Availity news center

News Center

Availity today announced its recognition as one of the Achievers 50 Most Engaged Workplaces™ in North America. The annual award, issued by Achievers, an industry leading provider of employee recognition and engagement solutions, commends top employers that display leadership and innovation in engaging their workforces.

Administrative costs make up about 15% of all healthcare expenditures—well over $300 billion annually, according to the 2016 index report from the California Association for Healthcare Quality. Outdated, manual processes and rejected claims eat up a large portion of this cost. The key to reducing administrative costs lies in refining these processes and changing with the times, according to industry leaders. Here are five strategies to consider implementing at your organization.

Payers and providers have for decades stayed in their silos, leading to a more fractured and adversarial healthcare system. That relationship, however, is starting to soften for many in the industry. Payer-provider partnerships put the two groups on the same team in hopes of reducing costs and improving care and outcomes through sharing data and better communication.

Availity, LLC, the nation’s largest payer and provider engagement network, today announced it has closed a five year $200 million senior secured revolving credit facility. The facility includes an accordion feature which allows for an additional $100 million of capacity when exercised. The revolver will be largely undrawn at close.

Although collaboration between payers and providers will be critical if they are to succeed in transitioning to value-based payment models, they continue to struggle with information exchange in the current fee-for-service environment. That’s the finding of a new survey of 40 health plans and more than 400 practice- and facility-based providers, which found significant communication gaps between the stakeholder groups.

Online and multi-payer portals are viewed as promising solutions to improve communications between payers and providers while also mitigating costs, yet these tools are underutilized. While 60 percent of payers prefer the use of online portals as the primary means of communication with providers, it seems providers are less enthusiastic, as only 39 percent of practice-based providers and 40 percent of facility-based providers strongly support online portals as a primary source, according to a survey by Availity.

A survey conducted by Availity, the nation’s largest real-time health information network, found that while payers and providers want to collaborate more closely on value-based care initiatives, such partnerships remain vulnerable to poor data transparency, competing business goals, and significant administrative burdens.

Healthcare industry trends such as growth in data analytics and high-deductible health plans are causing payer and provider relationships to evolve. With this evolution comes the need for greater communication and collaboration between the two sides. A recent Availity survey of 40 health plans and 400 practice- and facility-based providers found 53 percent of payers "strongly agree" providers and health plans need to collaborate to be profitable.

Mark Martin, Director, Payer and Vendor Portfolio at Availity, the nation’s largest real-time health information network, will take part in a panel discussion titled “Solving the Inaccuracy and Inadequacy of Provider Directories” at WEDI 2017, May 15-18, in Los Angeles.

In an era of shrinking reimbursements, it's more important to capture every dollar owed to your practice as far forward in the process as possible. It's a matter of time and money. According to a 2016 Kaiser Family Foundation study, average deductible and co-insurance costs have seen the biggest increases between 2004 and 2014, and continue to grow while copays are continuing to decline. The shift toward high deductible health plans has fueled that rise.