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Health Insurers Adding Incentives and Footing the Bill on Electronic Records Until Physician Stimulus Money Arrives

Posted Aug 09 2010 5:02pm

We all know that electronic medical records lead to better care and in the case of insurers it leads to faster pay and more profits as it’s a known fact and has been stated many times over the years that they are the ones that benefit in the pocket book the most.  Patients and doctors benefit with better care but there’s a learning curve and it’s not always easy and takes time.  image

You can read through the article highlights below on who’s doing what and again the one who is growing by leaps and bounds is United with owning their own EHR system.  Data will be aggregated, analyzed and so forth but by who and where remains to be seen, but it will happen.  United of course wants you to cozy up to Ingenix after you are done filing your underpayment claims.  In Michigan they are giving away the medical records and their services to a number of physicians. 

Where are the records stored is the big question and who has access.  Risk image management when it comes to managing money will trip over 3 barrels to get data one way or another.  With algorithmic formulas running wild it’s hard to tell who really gets to see what.  Ingenix already has some data on you more than likely from one subsidiary or another as if they are not insuring your, they might be selling your medication data from the Pharmacy Benefit Management data base, or their software could be used by a 3rd party where they are partners.  The seem to be embedded all other the place and know where to get data and use it for analysis purposes that lead to risk management projections and decisions. 

So is this the next step to medical records with insurers taking over that part of the market as well?  They are taking over everything else in healthcare as they have the “machine gun” technology while the rest of us are running around with “swords and daggers”.


I have been saying all along that this is where it was going to lead if the other side, which means the rest of us don’t have sufficient Health IT software and skills and it appears that day is getting closer. 

Wonder if single pay will still end up shuffling out of all of this, that is if our leaders image are cognizant enough to see what is happening as they pretty much are non participants in all of this.  The Senate didn’t even know what to do with Cloud Services and cut the budget there, so the insurers have to be loving that as this means a longer period of Health IT literacy and they can continue on their data missions for profit. 

I don’t deny anyone the opportunity to make a profit but as we have seen this is very lopsided and now I believe it is beginning to crush the whole system and nobody is happy.  How do you trust them?  The track record for honesty has not been that good and now with even more intelligence it’s easier to create desired results from algorithmic formulas for profit, that is unless our government gets serious about regulations and digital laws.  It that doesn’t happen soon, it’s big business and not healthcare ruling first.  BD  image

Health-insurance companies including Humana Inc. and Aetna Inc. are stepping into the race to equip doctors with high-tech patient records.

The lure: the estimated 80% of U.S. physicians and 90% of hospitals whose records are still on paper, and the $27 billion in federal stimulus money available to help these holdouts switch. The Obama administration last month outlined how doctors can qualify for the funds starting next year. Come 2015, doctors will be penalized under Medicare if they haven't computerized their records.

On Monday, Humana is teaming up with health-IT company athenahealth Inc. to offer subsidized electronic medical records for about 100 primary-care practices in the insurer's network. Humana will cover 85% of the product's implementation costs, roughly $4,000, and pay doctors as much as 20% more if the records show they are meeting certain performance standards, such as dispensing generic drugs or ensuring preventative screenings.

Aetna and International Business Machines Corp. are launching a Web-based, or cloud, system that will pool patient records as well as lab and claims data, and help doctors measure their care against national quality standards. Aetna says the data will belong to the doctors and the insurer won't have access. The system will be sold to doctors outside of the Aetna network as well as within.

WellPoint Inc., meanwhile, plans to help rural hospitals finance health-IT infrastructure, contributing hundreds of millions of dollars to the effort, said Charles Kennedy, the company's vice president for health information technology. WellPoint says it has no plans to tie its billing system into whatever health records the hospitals buy.

Getting doctors to sign up is still going to be a challenge. UnitedHealth is teaming up with the American Medical Association to set up a pilot with "model physician offices" in Michigan. Ingenix is giving doctors its patient-record software and consulting services for free. The program's goal is to find out what doctors struggle with and ideally iron out wrinkles.

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