GE Healthcare and Accenture Target $2 Billion in Lost Revenue Among U.S. Healthcare Providers
May 19 2016 - 10:00AM
Business Wire
GE Healthcare (NYSE: GE) and Accenture (NYSE: ACN) today
introduced a new offering to help improve medical claims processing
and related cash flow for healthcare providers. The alliance,
targeting medical claims management, one of the largest areas of
lost revenue in the U.S. healthcare system, was announced at GE
Healthcare’s annual software users conference in Phoenix, where
more than 1,500 users are gathered.
GE Healthcare estimates that, through the combination of
analytics and consulting services, these offerings could help
healthcare providers to, on average, save between 25-50 percent of
their current costs to re-process denied claims.
Part of the GE-Accenture alliance announced in 2013, the
offering combines GE Healthcare’s advanced analytics solution,
DenialsIQ—which flags claims denials and uncovers potential hidden
patterns and root causes therein—with Accenture’s experience and
expertise in consulting. The comprehensive solution can help
providers, including large health systems, physician groups and
hospitals, understand how claims management affects their financial
performance and then take action to redesign workflows and
financial operations based on those insights.
“Our alliance with Accenture is an example of how GE Healthcare
is developing game-changing partnerships to deliver what our
customers want and need in an era of value-based care,” said Jon
Zimmerman, VP and general manager, GE Healthcare IT Clinical
Business Solutions. “GE Healthcare’s leading analytics technology,
combined with Accenture’s proven consulting capabilities, will help
our customers deliver better outcomes, putting financial savings to
better use improving clinical care and health system
operations.”
Managing claims denials has proven challenging for healthcare
providers. Accenture estimates1 that of the one in every
five claims that’s denied, it will cost a typical health system, on
average, $25 per claim to re-process. For a $1 billion health
system, reducing claims denials can yield a 0.5-1 percent
lift in operating margin amounting to $5- 10 million annually.
DenialsIQ uses powerful algorithms originally designed by GE’s
Global Research Center for GE’s Aviation business. Similar to
online shopping software that prompts a user with product
recommendations, DenialsIQ can show administrators hidden patterns
and root cause factors before medical claims denials negatively
impact the revenue cycle.
Leveraging GE’s DenialsIQ solution, Accenture will offer
services to help support three types of revenue cycle
engagements:
- A denials management assessment
- A more extensive consulting engagement
that uses DenialsIQ data to help redesign claims workflow and help
reduce the volume of denied claims; and
- Claims management and operations
support services using DenialsIQ
“Accenture and GE are building on our strong alliance to help
address a critical pain point for U.S. health systems,” said
Matthew Collier, managing director, Accenture Strategy, Health. “We
see the challenges providers face with the medical claims process.
We are pivoting to the new by combining our capabilities to bolster
the use of analytics in driving financial performance and provide
health systems with actionable insights to reduce claims
denials.”
DenialsIQ, launched in late 2014, has had tremendous commercial
success, helping healthcare providers improve their revenue cycle
management. “At less than 5 percent, our denials rate is
considerably below the industry average, but at any given time we
still have approximately 16,000 outstanding denied claims,
representing about $1.5 million in potential revenue,” said Val
Cina, chief revenue officer, Southwest Diagnostics. “Speed is
critical to successfully appealing claims, and with Denials IQ we
are seeing that research and analysis that can take a month, can
now be done in a week.”
DenialsIQ is built in the GE Health Cloud, which runs on Predix,
GE’s platform for the Industrial Internet designed to meet the
unique strength, scale and security requirements of industrial big
data. As a global strategic partner of GE Digital, Accenture and GE
are using the Predix platform to jointly develop new technology
services and solutions across a range of industries.
Sources
1 Source: Accenture
About GE Healthcare
GE Healthcare provides transformational medical technologies and
services to meet the demand for increased access, enhanced quality
and more affordable healthcare around the world. GE (NYSE: GE)
works on things that matter - great people and technologies taking
on tough challenges. From medical imaging, software & IT,
patient monitoring and diagnostics to drug discovery,
biopharmaceutical manufacturing technologies and performance
improvement solutions, GE Healthcare helps medical professionals
deliver great healthcare to their patients. For more information
about GE Healthcare, visit our website at www.gehealthcare.com.
About Accenture
Accenture is a leading global professional services company,
providing a broad range of services and solutions in strategy,
consulting, digital, technology and operations. Combining unmatched
experience and specialized skills across more than 40 industries
and all business functions – underpinned by the world’s largest
delivery network – Accenture works at the intersection of business
and technology to help clients improve their performance and create
sustainable value for their stakeholders. With approximately
373,000 people serving clients in more than 120 countries,
Accenture drives innovation to improve the way the world works and
lives. Visit us at www.accenture.com.
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AccentureJenn Francis+1
630-338-6426Jennifer.francis@accenture.comorGE HealthcareTracy
Doyle+1 262-853-6983Tracy.doyle@ge.com
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