WATERTOWN, Mass., May 28, 2009 (BUSINESS WIRE) -- athenahealth, Inc., (NASDAQ: ATHN), a leading provider of internet-based business services to physician practices, and Physicians Practice(R),America's leading practice management journal for physicians, today released the fourth annual PayerViewSM Rankings that indicate national health insurers are paying physicians 5.3 percent faster and denying 9.0 percent fewer medical claims over the prior year, with Humana, Inc. assuming the top ranking among national payers. These positive results support athenahealth's ongoing efforts to use PayerView as a framework to address process gaps that exist in the complex relationship between payers and medical providers on behalf of its national physician network. The data also support current government and industry efforts to reduce administrative costs in health care and expand access to care through greater automation and transparency of health information. The complete 2009 PayerView Rankings and trends, evaluating 172 national, regional, and government payers in 40 states, can be found at athenahealth's new Corporate and PayerView Ranking's website www.athenahealth.com/PayerView.
This year's rankings represented the largest data set to date, using performance data from more than 18,000 medical providers representing over 41 million medical charge lines and $7 billion dollars in charges billed to payers in 47 states for all four quarters of 2008. The data is derived from athenahealth's national electronic health record (EHR) and practice management platform, athenaNet(R), and ranks health insurers according to specific measures of financial performance, administrative performance, and medical policy complexity.
The 2009 PayerView Rankings and athenahealth's collaborative work with national and regional payers highlight programs underway to automate various claims and billing work conducted by physician practices in an effort to address growing healthcare administrative costs and streamline claims processing to allow providers and their staff to focus more on the delivery of care. This further underscores the findings of the May 2009 study conducted by The Commonwealth Fund and Robert Wood Johnson Foundation's Changes in Health Care Financing and Organization (HCFO), which found that the overall costs associated with physician practices' administrative and business interactions with health insurers is $31 billion annually or 6.9 percent of all U.S. expenditures for physician and clinical services. It was also determined that physicians on average are spending the equivalent of three work weeks annually on administrative and medical billing tasks.
"With much of the current attention and dialogue on health care reform focusing on driving greater use of electronic health records, our latest PayerView data and ongoing collaborative efforts with payers illustrate the tremendous challenges and opportunities that exist in addressing the billing and administrative breakdowns in our care delivery system which represent the largest source of cost waste and burden for doctors and their patients," commented Jonathan Bush, Chairman and CEO of athenahealth.
"Humana's ascent to the top of the rankings can be credited to faster claims payment with fewer denials than its peers," said William F. Jessee, MD, FACMPE, President and CEO of the Medical Group Management Association (MGMA). The MGMA serves 22,500 members who lead and manage more than 13,700 organizations in which almost 275,000 physicians practice. "Receipt of fast, accurate payments is critical to effectively managing the business operations of physician practices. While MGMA commends Humana for this important achievement there remains considerable room for improvement across the industry. Humana has shown a willingness to reach out directly to MGMA and carefully listen to the needs of our members. Its ability to embrace new technologies and adapt to meet the needs of its group practice customers is clearly beginning to pay off."
The PayerView Rankings are 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. The rankings include national payers with at least 120,000 charge lines of data and regional payers with a minimum of 20,000 charge lines.
"We are honored to be named as top payer by athenahealth again this year," said Bruce Perkins, Senior Vice President, health care delivery systems and clinical processes, for Humana. "This is a reflection of the work we are doing to eliminate the 'hassle factor' for health care providers. Humana and athenahealth share the common goal of bringing transparency to health care. As part of our effort to make it easier for hospitals and physicians to do business with us, our work with athenahealth and other organizations continues to help us simplify and standardize our claims payment processes. We are deeply committed to creating a smooth administrative experience by paying claims timely and accurately the first time."
About Physicians Practice
Physicians Practice creates content to help physicians strengthen their practice operations to improve patient care through its award-winning journal, popular Web site, audioconferences, newsletters, and live seminars. Physicians Practice(R), America's Leading Practice Management resource, received numerous awards in 2006-2007, including: Publication of the Year, Best Publication Redesign, and Best Regular Column for "The Bigger Picture" from the American Society of Healthcare Publication Editors (ASHPE); Publication Redesign from the American Society of Business Publication Editors (ASBPE); and recognition as one of Baltimore's Future 50 companies from SmartCEO magazine. For more information about Physicians Practice, visit our web site at www.PhysiciansPractice.com
athenahealth is a leading provider of internet-based business services for physician practices. The Company's service offerings are based on proprietary internet-based practice management and electronic health record (EHR) software, a continuously updated payer knowledge-base and integrated back-office service operations. For more information visit www.athenahealth.com or call (888) 652-8200.