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February 15, 2013 at 08:30 AM EST
Moving Forward: Payers Weigh in on Priorities for 2013 and Beyond
The Managed Care Executive Group and HTMS survey demonstrates that health plans are optimistic and believe opportunities exist in post-reform era

NASHVILLE, Tenn., Feb. 15, 2013 /PRNewswire/ -- The Managed Care Executive Group (MCEG) and HTMS, an Emdeon company, today jointly issued their fourth annual report examining critical issues, priorities and challenges for regional health plans in the post-reform era. The report, titled "Moving Forward: Payers Weigh in on Priorities for 2013 and Beyond," is based on a survey of 75 health plans.  

A highlight of this year's findings was the health plans' general optimism despite recent industry challenges. According to the survey, 82 percent of payers saw opportunities for their companies related to the Affordable Care Act (ACA).

"A common public perception is that health plans oppose reform," said Ferris Taylor, strategy and planning director for MCEG and president of Armored Online. "Our findings show that sentiment is not the case. Only 13 percent of the health plans surveyed believe the ACA to be wholly negative for their business. Rather, organizations see opportunity for growth as the market changes."

Full survey results will be shared during a webinar to be held at 3 pm ET on February 19, 2013. MCEG and HTMS executives will present results regarding how payers are handling operational issues, such as the Medical Loss Ratio (MLR), and challenges presented by the ACA, including participation in state health insurance exchanges (HIX). To register for the online event, visit http://www.htms.com/industrypulse.php.  

Overwhelmingly, health plan respondents listed cost containment as their number one priority for 2013. Other continuing trends, such as participation in HIXs, accountable care and health information exchanges, appear to be stronger industry forces. In contrast to the 2012 report, administrative mandates were not a key focus for health plan respondents in the 2013 survey, likely due to the recent ICD-10 implementation deadline extension to October 1, 2014, and the transition to HIPAA 5010 that occurred last year.

Not surprisingly, growth also remained a key payer focus. "Health plans responding to the 2013 survey unanimously listed member retention and growth as their top operational objectives," said Nancy Wise, vice president of strategic consulting for HTMS. "We believe that current industry drivers, including accountable care and the state HIXs, present opportunities for payers to expand their member base."

To download a copy of "Moving Forward: Payers Weigh in on Priorities for 2013 and Beyond," or to view previous research reports, visit http://www.htms.com/industrypulse.php.

About The Managed Care Executive Group

The Managed Care Executive Group (MCEG) is a national organization that provides a forum for the open exchange of information, innovative ideas and experience among senior health plan leaders. MCEG was formed in 1988 to create a comfortable forum for the exchange of ideas, the development of valuable peer relationships and the opportunity to explore the innovation that will transform organizations and the industry. Its 24th Annual Forum begins March 10, 2013. Register at www.mceg.net.

About Emdeon

Emdeon is a leading provider of revenue and payment cycle management and clinical information exchange solutions, connecting payers, providers and patients in the U.S. healthcare system. Emdeon's product and service offerings integrate and automate key business and administrative functions of its payer and provider customers throughout the patient encounter. Through the use of Emdeon's comprehensive suite of products and services, which are designed to easily integrate with existing technology infrastructures, customers are able to improve efficiency, reduce costs, increase cash flow and more efficiently manage the complex revenue and payment cycle and clinical information exchange processes. For more information, visit www.emdeon.com.

SOURCE Emdeon Inc.

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