Health plans and health information exchanges (HIEs) are quickly becoming one of the most dynamic duos in the healthcare landscape. Like many great partnerships, there was a bit of a will-they or won’t-they history to the relationship. It’s taken some time for payers and HIEs to find their way to each other. However, there’s new recognition today of the rewards of health plans and HIEs working together in the context of value-based care.
Why does it work now? Health plan responsibilities to coordinate members’ overall health are ever larger and include a broader set of players, including social service organizations and long-term care as well as and behavioral and telehealth. This summer’s announcement that America’s Health Insurance Plans rebranded to just “AHIP” and embraced a broader mission of “guiding greater health” was a sign of the times.
Health plans need quality clinical data to better evaluate member risk, case manage, comply with regulations and streamline HEDIS—and also benefit from a secure, neutral third party to help connect with what is often a somewhat distrustful provider community.
Read the article by Claudia Williams, CEO, Manifest MedEx, published in Fierce Healthcare.