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More Tech Spending Coming for Health Claims: Enkata Survey

Increasing technology spending for technology upgrades is one major way healthcare claims executives plan on handling changes set by ICD-10 and Affordable Care Act.

Healthcare claims executives plan to increase spending to tackle changes caused by ICD-10 and the Affordable Care Act, says the Healthcare Claims Executive Survey by Enkata, an employee performance optimization solution provider based in Redwood City, Calif.

About 77% of respondents said they would handle the upcoming changes by upgrading technology, while only 5% plan on hiring new staff.

“These changes promise to deliver a substantial impact on the volume and complexity of claims, and managers need to be ready to respond with the same level of accuracy and efficiency that their customers expect,” says Dan Enthoven, CMO at Enkata in a release.

While claims volumes are expected to rise in the next two years, about 68% of respondents have reported that the approximate cost of manually adjudicating a claim is $5 or more.

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Enthoven adds, “Interestingly, our survey also found healthcare claims executives plan to rely on new technology investments and upgrades to navigate the changes, without additional personnel support.”

Employee productivity levels have a high variance, according to 50% of respondents and 45% cited compliance with processes as the biggest headache. Also, 41% mentioned budget constraints as a problem for employees. About 13% or managers have an issue with addressing remote workers on their performance.

Enkata surveyed about 200 healthcare insurance executives on claims operation, claims audit and compliance, claims quality, and claims risk management in Sept 2013.

Zarna Patel is a staff writer for InformationWeek's Financial Services brands, which include Bank Systems & Technology, Insurance & Technology and Wall Street & Technology. She received her B.A. in English and journalism from Rutgers University College of Arts and Sciences in ... View Full Bio

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