By Lee Barrett of EHNAC
There are major industry shifts already underway that will change how the payment and document industry transacts business. With the complexity of changes taking place in relation to how ARRA, HITECH and HIPAA affect our industries, every payment processor and document manager would be wise to keep a finger on the pulse of the hot topics of the day and trends that provide indication of future directions for the industry.
One important change is the fact that providers and banks will be able to provide reconciled data streams so that any needed claim adjustments can be minimized and there can be a marrying of the remittance and electronic funds transfer. The benefit of this reconciliation is that manual intervention becomes minimal for inputting data into accounts payable applications, and there are few additional contractual adjustments required as compared to the large number needed today. This is, of course, all to the benefit of the provider organization and ultimately the patient or payer.
The second recent trend is, in fact, the revitalization of an old trend. With the ever-increasing cost of health insurance, organizations are seeking more economical solutions to meet the needs of their employees. As a result of this, the industry is seeing healthcare savings plans regaining traction at a significant rate. Health savings accounts or HSAs are most frequently used in conjunction with a benefit debit card, and give employees the benefit of being able to put pre-tax dollars toward deductible payment or coverage of other health related services. Given the complexities of HITECH, HIPAA and COBRA, organizations and financial institutions offering HSAs are required to keep track of changing regulations regarding excise taxes and concerns related to health and financial data security, privacy and confidentiality.
A third recent trend the industry is witnessing arises from the consumer demand for transparency in their healthcare experience, and the desire to have all healthcare payment and records available through a single portal. These “Wealth Care portals” provide for connections and efficient processing of all healthcare needs for a patient, allowing a patient to determine what they owe different providers, by tracking their invoices and payments through a single site. These portals would also give patients the ability to make better-informed decisions, make use of calculators and tools to determine costs and savings and track the status of claims made to their health insurance.
The electronic healthcare and payment-document processing worlds are changing rapidly, with exciting developments coming to light almost daily. To ensure that these trends truly benefit our own customers, it makes sense to stay abreast of the changes, and constantly analyze what the changes mean to our organizations as well as to our stakeholders.
Lee Barrett is executive director of the Electronic Healthcare Network Accreditation Commission (EHNAC).
Showing posts with label ARRA. Show all posts
Showing posts with label ARRA. Show all posts
Wednesday, November 17, 2010
Sunday, August 1, 2010
State Government IT: Version 2010
Posted by Mark Brousseau
As with every arm of government in today’s environment, state government chief information officers (CIOs) must do more with less. A search for lower costs will drive the agendas of many state CIOs for the next few years, as they look for ways to enhance IT performance. According to the 2010 State CIO Survey, conducted by Grant Thornton LLP, the National Association of State Chief Information Officers and TechAmerica, two-thirds of state and territorial CIOs face budget decreases in 2011 through 2013. However, some state CIOs see a silver lining — public sector IT departments are increasing the use of shared services, reassessing contracts and leveraging economies of scale when purchasing.
Three out of four CIOs say their offices receive some form of American Recovery and Reinvestment Act of 2009 (ARRA) funding. Eighty percent say other state agencies have also benefitted from ARRA money. Although additional funding undoubtedly helps cash-strapped IT departments, it’s not always easy to determine the impact on performance — one-third of CIOs say they do not formally measure how IT contributes to agency missions and strategies.
At a time when government and citizens are demanding increased transparency, CIOs must find ways to demonstrate the efficiency and value of IT, Grant Thornton concludes.
What do you think?
As with every arm of government in today’s environment, state government chief information officers (CIOs) must do more with less. A search for lower costs will drive the agendas of many state CIOs for the next few years, as they look for ways to enhance IT performance. According to the 2010 State CIO Survey, conducted by Grant Thornton LLP, the National Association of State Chief Information Officers and TechAmerica, two-thirds of state and territorial CIOs face budget decreases in 2011 through 2013. However, some state CIOs see a silver lining — public sector IT departments are increasing the use of shared services, reassessing contracts and leveraging economies of scale when purchasing.
Three out of four CIOs say their offices receive some form of American Recovery and Reinvestment Act of 2009 (ARRA) funding. Eighty percent say other state agencies have also benefitted from ARRA money. Although additional funding undoubtedly helps cash-strapped IT departments, it’s not always easy to determine the impact on performance — one-third of CIOs say they do not formally measure how IT contributes to agency missions and strategies.
At a time when government and citizens are demanding increased transparency, CIOs must find ways to demonstrate the efficiency and value of IT, Grant Thornton concludes.
What do you think?
Sunday, February 28, 2010
Unifying Information Channels
By Mark Brousseau
Healthcare organizations should look at new ANSI 5010 standard as an opportunity to modernize their entire information processing infrastructure, Edifecs CEO Sunny Singh told attendees this afternoon at the Medical Banking Project Boot Camp at HIMSS10 in Atlanta.
By January 1, 2012, all covered entities must be able to send and receive all HIPAA transactions in the 5010 format. With more than 1,300 changes in 5010, compared to 4010A1, organizations must understand the new information contained in 5010 and how best to use this data. Combined with all of the other corporate strategies that healthcare organizations face, 5010 is a complex challenge – and its deadline is fast approaching. “Deadlines make everybody nervous,” Singh said, adding that organizations that haven’t started implementing a 5010 solution need to do it now.
But the new 5010 standard provides healthcare organizations with the chance to finally unify their information channels, to ensure that they process all of their information – incoming and outgoing – in a consistent way. This will help organizations achieve operational efficiencies and remain competitive, while easing their path to compliance with inevitable future regulations, Singh said.
“Healthcare organizations are getting information from various channels,” Singh explained. “When you make sure that every channel is unified, initiatives like 5010 become much easier to implement.”
Faced with meeting the new 5010 standard, healthcare organizations face three options, Singh said: complete replacement of all systems (“rip and replace”); remediation of core processing systems; and step-up/step-down. Singh noted that the complete replacement of core systems is a very expensive proposition for which there doesn’t seem to be a lot of takers. Remediation takes less time, Singh said, but organizations must have a sizeable team working on the project, and, depending on the existing systems involved, may still require considerable time, money and resource investments.
The option that is gaining the most traction, he said, is the step-up/step-down approach. In this scenario, organizations would convert 5010 information to 4010 and pass it throughout their systems; they also can convert the 4010 information to 5010 format and pass that throughout their systems.
“This is the most pragmatic option if 5010 planning and implementation has not yet commenced,” Singh said. “It has the least impact on core processing systems and other ongoing projects.”
But most importantly, it helps to unify a healthcare organization’s information channels.
Healthcare organizations should look at new ANSI 5010 standard as an opportunity to modernize their entire information processing infrastructure, Edifecs CEO Sunny Singh told attendees this afternoon at the Medical Banking Project Boot Camp at HIMSS10 in Atlanta.
By January 1, 2012, all covered entities must be able to send and receive all HIPAA transactions in the 5010 format. With more than 1,300 changes in 5010, compared to 4010A1, organizations must understand the new information contained in 5010 and how best to use this data. Combined with all of the other corporate strategies that healthcare organizations face, 5010 is a complex challenge – and its deadline is fast approaching. “Deadlines make everybody nervous,” Singh said, adding that organizations that haven’t started implementing a 5010 solution need to do it now.
But the new 5010 standard provides healthcare organizations with the chance to finally unify their information channels, to ensure that they process all of their information – incoming and outgoing – in a consistent way. This will help organizations achieve operational efficiencies and remain competitive, while easing their path to compliance with inevitable future regulations, Singh said.
“Healthcare organizations are getting information from various channels,” Singh explained. “When you make sure that every channel is unified, initiatives like 5010 become much easier to implement.”
Faced with meeting the new 5010 standard, healthcare organizations face three options, Singh said: complete replacement of all systems (“rip and replace”); remediation of core processing systems; and step-up/step-down. Singh noted that the complete replacement of core systems is a very expensive proposition for which there doesn’t seem to be a lot of takers. Remediation takes less time, Singh said, but organizations must have a sizeable team working on the project, and, depending on the existing systems involved, may still require considerable time, money and resource investments.
The option that is gaining the most traction, he said, is the step-up/step-down approach. In this scenario, organizations would convert 5010 information to 4010 and pass it throughout their systems; they also can convert the 4010 information to 5010 format and pass that throughout their systems.
“This is the most pragmatic option if 5010 planning and implementation has not yet commenced,” Singh said. “It has the least impact on core processing systems and other ongoing projects.”
But most importantly, it helps to unify a healthcare organization’s information channels.
Start ARRA Awareness Training Now
By Mark Brousseau
If they haven’t done so already, companies in the healthcare space should conduct organizational awareness training on ARRA and HITECH, Mary Rita Hyland, AVP, regulatory affairs, The SSI Group, Inc., told attendees at the Medical Banking Project Boot Camp at HIMSS10 this afternoon.
Organizations also should conduct a HIPAA and HITECH gap analysis to identify any products, procedures and services that need to be updated and modified, Hyland told attendees. As part of this exercise, organizations need to identify and coordinate technical or product updates, as well as coordinate and implement policy and procedural updates. “Operationally, ensuring compliance with HITECH’s security and privacy provisions is, to a large degree, an IT function,” Hyland noted.
Once they’ve reviewed their systems, policies and procedures, organizations need to audit and assess their compliance. “You don’t want to wait for an audit to be done on you by a whistleblower or someone else in the industry who doesn’t believe you are in compliance,” Hyland warned. “Audits are going to be important in meeting the guidelines and maintaining your compliance.”
If they haven’t done so already, companies in the healthcare space should conduct organizational awareness training on ARRA and HITECH, Mary Rita Hyland, AVP, regulatory affairs, The SSI Group, Inc., told attendees at the Medical Banking Project Boot Camp at HIMSS10 this afternoon.
Organizations also should conduct a HIPAA and HITECH gap analysis to identify any products, procedures and services that need to be updated and modified, Hyland told attendees. As part of this exercise, organizations need to identify and coordinate technical or product updates, as well as coordinate and implement policy and procedural updates. “Operationally, ensuring compliance with HITECH’s security and privacy provisions is, to a large degree, an IT function,” Hyland noted.
Once they’ve reviewed their systems, policies and procedures, organizations need to audit and assess their compliance. “You don’t want to wait for an audit to be done on you by a whistleblower or someone else in the industry who doesn’t believe you are in compliance,” Hyland warned. “Audits are going to be important in meeting the guidelines and maintaining your compliance.”
Monday, February 15, 2010
Healthcare Standardization
Posted by Mark Brousseau
Standardization of industry practices is critical to the strength of the healthcare market. Lee Barrett, executive director of the Electronic Healthcare Network Accreditation Commission (EHNAC) explains:
As the healthcare industry continues to evolve to meet regulations and requirements outlined in ARRA, HITECH and HIPAA, more than ever, there’s need for standardization of industry practices and optimization of stakeholder cooperation. Coupled with the complex issues surrounding interoperability, privacy, security and access is the fact that healthcare networks, financial service firms, payer networks, e-Prescribing and other solution providers and vendors need to overtly demonstrate their readiness, competence and capability to address these issues and comply with a complex web of regulations.
When any industry goes through the process of defining the standards to which industry participants should adhere, that industry becomes stronger in its own operations and earns greater respect from affiliated and external stakeholders. This is precisely the case with the electronic healthcare transaction industry.
EHNAC, or the Electronic Healthcare Network Accreditation Commission, is focused on establishing, developing, updating and filtering the criteria that define whether organizations operating in the healthcare electronic transaction industry receive accreditation or not. Through a dialogic process, that builds on stakeholder recommendations, insights and comments, EHNAC develops and promotes criteria for best practices, which focus on simplifying administrative processes, maintaining open competition and enhancing operational integrity.
In January, EHNAC announced the finalization and adoption of program criteria for 2010. This announcement concluded a 60-day public comment period for the following programs:
1. ASPAP-EHR – Application Service Provider Accreditation Program for Electronic Health Records
2. ePAP – e-Prescribing Accreditation Program
3. FSAP EHN – Financial Services Accreditation Program for Electronic Health Networks
4. FSAP Lockbox – Financial Services Accreditation Program for Lockbox Services
5. HNAP EHN – Healthcare Network Accreditation Program for Electronic Health Networks
6. HNAP Medical Biller – Healthcare Network Accreditation Program for Medical Billers
7. HNAP TPA – Healthcare Network Accreditation Program for TPAs
8. HNAP-70 – Healthcare Network Accreditation Plus Select SAS 70© Criteria Program
9. OSAP – Outsourced Services Accreditation Program
In addition, the commission developed draft criteria for Health Information Exchange (HIE) entities. In February, this draft criteria was released for 60-day public comment and review and will be finalized during the second quarter 2010.
The issues addressed through the criteria review and approval process become increasingly complex, as the industry responds to specific provisions in the federal acts. Criteria for accreditation programs today address health data processing response times and security; privacy and confidentiality for financial service providers; and e-Prescribing timeliness and security. As regulatory guidelines become more complex, industry participants are called on to make sure their operations are simplified, secure and compliant.
Accreditation also simplifies the process of discerning between those who are adhering to industry standards, and those who are not.
Standardization of industry practices is critical to the strength of the healthcare market. Lee Barrett, executive director of the Electronic Healthcare Network Accreditation Commission (EHNAC) explains:
As the healthcare industry continues to evolve to meet regulations and requirements outlined in ARRA, HITECH and HIPAA, more than ever, there’s need for standardization of industry practices and optimization of stakeholder cooperation. Coupled with the complex issues surrounding interoperability, privacy, security and access is the fact that healthcare networks, financial service firms, payer networks, e-Prescribing and other solution providers and vendors need to overtly demonstrate their readiness, competence and capability to address these issues and comply with a complex web of regulations.
When any industry goes through the process of defining the standards to which industry participants should adhere, that industry becomes stronger in its own operations and earns greater respect from affiliated and external stakeholders. This is precisely the case with the electronic healthcare transaction industry.
EHNAC, or the Electronic Healthcare Network Accreditation Commission, is focused on establishing, developing, updating and filtering the criteria that define whether organizations operating in the healthcare electronic transaction industry receive accreditation or not. Through a dialogic process, that builds on stakeholder recommendations, insights and comments, EHNAC develops and promotes criteria for best practices, which focus on simplifying administrative processes, maintaining open competition and enhancing operational integrity.
In January, EHNAC announced the finalization and adoption of program criteria for 2010. This announcement concluded a 60-day public comment period for the following programs:
1. ASPAP-EHR – Application Service Provider Accreditation Program for Electronic Health Records
2. ePAP – e-Prescribing Accreditation Program
3. FSAP EHN – Financial Services Accreditation Program for Electronic Health Networks
4. FSAP Lockbox – Financial Services Accreditation Program for Lockbox Services
5. HNAP EHN – Healthcare Network Accreditation Program for Electronic Health Networks
6. HNAP Medical Biller – Healthcare Network Accreditation Program for Medical Billers
7. HNAP TPA – Healthcare Network Accreditation Program for TPAs
8. HNAP-70 – Healthcare Network Accreditation Plus Select SAS 70© Criteria Program
9. OSAP – Outsourced Services Accreditation Program
In addition, the commission developed draft criteria for Health Information Exchange (HIE) entities. In February, this draft criteria was released for 60-day public comment and review and will be finalized during the second quarter 2010.
The issues addressed through the criteria review and approval process become increasingly complex, as the industry responds to specific provisions in the federal acts. Criteria for accreditation programs today address health data processing response times and security; privacy and confidentiality for financial service providers; and e-Prescribing timeliness and security. As regulatory guidelines become more complex, industry participants are called on to make sure their operations are simplified, secure and compliant.
Accreditation also simplifies the process of discerning between those who are adhering to industry standards, and those who are not.
Wednesday, May 13, 2009
Confusion Over ARRA Funding
Posted by Mark Brousseau
A Dell survey of 662 public-sector IT professionals indicates a need for clearer, more customized information related to the flow and impact of American Recovery and Re-Investment Act (ARRA) funds. The survey results also suggest mounting IT challenges among public-sector healthcare and government organizations. Among the findings of the survey:
... 79% of public-sector IT professionals indicated they don’t have enough visibility or are only somewhat aware of the impact and flow of ARRA funds on their organizations.
... 78% said ARRA-related information is non-existent, too generic or not understandable and that tailored tools are needed to better navigate the recovery package.
... Higher education IT professionals rank resources as largest IT-related impediment to modernizing America’s educational institutions.
... Federal, state and local government IT professionals said a lack of standards, budgets and resources for IT deployment and management each has a “high impact” on infrastructure modernization.
... Healthcare IT professionals indicated that budgets, interoperability and disparate networks are the “largest IT impediments” to modernizing America’s healthcare system.
Frank Muehleman, vice president and general manager, Dell North America Public Business Group, noted that Dell sees three consistent themes from customers who want to use the ARRA to invest in IT: they want cost and energy efficiency, they demand transparency, and they are focused on IT that is simple to deploy and manage.
What do you think? Post your comments below.
A Dell survey of 662 public-sector IT professionals indicates a need for clearer, more customized information related to the flow and impact of American Recovery and Re-Investment Act (ARRA) funds. The survey results also suggest mounting IT challenges among public-sector healthcare and government organizations. Among the findings of the survey:
... 79% of public-sector IT professionals indicated they don’t have enough visibility or are only somewhat aware of the impact and flow of ARRA funds on their organizations.
... 78% said ARRA-related information is non-existent, too generic or not understandable and that tailored tools are needed to better navigate the recovery package.
... Higher education IT professionals rank resources as largest IT-related impediment to modernizing America’s educational institutions.
... Federal, state and local government IT professionals said a lack of standards, budgets and resources for IT deployment and management each has a “high impact” on infrastructure modernization.
... Healthcare IT professionals indicated that budgets, interoperability and disparate networks are the “largest IT impediments” to modernizing America’s healthcare system.
Frank Muehleman, vice president and general manager, Dell North America Public Business Group, noted that Dell sees three consistent themes from customers who want to use the ARRA to invest in IT: they want cost and energy efficiency, they demand transparency, and they are focused on IT that is simple to deploy and manage.
What do you think? Post your comments below.
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