WATERTOWN, Mass. and BALTIMORE, May 2, 2007 (PRIME NEWSWIRE) -- athenahealth, Inc., a leading provider of web-based services, knowledge, and software for medical practices, and Physicians Practice(r), America's leading practice management journal for physicians, today released the second annual PayerView(sm) Rankings. This year's rankings have been expanded from 2006, utilizing claims performance data from more than 8,500 medical providers representing over 28 million medical charge lines for all four quarters in 2006. This data included medical services that were billed in 33 states and submitted to payers in 46 states. The PayerView data is derived from athenahealth's web-based athenaNet(r) practice management system database, and ranks health insurers according to specific measures of financial, administrative performance, and medical policy complexity.
"Administrative waste associated with processing medical claims is costing Americans and businesses billions of dollars," said Jonathan Bush, Chairman and CEO of athenahealth. "Our primary goal in creating PayerView was to bring transparency to all stake holders in healthcare and help create an industry-wide dialogue on how breakdowns in these relationships can be addressed. This year's results indicate that some payers are making strides toward operational improvements on behalf of physicians which we believe will translate into larger cost savings to the industry at large, but there is still significant work to be done."
"Physicians struggle daily to get paid fairly for the work they do. PayerView is one opportunity to bring that issue to the public forum as well as for physicians to make better, data-based decisions about whether to continue working with certain payers. We see PayerView as a form of empowerment for physicians as much as a wake-up call for payers," says Pamela Moore, senior editor for Physicians Practice, the business journal that helps more than 300,000 physicians and their staff in the United States and Canada run their practices more efficiently in order to spend more time with patients.
Since its launch in June 2006, PayerView has provided an industry-unique framework to systematically address what athenahealth and Physicians Practice 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. 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.
To view the complete 2007 PayerView Ranking, visit www.athenaPayerView.com.
PayerView National Payer Results
National Payer 2007 Rank 2006 Rank ---------------------------------------- CIGNA Healthcare 1 5 ---------------------------------------- Aetna 2 4 ---------------------------------------- Medicare - B 3 2 ---------------------------------------- Humana 4 1 ---------------------------------------- UnitedHealth 5 3 Group ---------------------------------------- Wellpoint 6 7 ---------------------------------------- Coventry Health 7 Not Care ranked ---------------------------------------- Champus/Tricare 8 6 ----------------------------------------
Findings 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. Former top ranked payer Humana dropped to 4th. * 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.
There were also significant items to note for Regional payers
* Blue Cross & Blue Shield Rhode Island had the lowest DAR of any payer in the nation averaging an impressive 16.8 days to process a claim. This compared to New York-Medicaid, the payer with the highest DAR, averaging over 111 days. * As industry trends indicate, patient liability is on the rise. Blue Shield of California was the lowest ranked payer in the nation with a percent patient liability of 16.86 percent.
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 Journal, 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
About athenahealth
athenahealth provides a physician revenue and clinical cycle management offering that integrates Web-based practice management and electronic medical record (EMR) software, continually updated payer knowledge, and back-office processing specialists into a single service. The results are faster payment at lower cost, improved patient care, higher revenue retention and less hassle for the thousands of physicians using athenahealth nationwide. The company currently collects over $2 billion on behalf of its clients on an annualized basis. athenahealth is dedicated to helping providers make optimum use of their time, ultimately improving the quality of service delivered and the financial reward for it. For more information, visit www.athenahealth.com or call (888) 652-8200.