Reducing Administrative Costs
Proving that you truly can do more with less, in 2010 we reduced our total administrative expenses by 3 percent, or $271 million, while also improving key customer service and operational efficiency measurements. By leveraging technology to auto-adjudicate claims, securely transfer medical information and accelerate payments, we are creating leaner, faster benefit systems and improved experiences for members, providers and employers alike. The result is improved outcomes— from the back office to the doctor’s office.
Payment Innovation
We are actively engaged in assessing Accountable Care Organizations (ACOs) as part of our payment innovation strategy to help transform the current delivery model and provide members with access to the right care, at the right time and at the right cost. We have initiated discussions around ACOs in a number of states and plan for more. As a model, ACOs seek to encourage physicians, hospitals, and insurance companies to work together to better coordinate care, improve quality, and reduce costs. Our industry-leading work with ACOs is another way we are collaborating to find innovative solutions to slow the rise in health care costs and improve value.
Emergency Room Utilization Management
Our Emergency Room Utilization Management initiative utilizes numerous communication channels, including the Web, Google Maps directories, interactive, telephonic voice-recognition technology, and useful brochures to help educate members about possible alternatives to visiting the emergency room for routine care. Providing information about available resources within our health plan networks, such as urgent care centers, after-hours providers and retail health clinics, can offer members more choice in finding timely and appropriate care at a lower cost.
Efficient Medicaid Solutions
As states prepare for unprecedented Medicaid growth due to health care reform, the need for Medicaid efficiency has never been greater. WellPoint’s State Sponsored Business (SSB) has created opportunities to partner with states or other health plans to provide them with consultative solutions based on their unique needs. Whether the concern is reducing premature births or a growing chronically ill population, SSB has the ability to design programs that are scalable and provide greater access to resources, expertise and efficiencies to better manage care for a growing sector of health care consumers.
