Proving the Business Case for the Internet of Things

GE and Accenture build on IoT platform to save $2 billion in healthcare costs

William Payne
June 2, 2016
GE Healthcare and Accenture have partnered to build a medical claims processing and cash flow system for US healthcare providers using GE Digital's Internet of Things Predix platform. According to GE Healthcare, the Predix-based IoT analytics system could help healthcare providers to save between 25-50 percent on average of their current costs to re-process denied claims.

The proposed solution is a development of GE Healthcare’s analytics solution, DenialsIQ built in the GE Health Cloud, which runs on Predix, GE’s platform for the Industrial Internet.

DenialsIQ flags claims denials and uncovers potential hidden patterns and root causes. The solution is intended to help providers, including large health systems, physician groups and hospitals, understand how claims management affects their financial performance and then take action to redesign workflows and financial operations based on those insights.

“Our alliance with Accenture is an example of how GE Healthcare is developing game-changing partnerships to deliver what our customers want and need in an era of value-based care,” said Jon Zimmerman, VP and general manager, GE Healthcare IT Clinical Business Solutions. “GE Healthcare’s leading analytics technology, combined with Accenture’s proven consulting capabilities, will help our customers deliver better outcomes, putting financial savings to better use improving clinical care and health system operations.”

Managing claims denials has proven challenging for healthcare providers. Accenture estimates that of the one in every five claims that’s denied, it will cost a typical health system, on average, $25 per claim to re-process. For a $1 billion health system, reducing claims denials can yield a 0.5-1 percent lift in operating margin amounting to $5- 10 million annually.

DenialsIQ uses algorithms originally designed by GE’s Global Research Center for GE’s Aviation business.

Similar to online shopping software that prompts a user with product recommendations, DenialsIQ can show administrators hidden patterns and root cause factors before medical claims denials negatively impact the revenue cycle.

“Accenture and GE are building on our strong alliance to help address a critical pain point for U.S. health systems,” said Matthew Collier, managing director, Accenture Strategy, Health. “We see the challenges providers face with the medical claims process. We are pivoting to the new by combining our capabilities to bolster the use of analytics in driving financial performance and provide health systems with actionable insights to reduce claims denials.”

DenialsIQ, launched in late 2014, is designed to help healthcare providers improve their revenue cycle management.

“At less than 5 percent, our denials rate is considerably below the industry average, but at any given time we still have approximately 16,000 outstanding denied claims, representing about $1.5 million in potential revenue,” said Val Cina, chief revenue officer, Southwest Diagnostics. “Speed is critical to successfully appealing claims, and with Denials IQ we are seeing that research and analysis that can take a month, can now be done in a week.”

Accenture and GE are using GE's Industrial Internet of Things Predix platform to jointly develop new technology services and solutions across a range of industries.