The 2014 PayerView Report reflects 2013 payer data that can help providers anticipate the impact of health reform:
This year's PayerView is dedicated to helping providers use payer performance data to identify risks to their bottom line, and to maintain smooth operations in light of industry change.
As the impact of these trends becomes greater, it will be important for providers and payers to work closely together to solve the problems that arise. In order to do this, both need to understand what is happening in healthcare reimbursement. The purpose of PayerView is to identify where payers and providers could better focus their efforts.
Unlike other medical billing, EHR, and patient communication solutions, athenahealth uses a combination of centrally hosted, cloud-based software tools and robust back-office services. Because each of our more than 59,000 providers shares a single web-based instance of software, data and intelligence are pooled through a powerful network effect. This means that every detail of every billing transaction—patient eligibility check, claim submission, processing time at the payer, claim denials, receipt of electronic or paper remittance, and more—is captured electronically across our national network of providers.
Since its launch in 2006, PayerView has provided a unique framework that systematically addresses unnecessary administrative complexity in healthcare reimbursement. PayerView is designed to evaluate each payer's performance based on a number of key metrics which, when combined, provide an overall ranking that attempts to quantify the ease of doing business with that payer.
All data comes from the actual claims performance of payers that work with athenahealth providers, and reflects athenahealth's experience in dealing with individual payers across the U.S. While our claims billing data set isn't perfect—as no single set can be—through PayerView we strive to bring transparency and process integrity to the analysis of the provider-payer relationship.
"This year's PayerView provides clear insight into how payers are succeeding and faltering. The data reveals existing pain points for providers and, even more critically, areas of payer weakness that could have significant impact during the first full year of the Affordable Care Act. As the only HIT company with the national knowledge and data insight into the working relationship between health care providers and payers, PayerView is part of athenahealth's commitment to keep the industry abreast of trends and prepare providers to thrive through change."Todd Rothenhaus, M.D.