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Prior to the introduction of the electronic health record CMS (Medicare) and other health plan administrators relied upon claims data. Now the mandate of meaningful use has made clinical data available via the electronic health record. Physicians disparage the EHR because of its disruption of the clinical encounter and inefficiency in data entry. Few would deny the enormous data collection which has taken place.

As you are likely aware by now, CMS’ final rule on Emergency Preparedness Requirements for Medicare and Medicaid Providers and Suppliers went into effect on November 15, 2016 and will be implemented on November 15, 2017. This final rule establishes national emergency preparedness requirements for Medicare and Medicaid participating providers and suppliers to plan adequately for both natural and man-made disasters and coordinate with federal, state, tribal, regional, and local emergency preparedness systems.

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 Outdated, manual processes and rejected claims eat up a large portion of this cost.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.

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.

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.

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.

Availity, the nation’s largest real-time health information network, announced the launch of its automated prior authorization platform, which eliminates the cost, time, and administrative burdens associated with manual authorization processes.

A myriad of factors stand in the way of health care organizations using data analytics to boost reimbursement. As hospitals transition to a value-based reimbursement model, data analytics may play a leading role. However, with an overwhelming wealth of information being generated each day, key decisions must be made to ensure the captured data are truly of benefit.