Health Savings Account Workgroup

Mission

Develop and promote conceptual models for administering HSA accounts that integrate healthcare providers, insurers, financial institutions, employers and consumers to simplify and reduce the cost of heatlhcare.  Provide cross-industry and vertical expertise and leadership for HSA stakeholders.

Charter

• Draft business rules for enabling HSA real time financial transaction processes
• Oversee the adaptation and testing of these rules within an open source, services oriented architecture
• Pilot real-time transactions between employers, payers, providers, financial institutions and banks using new architecture

Guiding Principles

• Accelerate adoption of HIPAA's transactions code sets.
• Promote additional standards in healthcare.
• Promote administrative simplification between healthcare stakeholders.

• Lead healthcare industry towards "banking"model for transactions process and electronic medical records (EMR).
  

• Enhance integration between healthcare providers, insurers, banks, financial institutions and employers--creating one revenue cycle.

Goals

• Simplicity is required for consumers. This means a standard statement showing any amounts outstanding or paid by their plan.  It also means that the security and privacy environment when processing a consumer's health information must be treated as a top priority.  Finally, consumer convenience in terms of "one-stop shopping" for financial and healthcare information was discussed (i.e., online banking portal).
• The ideal infrastructure for HSA management must be articulated and should include disease management components.  The structure will support interoperability between an individual's High Deductible Health Plan and any bank system for account management purposes.
• The back end reconciliation process should not be overlooked; specifically straight through processing of remittance data between insurer and provider.

• Issues surrounding Bad Debt Expense and HSAs should be monitored and isolated.  Best practices should be developed that are responsive to these issues.

• Interoperability between healthcare and financial systems, and open access to these systems, needs to be prioritized to create a seamless and consumer/business-friendly account management process.

Leadership

Leader: Dave Harris, National Healthcare Revenue Cycle Partner, PricewaterhouseCoopers

Vision

To have the ability to one day walk up to an ATM style kiosk at a hospital, swipe your insurance smartcard with debit card functionality and never have to worry about complex paperwork commonly associated with approved HSA approved high deductible health plans (HDHPs).

Deep-dive Examples

• Credit Card Dispute Resolution between Merchants and Consumers:  Determine the necessary data sets (i.e., HIPAA 837/835 transactions) necessary for banks to assist merchants (i.e., healthcare providers) in resolving credit card disputes with their consumers (patients)
• Pricing Transparency:  Develop an operating model for providers to effectively communicate their pricing structure and explain the difference between their list prices and negotiated reimbursement amounts with insurers

Participants

Large employers, healthcare insurers and providers, banks, benefit consulting companies and consumer advocate group involved with consumer-directed health

Deliverables

• HSA Playbook for healthcare providers, insurers, financial institutions, employers and consumers
• HSA Readiness Litmus Test for healthcare insurers and providers

Accomplishments

• Click here for "Dr. HSA" monthly news column implemented in MBProject site

Dissemination Venues

• HSA@Work | A Cross-Industry National Webcast Series
• National Medical Banking Institutes