The Zelis Payment Harmonization Index
The Business Case for Harmonizing the Payment Experience
A commissioned third-party assessment from Aite-Novarica on how well commercial payers are enabling a harmonious payment ecosystem, including designing, building, and managing networks, ensuring accurate and swift electronic payments, and reducing processing costs.
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The business case for bringing harmony to healthcare payments.
The industry index that establishes the current state of healthcare payments modalities available to providers and identify the gaps in modern payment methods — with practical and prescriptive ways to align your business around the optimal healthcare financial experience for all.
88% of healthcare payer executives believe it is important to collaborate with providers to generate a regularly updated provider directory.
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72% of healthcare payer executives indicated they have a ways to go in member engagement efforts despite multi-faceted initiatives in this area.
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27% or less of claims adjudication and appeals management is fully automated despite automation being rated as very important.
45% of respondents indicated increasing efficiency of revenue cycle workflows through electronic receipt of remittance data is very important.
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Methodology you can trust
The index was conducted by the Aite-Novarica Group, a leading financial services research firm.
This study was based on a quantitative survey conducted from January through March 2022. 214 healthcare payer executives participated, 75% of whom worked at health plans, and the remainder at third-party benefit administrators (TPAs). The data has a margin of error of 6 points at the 95% level of confidence; statistical tests of significance were conducted at the 95% level of confidence.
The survey design screened participants to identify and select those respondents with responsibilities and expertise that tied directly to four functions that had a role in payments modernization. These four functions were payments, cost containment or payment integrity, provider network management and member engagement. Many were knowledgeable about multiple functions. The survey screened potential participants to ensure their roles had an influence in the health plan or TPAs’ payment modernization efforts. Most prominent roles were finance, accounts payable, client experience, member engagement, claims review, and payment integrity. Over 70% of respondents held titles of Chief Officer, Vice President, Director, or Manager.
The survey also screened potential participants to ensure their roles had an influence in the health plan or TPAs’ payment modernization efforts. Most prominent were roles that touched finance, accounts payable, client experience, member engagement, claims review and payment integrity. Over 70% of respondents held the roles of Chief Officer, Vice President, Director, or Manager.
This report is relevant for B2B payments executives at health plans and third-party administrators (TPAs) that make disbursements to healthcare providers, as well as for payment integrity officers, provider network development and management executives and member engagement leaders. The report is also relevant to banks (commercial card and treasury businesses), benefits administration companies, claims clearinghouse businesses, merchant-acquiring businesses, patient accounting or practice management software vendors, payments networks, remittance solution providers, and third-party payment platforms that operate in the digital payments market.