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This week, state officials advanced a plan to cut needless administrative paperwork -- red tape that wastes doctors’ time and adds to already unaffordable health care costs.
The plan is one of many pieces moving forward as a result of the Oregon health reform law passed by the 2009 Legislature.
“This is great news for health care consumers,” said Laura Etherton, OSPIRG health care advocate and co-chair of the workgroup convened to develop the plan, “Health care costs more than it should; we can’t afford waste, especially if it ties up doctors’ time that could be spent with patients.”
Etherton co-chaired the public-private workgroup with Dale Johnson, head of Human Resources for Blount and chair of the Oregon Coalition of Health Care Purchasers.
Convened by the Oregon Health Authority’s Office of Health Policy and Research, the workgroup brought together health providers, insurance company representatives and others to develop the recommendations.
Based on an “administrative simplification” approach already in place in Minnesota, and building on work already happening in Oregon, the plan requires insurance companies to move away from each using different paper administrative forms, and instead move to one standard electronic form. Physicians’ offices will then only have to use one system to check a patient’s eligibility for benefits, submit claims, and receive payments.
The Oregon administrative simplification plan will go into place in phases, with the first changes – standard electronic forms for eligibility verification – scheduled to come online in January 2012.
Between now and then, the Health Leadership Council and others will adjust the Minnesota approach to fit Oregon, and the Oregon Department of Consumer and Business Services will issue rules requiring all insurance companies to use the standard forms. The 2011 Legislature is expected to consider legislation needed to apply the standard forms to all segments of the market, including third-party administrators which administer the self-insured plans of very large employers, and the clearinghouses that work with providers to submit administrative forms to insurance companies.
A copy of the Administrative Simplification plan is available at: http://www.oregon.gov/OHPPR/HEALTHREFORM/AdminSimplification/Docs/FinalReport_AdminSimp_6.3.10.pdf
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