an HIE). This is an OLD SCHOOL strategy that isn’t economically sustainable, places an enhanced financial burden on the primary care physician, and does nothing to ensure that the right data gets to the right healthcare provider at the right time. Practically speaking, it won’t work.

athenahealth is launching athenaCommunity to solve this problem. This new service offering is designed to simplify clinical data exchange between physicians and other health care participants in a way that empowers primary care physicians to truly care for their patients by ensuring that appropriate clinical and administrative data is routed to downstream trading partners without undue effort on the part of their staff. As a service organization, athenahealth will take on the majority of work (e.g., compilation of key insurance and demographic data, including pre-authorizations) related to generating and processing a clean order. Also, to ensure that patients comply with referral requests made by their PCP—a problem that often exacerbates what could otherwise be a minor healthcare issue—athenahealth will place a “reminder call” to every patient that has a referral processed through our network. In return for a clean order, athenahealth will charge the receiving provider a nominal transaction fee. Simple supply chain economics—the party that receives value pays something for it.

In short, our mission as a company is to make healthcare work as it should. In the context of this conversation, this means (1) enabling primary care providers to effectively and economically care for their patients, (2) assisting patients in their efforts to comply with the “orders” requested by their PCP, which will drive the highest quality healthcare outcome, and (3) enabling a sustainable business model. In light of recent legislative and market gyrations, this seems to make a lot of sense.