Growth Forecast
- In February, Anthem has suggested that the funds would be raised by 18 %;
- Although the leverage was effective, the government decided to decrease the rate to 14 % (California Department of Insurance, 2013);
- Anthem Blue Cross introduces available resources, including such health information networks as Availity and member medical record Member History Plus (MMH+).
- The Patient-Centered Primary Care programs provide access to regular Learning Collaborative procedures, Provider Toolkit (Anthem Blue Cross, n. d.)
Pending Legislation
- Anthem Blue Cross will start processing and accepting pre-authorization requests with ICD-1o codes in June, 2014 for services launched after October, 2014;
- To establish ICD-10, Athem introduced team that represent all technology functions all over the organization and are contributed to assessing systems, researching data, and examining business processes (California Department of Insurance, 2013);
- Introducing this code to the organization can increase the quality and accuracy of healthcare and patient treatment.
Current State of Data Collection System
- Anthem Blue Cross collects information each year on the Healthcare Effectiveness Data Information set because it has been accredited by the National Committee for Quality Assurance.
- The organization also makes use of electronic health records, Health Information Exchanges, and patient records.
- 93 % of claims are received via electronic channels.
Current and Future Roles of HIS Professionals
- The main role of HIM professionals consists in exchanging and transparent reporting;
- Introducing electronic databases can ensure accurate patient registering both inside the United States and beyond it (California Department of Insurance, 2013);
- Most of claims that Anthem receives is provided through online channels;
- The organization has provided a list of approved software vendors.
Impact of Health Care Reform
Managed care should be accompanied by high insurance and information processing standards and, therefore, the emphasis should be placed on Affordable Care Act that allows hospitals to introduce these changes (Fabreau & Kuehn, 2011);
The network model is efficient for ensuring sufficient collaboration among health care professionals who should take care of the reform project accomplishment (Fabreau & Kuehn, 2011).
References
Anthem Blue Cross (n. d.) Provider Toolkit – Health Information Technology. Web.
California Department of Insurance. (2013). Anthem Blue Cross Agrees to Lower February 1 Rate Increase for Individual and Family Health Insurance Products. Press Release. Web.
Fabreau, C. and Kuehn, L. (2011) Managed Care, In: Comparative Health Information Management. (pp. 113-145) US: Cengage Learning.