Reimbursement
CDPHP, a not-for-profit health insurer in New York, has deployed new software to help reduce costs and boost quality.
The healthcare reform bill is far from settled, but its current state is placing great emphasis on how benefit products are designed, according to an industry analyst.
While legislation is a moving target, payers need tools that will serve both consumers and their employer groups, said Janice Young, research director for Health Industry Insights.
ChoiceLinx, a wholly owned subsidiary of Cigna with two primary product lines, is gaining traction in this market.
With the group-based market continuing its decline, payers are turning their attention to the growing individual plan market.
In order to capture that business and engage consumers, payers need to build a direct-to-consumer online capability, which is cost-efficient and can be implemented fairly quickly, said Nancy Sansom, spokeswoman for Benefitfocus.
Historically, payers aggregated data for actuarial purposes or for their sponsoring employer groups' use. Today, data is in greater demand across the industry.
The demand for sharing data with providers and members is creating a big shift in data warehousing, said Dane Iverson, vice president of information management for WellPoint.
Blue Cross Blue Shield of Oklahoma (BCBSOK) is launching its patient-centered medical home (PCMH) in early 2010.
With Oklahoma's growing primary care physician shortage and its bottom five national ranking of their ratio per capita, the payer is looking for ways to impact quality of care while expanding its provider footprint.
Independence Blue Cross' healthcare information technology capabilities helped the company land a new health benefits contract with Lincoln Financial Group, IBC executives announced Thursday.
Physicians in Maine are piloting electronic visits with their patients as part of a program developed between Eastern Maine Healthcare Systems (EMHS) and Anthem Blue Cross and Blue Shield in Maine.
Genetic testing and electronic medical records are top of the ECRI Institute's 2010 technology watch list for health plans.
Compared to other stakeholders in the healthcare ecosystem, payers are late adopters of Health 2.0 technology.
While many payers are beginning to invest, a panel at the Health 2.0 Conference in San Francisco in October demonstrated how they are leading the pack.
Kaiser Permanente's electronic health record system is well known in the industry. The healthcare organization is putting the finishing touches to its EHR throughout the enterprise, said Christopher Ohman, senior vice president of health plan operations outside California for Kaiser.
In a move to drive more transparency in the healthcare insurance market, the Oregon legislature has mandated health plans to provide the cost of 35 different treatments to consumers.
PacificSource has delivered nearly 1,000 estimates for its members since it deployed TriZetto's Treatment Cost Navigator in July, said CIO Erick Doolan.