Integrated Highmark and Allegheny team with Cedar to align the billing experience

Seth Cohen of Cedar Health, James Rohrbaugh of the Allegheny Health Network and Neil Kulkarni of Highmark Health spoke at the HFMA annual conference.

Photo: Courtesy of Cedar Health

Highmark Health, the integrated health network, and Allegheny Health Network, which is part of Highmark, have collaborated with Cedar Health to improve the patient's financial journey in a program slated to go live in September.

The model will bring together the explanation of benefits with the hospital bill for a single source of truth, according to Seth Cohen, president of Cedar Health, which focuses on patient billing. In addition, the program will include health savings account balances to help remove fragmentation in billing. This is the first time Cedar is integrating HSA balances, Cohen said.

"What's exciting is, we're having a direct impact on the consumer," Cohen said. "We're taking advantage of alignment."

"We're getting ready to launch," said James Rohrbaugh, Allegheny's CFO and treasurer. "When we look at the process, we're pretty sure there will be strong ROI [return on investment]."

Highmark and Allegheny have long had an enterprise strategy called "Living Health" to keep the customer at the center of the model to eliminate administrative friction and burden, said Neil Kulkarni, vice president of Clinician Experience Solution for Highmark. 

Rohrbaugh said, "The reality of this is, at the end of the day, we're making healthcare simpler."

Allegheny includes eight hospitals in western Pennsylvania. 

The collaboration with Cedar began after Highmark and Allegheny researched problem areas and pain points. They picked prior authorization, utilization management and the consumer experience in paying for care as high priorities.

Cohen, Rohrbaugh and Kulkarni addressed "Collaborating for Consumers: How to Bring Together Payers & Providers to Improve the Healthcare Financial Journey" during the Healthcare Financial Management Association (HFMA) annual conference in Denver last week. 

Cohen said people frequently ask him how to get a hospital and insurer at the table together. 

"It doesn't mean it's always easy," Cohen said. "The area of patient experience, it's the one thing everyone can rally around. They can find things to create a material benefit for the consumer."

HFMA's annual conference attracted an estimated 4,000 people on site for seven content tracks over four days, according to the organization.

"I thought the conference was great," Rohrbaugh said. "It was clear to me. … It's a pivotal moment, an opportunity to do some unique things in the industry. There's a lot of energy around the opportunities ahead." 

Twitter: @SusanJMorse
Email the writer: SMorse@HIMSS.org