Athenahealth: Innovating at the Point of Delivery

This case describes the origins and evolution of Athenahealth, a healthcare IT company focused on administering claims and payments between payers and providers. The company began as a network of Ob/Gyn clinics in the San Diego area and evolved into a healthcare information technology company based on a software and database developed to help them manage their own finances. Athena’s IT system learns the rules and plans that canvas payer/provider contracts and payer/patient plans. Their software uses this database to ensure proper processing of provider claims which ultimately reduces accounts receivable turnover and administration costs of resubmitting claims. They were able to attract providers because their services were fundamentally aligned with provider interests - they helped providers get paid. Since the system gained power and function as more providers used it, Athenahealth’s benefits grew substantially with scale. Expanding on their relationships with provider networks, Athenahealth then developed an electronic medical record (EMR) product to complement their existing services. By expanding their suite of product offerings Athena hoped to capture greater market share and create complementary IT systems for the healthcare service industry. Athena strives to make a difference in healthcare services. They hope to one day integrate data captured in EMR and claims processed through AthenaCollector to inform pay for performance metrics, to develop large scale epidemiological analysis of cost effectiveness and to improve quality of care for the healthcare system as a whole.