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TECH/HEALTH PLANS: AthenaHealth causing trouble again

AthenaHealth caused a ruckus last year when it put out  a ranking of how fast health plans were paying doctors. Now they’re at it again. Cigna ranked No. 1 and United didn’t do so well. Of course if just speed of payment were the problem in American health care, it would have been fixed long ago.

But surely there’s much else in their data that would be interesting to know about. For example, I’m looking forward to AthenaHealth telling us from its data what activities of its physician customers were appropriate given their patients’ conditions. I’m interviewing AthenaHealth CEO Jonathan Bush in a few days, and I’ll ask him about that.

Any other suggested questions?

UPDATE: Here’s the chart of AthenaHealth’s 2007 Payerview rankings. They’ve also put up a rather flashy website explaining it all.

PAYERVIEW NATIONAL PAYER RESULTS:

National Payer 2007 Rank 2006 Rank
CIGNA Healthcare 1 5
Aetna 2 4
Medicare – B 3 2
Humana 4 1
UnitedHealth Group 5 3
Wellpoint 6 7
Coventry Health Care 7 Not ranked
Champus/Tricare 8 6

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ChironScottBrian KlepperBenjamin AtkinsonBarry Carol Recent comment authors
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Chiron
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Chiron

Scott, I’m sorry, but your characterization of the current discourse as “slamming AthenaHealth” seems disengenuous. Aside from that, although the window of opportunity to suggest input to the interview with Jonathan Bush is gone, I am curious as to anyone’s speculation on the significant shifts between health plan ratings from 2006 and 2007. (e.g. In 2006, Human ranked 1st. In 2007 it dropped to 4th place.) In reference to Brian’s idea about access to health claim information, I suspect that data is not readily accessible due to concerns about patient health information privacy. Although in theory it should be possible… Read more »

Scott
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Scott

WOW. This site applauded BCBS of Minnesota for creating a “nutritional” chart for providers that essentially ranked providers based on cost and quality/level of care. Now this site is slamming AthenaHealth for putting data together that creates some transparency for insurers. Tisk, tisk.

Brian Klepper
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Brian Klepper

I suspect that AthenaHealth would be unwilling to publicly report physician performance. Who wants to antagonize their clients? But if AH has access to the information within the individual claims records, it could add significant additional value by discretely providing physicians with their relative performance values and performance benchmarks. Physicians could use this information in health plan negotiations and to guide performance improvements that will become increasingly important as P4P takes root. At this point, the only data most doctors have access to during contracting are the numbers the health plans give them. While health plans have actively campaigned for… Read more »

Benjamin Atkinson
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I too would be interested in a breakdown of diagnostic, procedure and pharma reimbursements. I suspect we know what we would find. Mr. Bush is sitting on some valuable info. See if you can pry a few nuggets out of him. 😉

Barry Carol
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Barry Carol

Along the same lines as your question, I am curious as to the variance among doctors in risk adjusted utilization. How much is there and to what extent does it relate to defensive medicine, desire to make money from doctor owned diagnostic equipment, excessive caution or some other factor? Also, how much upcoding is there that insurers should be challenging? Any thoughts on the magnitude of fraud?