Survey: Medicare beats commercial payers for fair reimbursements

February 15, 2012

In a survey pitting Medicare against Medicaid and commercial payers, see which group healthcare providers say most often reimburses to expectations. The answer may surprise you.

More than 90% of healthcare providers said Medicare is “fair” all or most of the time with reimbursements while commercial payers received a much lower grade, according to the results of a survey from a national electronic claims exchange firm.

IVANS Inc. released results from a claims and payers’ survey taken by more than 700 providers from around the United States. Although many of the respondents represented hospitals, practices, and clinics (38%), nearly half of respondents (49%) represented home health companies and skilled nursing facilities. The latter organizations are predominately funded by Medicare and Medicaid.

More than 93% of healthcare providers surveyed believe Medicare is “fairest,” meaning the payer’s reimbursements most closely matched the physician’s expectations. Medicaid was also deemed “fair” all or most of the time by 65% of providers.

Conversely, 62% of providers surveyed stated they do not believe commercial payers are fair all or most of the time and state they are reimbursed much less than expected. Half of providers stated they are fair only some of the time when reimbursing claims.

The results also revealed that 65% of respondents said Medicare was the fastest payer, 26% said Medicaid, and 9% percent said commercial payers were the fastest.

Perhaps contributing to the slow pace, 39% of providers said they still use paper to submit claims to commercial payers, but less than 1% reported using paper for Medicare claims, and 11% use paper for Medicaid, according to results.

Providers would like to upgrade their technology but do not have the money or are unsure of how to do it, according to the survey. One-third of providers said that budgetary concerns are the biggest challenges preventing them from sharing information electronically, and 21% blamed technology requirements that keep changing.

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