Athenahealth and Physicians Practice Magazine today released the second annual ranking of health insurer performance. Dubbed PayerView Rankings, the report 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.”
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.
- There was a 19 percent increase in the amount of billed charges transferred to patients by national payers from last year’s rankings.
- DAR for processing claims decreased close to 5 percent for national payers and 3 percent for regional payers from the 2006 rankings.
So there is some good news here. The drop in A/R is significant, as payers are being more attentive to living up to their contractual obligations. Coupled with last Friday’s settlement with many of the Blue Cross plans, we may be moving into an era of fair business relationships between insurers and physicians. On the other hand, the portion that patients are responsible for climbed by 19 percent, entailed more complex, time consuming and costly collection efforts directed to patients.
These rankings are factors to consider in your contract considerations and in managing you’re A/R. Looking at your payer mix and your own A/R experience with payers enables you to develop better cash flow projections and manage your cash going forward. The escalating shift of the responsibility for health care costs to patients will exaserbate collection problems and the financial crunch on the general public.
For the complete report, go to Athena PayerView.