Workgroup For Electronic Data Interchange - WEDI Financials Identify $42 Billion in Potential Savings

WEDI Financials Identify $42 Billion in Potential Savings

WEDI expanded its financial analysis to encompass eleven health care transactions. Newly available data were added to estimate the potential savings for providers and to update the estimated savings for payors and employers. Additionally, the cost of implementing EDI was added to achieve a more comprehensive picture of EDI's financial impact on the health care industry.

WEDI's 1993 financial analyses concludes that combining the estimated implementation costs and the gross administrative savings potential, the cumulative net savings over the next six years (to the year 2000) is estimated to total over $42 billion. Although the estimated net savings may not translate directly to hard dollar savings for the nation's health care system, EDI savings will allow health care enterprises to reallocate resources from administrative activities to enhance quality, patient care, and customer service.

To achieve this large cost savings, WEDI's eleven Technical Advisory Groups developed the following major recommendations. These recommendations are summarized below according to the Technical Advisory Group that developed the recommendation:

• require specific and defined instructions through implementation guides to support uniform data content and coding structures (Standards Implementation and Uniform Data Content)

• develop a network architecture to support a broad array of applications, communications, access methods, protocols, and line speeds (Network Architecture and Accreditation)

• enact the model federal preemptive legislation drafted by WEDI to preserve confidentiality and privacy rights of individually identifiable health care information (Confidentiality and Legal Issues)

• identify unique, standard identification numbers to promote industry standardization and uniformity of health care data (Unique Identifiers for the Health Care Industry)

• develop and promote a comprehensive education and publicity work plan designed to provide standardized, economically affordable and geographically accessible education opportunities for all EDI constituents (Education and Publicity)

• develop an ASC X12 standard for data content and format for health identification cards (Health Identification Cards)

• continue demonstration projects that are ecumenical, identifiable to the public, demonstrate industry cooperation, leverage existing infrastructures, add something new, measure results, and meet aggressive time frames to demonstrate that technology is currently available to implement WEDI recommendations (Short-Term Strategies)

• clearly delineate state and federal roles for EDI implementation (State/Federal Role)

• provide ongoing analysis of the financial implications of EDI implementation (Financial Implications)

• automate the Coordination of Benefits process (Coordination of Benefits)

• use electronic environments and standardized data to improve fraud detection (Health Care Fraud Prevention and Detection).