NU Online News Service, Nov. 12, 1:42 p.m. – U.S. managed care companies are still expanding their use of Web-based customer service systems, according to a new study by Cap Gemini Ernst & Young U.S. L.L.C., New York.
The consulting firm, which based the results on a fall survey of 97 U.S. managed care organizations, found that 44% of the companies let plan members order prescription drugs online in September, up from only 14% in March.
Penetration increased to 66%, from 59%, for Web-based claims tracking; to 55%, from 45%, for distribution of explanations of benefits; and to 37%, from 29%, for tools giving members the ability to change primary care doctors.
Some Web-based services are almost universal: 97% of the companies surveyed, for example, offer Web-based provider directories.
Congress tried to increase the efficiency of the U.S. health finance system in 1996 by including provisions in the Health Insurance Portability and Accountability Act that require all health insurers to adopt a single health data communications standard.
But HIPAA also includes tough new health privacy rules, and Cap Gemini says the difficulty of complying with those rules, combined with the difficulty of complying with the data communications rules, has actually caused some retrenchment: only 21% managed care sites now let members submit claims electronically, down from 31% in March, and only 72% offer two-way electronic mail, down from 90%. Some carriers have temporarily suspended electronic claims submission and two-way e-mail services while upgrading their sites to comply with HIPAA, Cap Gemini says.