New, Expanded PayerView Now Available
We’re very excited to announce the release of the second annual PayerView Rankings. PayerView is the first-ever review of health industry payer performance from the vantage point of physicians, including payment speeds, denial rates, adherence to Medicare standards, and more.
This year’s rankings have been expanded from 2006, using claims performance data from more than 8,500 medical providers representing over 28 million medical charge lines for all four quarters in 2006. Data included medical services that were billed in 33 states and submitted to payers in 46 states.
Since its launch in June 2006, PayerView has provided an industry-unique framework to systematically address what athenahealth and Physicians Practice journal believe is unnecessary administrative complexity existing between payers and providers. PayerView is designed to look at payers’ performance based on a number of categories, which combine to provide an overall ranking aimed at quantifying the “ease of doing business with the payer.” All data used for the rankings come from actual claims performance data of athenahealth providers and depict athenahealth’s experience in dealing with individual payers across the nation.
Highlights from the 2007 PayerView Rankings
Among the eight large national payers ranked, there was significant movement and variability from 2006:
- CIGNA Healthcare assumes top overall ranking among national payers, moving up from 5th overall in 2006. Melissa Lukowski, athenahealth’s Director of Payer Outreach, explains this is because CIGNA implemented several initiatives to address key issues. She reports that CIGNA executives are pleased that PayerView reflects these efforts.
- Former top ranked payer Humana dropped to 4th. This is partly due to the fact that this is a competitive group of payers, and Humana remains consistent or even improved on some measures compared to last year.
- Aetna moved from a ranking of 4th in 2006 to 2nd in 2007, also having the lowest Days in Account Receivable (DAR) among national payers.
- The rankings indicate an increased burden put on physicians in having to manage patient collections due to consumer-directed health plans, co-insurance, co-pays, and high deductible plans. There was a 19 percent increase in the amount of billed charges transferred to patients by national payers from last year’s rankings. Coventry Health Care ranked last among national payers with a 10.7 percent patient liability rating.
- DAR for processing claims decreased close to 5 percent for national payers and 3 percent for regional payers from the 2006 rankings. This may indicate that the industry as a whole has improved with respect to claim processing, as has the athenahealth provider community’s ability to better manage the claim revenue cycle.
athenahealth’s annual PayerView Rankings are just one way that its service-based approach to billing and practice management supports physician practices. By offering PMIS and billing software to practices in addition to the largest database of insurance rules and back-office services we have the ability to:
- Manage payer relationships, process claims and monitor practice performance with our back-office service team
- Provide robust reporting tools that give insight into practice performance and allow a closer look at the payer mix
- Continually update our database of payer rules that allow us to catch claim errors as they happen for “clean” claims and accurate payments from your insurance payers
To view the complete 2007 PayerView Ranking, visit www.athenaPayerView.com.