A nationally known group of healthcare IT vendors announced an ambitious plan Tuesday (Feb 6) to link doctors, hospitals and insurers together with an ASP-delivered suite of applications that could save Montana health insurers $60 million per year.
“Healthcare is unique because you don’t have one vendor that provides a complete solution,” Mark Anderson, formerly a META Group ASP analyst and now the consortium’s lead organizer, told ASP News. “No one’s ever integrated this into one solution.”
The Community Health Information Consortium, as the group is called, is comprised of major hardware vendors including Compaq and Hitachi. Montana’s largest health insurer, Blue Cross/Blue Shield of Montana is a consortium member as is software developer Oracle Corp.
The consortium’s goal is to provide Montana’s healthcare providers and payers with an end-to-end, Web-based solution that connects healthcare providers (doctors and hospitals) with payers (health insurers) that eliminates more than 60 percent of the administrative costs of providing healthcare, Anderson said.
“We believe we can save (insurers) $10 per-member, per-month after the first year,” Anderson said. “But the only way it’s going to work is through ASP and the Internet. It has to be a browser-based system getting into the ASP.”
Without the low-cost, Web-based delivery that the ASP model provides, the whole idea just wouldn’t work, Anderson said. Similar attempts at providing a suite of applications that meet the needs of an entire community have failed because there was no viable delivery model that easily linked all the concerned parties.
With the ASP model even doctors in remote parts of the state can access the system and have claims processed in real time, for example, before the patient ever leaves the office.
“I think ASP is going to be the driver to the success of this,” Dana Walker, e-business executive with BC/BS of Montana, told ASP News. BC/BS of Montana insures over 50 percent of the state’s 800,000 residents and processes over 80 percent of submitted claims, he said.
Anderson expects that new federal regulations laid out in the Health Insurance Portability and Accountability Act of 1996 regarding the electronic exchange of patient information will be a main driver in the adoption of the CHIC solution. By providing HIPAA-certified compliant applications to the healthcare community, providers and payers will not have to develop in-house compliant systems to deal with the new regulations, he said.
Also, because the CHIC group intends to develop solutions that meet the needs of one community – defined as 500,000 covered lives – instead a one-size-fits-all type of approach, payer and providers will be more likely to adopt the model.
“Everyone is working on this, but not for the local community,” Anderson said.
Another key that Anderson believes will lead the plan’s successful adoption is consortium vendors will be paid only if the consortium’s insurers actually save money. “We get a percentage of the savings,” Anderson said.
The first phase of the plan will involve deciding which needs are most pressing and which applications best meet those needs. A data center will be set up locally to host applications and more consortium member vendors will courted, Anderson said. All of this is schedule to be completed by July. By November, applications are expected to be available for use.
