Nearly one in five of your private payer payments were inaccurate in 2011, according to the AMA's latest "National Heatlh Insurer Report Card," released June 20. The average rate of inaccurate payments is 19.3% in 2011, up from 17.3% in 2010, the AMA says. That 2% jump comes out to a $1.5 billion increase in administrative costs to the health system, the AMA estimates. "A 20% error rate among health insurers represents an intolerable level of inefficiency that wastes an estimated $17 billion annually," AMA Board Member Barbara McAneny, MD, said in a prepared statement.

Most practices have failed to progress toward the critical HIPAA Version 5010 implementation, which could impede claims processing and keep you from getting paid, according to a Medical Group Management Association (MGMA) follow-up survey.

Remember:  Since HIPAA 5010 is needed to process ICD-10 codes, which will take effect Oct. 13, 2012, not having a 5010-ready system by the Jan. 1, 2012 deadline would result in providers not getting paid (PBN 4/25/11).

Your providers' performance, based on Medicare claims data for Parts A, B and D of program, will be shared with the public under a new proposed rule from CMS. Certain "qualified entities" would process the Medicare data, along with private payer data, to create public reports. This new initiative, which was made possible by the health reform law, would be similar in principle to the Hospital Compare website, CMS says in a June press release.

You and your peers are likely to boost your health information technology (IT) spending this year, according to a May 2011 study by RNCOS Industry Research Solutions, a private market research company. Health IT spending is projected to hit $40 billion -- with a "B" -- in 2011, driven by massive growth in electronic health records (EHRs) and mobile health applications, the study claims.

You've heard it before -- you can improve your patients' health outcomes and waste fewer Medicare dollars by avoiding useless procedures and tests. Now a physician group has published a top-five list of don'ts for primary care doctors to avoid. Highlights include cautions against imaging scans for back pain within the first six weeks unless "red flags" are present and support for prescribing generic statins for lipid-lowering drug therapy. These are two of the five items listed by the non-profit National Physicians Alliance (NPA), which actually released three separate "top five" lists for internists, family practitioners and pediatricians.