HealthShare, payers, and managed care organizations
With U.S. healthcare expenditures expected to reach $3.46 trillion in 20161, everyone paying the bills — insurers, employers, governments and patients — is looking for ways to get more from that spend. We all want better outcomes, for more people, at lower cost. As a result, healthcare purchasers are actively pursuing ways to enhance collaboration, improve care quality, increase member satisfaction, and generally maximize value.
Health plans have a vested interest in promoting collaboration and engagement with providers and patients, but doing so requires finding a way for all participants in the care process to align around a common set of goals, supported by comprehensive and meaningful information. We believe this kind of information sharing has the power to transform healthcare. We call it strategic interoperability.
Put simply, strategic interoperability means that you capture health and health-related information from everyone involved in the care process, including patients, clinicians, and payers. You share that information in a meaningful way across all the constituents in the care process. You explore that information in context to understand, and with that understanding, act to drive improvements in care and efficiency.
InterSystems HealthShare® was created specifically to support healthcare transformation through shared information. When health plans, ACOs, and other payers invest in secure information sharing, it results in better care, stronger relationships, improved decision making, and higher satisfaction.
Dynamic Information Sharing Makes a Difference
Enabling the best care for your members requires timely access to information that will make a difference in their outcomes. This is the essence of proactive risk management and care collaboration.
Risk is constantly changing because member profiles are dynamic. Emergency room visits, admissions, diagnoses, readmissions, and care plan or medication compliance can all affect risk and influence outcomes. The only way to stay ahead of risk is for health plans and providers to exchange timely, complete, and credible information at the point of care.
HealthShare lets you integrate and share information across health plan systems, provider systems, and care delivery workflows. Information such as pharmacy claims, ADTs, test results, and clinical notes help complete the picture of a member’s profile and care requirements.
With comprehensive member-centric information available in real-time, care managers can be notified of events that matter to the health of your members. They can collaborate effectively with you, with your members, and with each other.
With strategic interoperability, you create a connected community with your members at the center. When you share and receive the right information, at the right time, you foster safer, more cost-effective care and a positive member experience. Engage when your members would benefit from assistance navigating the healthcare system. Ensure that care decisions are based on complete information. And support care transitions with timely information for the entire care team.
Success stories and reference
- KLAS HIE Report 2014
- How Shared Risk and New Reimbursement Models are Improving Healthcare
- Collaboration is the Key for Health Plans in a Shared Risk Environment
- Clinical Event Notifications Promote Well Coordinated, Patient-Centric Care for New York Health Plan Members