The “Medical Clean Claims Transparency and Uniformity Act” is expressly designed to save Coloradans millions of dollars a year with no expenditure required from the General Fund or any other taxpayer source. In addition this work may inform a national initiative on this topic.
In brief, considering several recognized data sources we are brought to the common conclusion that by adopting uniform medical claim edits and payment rules to be shared among all payers in Colorado, both payers and providers will be unburdened of 10’s of millions of dollars of administrative redundancy and out-right waste which can be redirected toward reducing the actual cost of care.
In one well documented example Colorado’s SB06_208 Blue Ribbon Commission on Health Care Reform found that of $30 billion per year overall expenditures projected for 2007-2008 more than $2.2 billion was for administration. If we are able to redirect only 10% of that amount it will result in over $200 million being diverted from administration to actual health care for Coloradans.
The Task Force work plan has at its core principles of “Administrative Simplification”, they are: Consistency; Standardization; Transparency; and Appropriate Savings to the System
These shall be the test of our processes and outcomes at each juncture.