WEDI: Providers See Little Value In HPIDs
By Christine Kern, contributing writer
Only 15 percent of respondents find any value in the use of Unique Health Plan Identifier within transactions.
A new survey conducted by Workgroup for Electronic Data Interchange (WEDI) concludes that, across the various stakeholders, it was abundantly clear that the “unique Health Plan Identifier (HPID) holds ‘little to no value’ for stakeholders when used within electronic transactions adopted under HIPAA.”
WEDI surveyed 262 respondents – health plans, self-insured health plans, providers, third-party administrators, clearinghouses, and software vendors – and report only 15 percent find any value in the use of the HPID within transactions, while 64 percent indicate they find no value. Twenty-one percent do not know whether there is value.
WEDI provided the results of its survey to Health and Human Services Secretary Sylvia Mathews Burwell in a letter in which the group argues the survey results “further strengthen WEDI’s recommendation to CMS from October 2013 that CMS modify the rule to make HPIDs not used in transactions.” An HHS final rule published in September 2012 adopted a standard for a unique HPID which, according to CMS, is a standard identifier that was required by the original HIPAA in 1996.
Under the final rule, larger health plans are required to obtain HPIDs by November 5, 2014 and small health plans are required to obtain HPIDs by November 5, 2015. Without exception, all covered entities are required to use HPIDs in the standard transaction by November 7, 2016.
When HHS published its final rule in 2012, the department made the case that by establishing a unique HPID it will “save time and money for physicians and other healthcare providers.” However, WEDI asserts that overall there is confusion within the industry as to what HPID is intended to solve in the current healthcare environment.
The letter states, “The industry understands the intent of the original HIPAA statute was to solve routing issues that existed more than 15 years ago, however, the industry has resolved those issues, with special attention to privacy and security risk mitigation.” Moreover, the letter continues, “WEDI is concerned that in order to enumerate health plans, both government and commercial funds will be required, diverting those dollars from being used to achieve healthcare goals of greater quality of care, greater patient safety, and reducing costs.”
Chief concerns revealed by the survey are the cost of implementation, with only 30 percent of non-provider respondents indicating the cost of implementation to be less than $500,000, and an additional 33 percent unable to provide a cost estimate at all. Only 19 percent of providers indicated that the implementation costs to be less than $50,000 with 56 percent unable to provide estimates. Privacy and security risks were also of concern, with only 11 percent of respondents stating that the risks would be less than current risks under HIPAA.