[Congressional Record Volume 142, Number 123 (Tuesday, September 10, 1996)]
[Extensions of Remarks]
[Page E1547]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         GUESS WHAT CLUNKY BUREAUCRATIC MACHINE COMES IN NO. 1

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                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                      Tuesday, September 10, 1996

  Mr. STARK. Mr. Speaker, you, Mr. Speaker, like to talk about the 
withering away of Medicare. When questioned about your statement, you 
say you didn't really, really mean for Medicare to whither away, just 
the agency that administers it, the Health Care Financing 
Administration [HCFA]. You like to make fun of HCFA as a clunky, 
bureaucratic machine.
  I'm not sure what the difference is between destroying a program and 
destroying its administration, but I hope you will take the time to 
read the enclosed opening paragraphs from the American Medical 
Association's newspaper American Medical News of August 26, 1996.

                       Medicare Shapes Up Claims

       Q: What well-known health insurer has the highest 
     proportion of claims filed electronically, the lowest average 
     cost per claim processed, and has cut the real cost per claim 
     processed by 85% since 1975?
       A: It's not some hotshot entrepreneur or Wall Street wonder 
     company.
       It's Medicare.
       You know, that federal program run by the Health Care 
     Financing Administration and the gang of 34 (carriers).
       Medicare is the undisputed leader in electronic claims. The 
     program now electronically processes 79% of all claims and 
     nearly 71% of Part B claims. That compares with 66% of claims 
     for the runner-up, the nation's Blue Cross and Blue Shield 
     plans, and a paltry 20% for commercial carriers.
       Increasing electronic claims processing has been the major 
     factor in driving down Medicare's processing cost per Part B 
     claim from $8.03 (in today's dollars) in 1975 to 94 cents in 
     1995.
       But HCFA isn't resting on its laurels. Over the next six to 
     12 months, the agency will begin implementing several 
     measures designed to increase claims processing efficiency 
     and lower costs even further.
       A first step will be taken toward standardizing electronic 
     claims formats. New universal provider identification numbers 
     will be issued, and a uniform payer identification system 
     will be developed. National uniform claims review standards 
     will be expanded, and steps will be taken to shift routine 
     claims processing from the local carriers to two giant 
     processing centers.
       All of these initiatives could help physicians by 
     streamlining medical review, coordination of benefits with 
     non-Medicare payers and speeding payments.

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