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The future of revenue cycle with automation & interoperability

July 20, 2023

Insider News for July 2023

For years, the conversations around interoperability have been focused primarily on clinical information with an emphasis on improving health for individuals and populations. What has often been overlooked is interoperability for administrative information. 

How big of a problem is the lack of interoperability in administrative data? According to McKinsey & Company, nearly a fourth of our nation’s healthcare expenditures goes towards administration. Those expenses could be reduced by an estimated $320 billion by implementing interventions that focus on reducing manual processes, improving payer-provider data-sharing, and making scheduling and staffing more efficient. Provider organizations spend approximately $39 billion each year and dedicate an average of 59 FTEs just to comply with hundreds of administrative regulations and requirements.

Our industry is unable to seamlessly access administrative data in real time when and where it’s needed. Any data that is accessed is often a piecemeal of outdated and incomplete patient information. This means providers must request information, aggregate the information (or use a third-party aggregator), and validate the information before it can be used. It’s a highly inefficient, manual, costly process that only delays care and causes friction between payers and providers, leading to a negative experience for patients/members.

Coverage verification is a prime example. Issues tracking down a patient’s benefits information, especially secondary and tertiary coverage, can lead to denied claims, cash flow issues, and write offs for providers. For patients, it can mean delayed or denied care or having to pay for care that should have been covered.

What we need is a way to completely reinvent administrative processes through automation and interoperability. The ideal solution is one where providers and payers could connect once and have direct access to always current, complete patient information—without having to depend on third parties for aggregation or validation.

That network already exists and is in use today by some of our industry’s largest payers and providers. I’m referring to the Avaneer Network.™

On a decentralized network payers and providers connect directly with each other without the need of a third party or the need to build multiple APIs to their payers. Transactions between payers and providers become seamless, fast, and highly efficient.

We have the capability to significantly slash the cost of administrative waste in the U.S. by leveraging a decentralized network like Avaneer Health. We invite you to join us as we work together to reinvent the business of healthcare. To learn more, click here.

In This Issue

Featured Avaneer Content

How a unique network is poised to reinvent the business of healthcare

It’s no secret that the U.S. wastes billions on administrative inefficiencies each year—money that could be better spent on direct patient care, investments in technology and innovation, and more value-based initiatives.
In our latest white paper, we take a deep dive into the challenges, as well as the opportunities, to finally fix our administrative woes. We also share how our founding members—some of our industry’s largest payers and providers—came together with a common goal of advancing healthcare transformation.

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Industry News

The typical hospital has 16 different electronic health records platforms and 10 or more EHRs in place.

Healthcare IT News

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Pros and Cons of Centralized and Decentralized Data Networks for Interoperability

Healthcare IT News
Of centralized and decentralized networks, both have their advantages but only one comes out on top when it comes to interoperability. In this interview with Healthcare IT News, Avaneer Health CEO Stuart Hanson shares his perspective and his vision for which network has the potential to deliver genuine interoperability and innovation in healthcare.

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ONC is Creating New Frameworks, Standards to Improve Data Sharing

Government CIO Media & Research
The Office of the National Coordinator for Health IT (ONC) has made significant progress bolstering the 21st Century Cures Act since the beginning of the year. This informative article outlines three key advancements made so far—the HTI-1 Proposed Rule, TEFCA, and USCDI—and provides a glimpse into what’s coming next.

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Interoperability: Past, Present and Future

MedCity News
Ever wonder how interoperability in healthcare compares to other industries? Or why it’s taking so long to achieve the kind of data fluidity we all dream of? This insightful article examines those questions and more, providing a high-level view of how we got to where we are and what it will take to get us to where we need to be. The answer may surprise you.

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Priming for the Future of Health Data Interoperability with FHIR

HealthData Management
Although we’ve made progress in establishing data standards in healthcare, many are still quite “limited in scope with a protracted learning curve.” This detailed article provides the information you need to know about how FHIR is helping to mitigate these limitations and where barriers still exist. You’ll also learn about the potential use cases for FHIR and next steps for getting started.

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