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Report: Administrative simplification standards could save $8.1 billion a year

August 20, 2014

U.S. health care providers could save an estimated $6.7 billion annually if all commercial health plans adopted six national standards for electronic business transactions, according to a new report by the Council for Affordable Quality Healthcare’s Committee on Operating Rules for Information Exchange. In addition, health plans could save an estimated $1.4 billion annually, based on the U.S. Healthcare Efficiency Index, a CAQH CORE database that tracks the adoption of the six standards. Language included in the Affordable Care Act at the urging of AHA requires health plans to certify that their data and information systems comply with the standards and corresponding operating rules starting Dec. 31, 2014. Operating rules already have been adopted for eligibility, claim status, electronic funds transfer and remittance advice; and AHA is working with CORE and the National Committee on Vital and Health Statistics as they develop the other operating rules that will add to the potential administrative savings.