Formerly, payers’ business was driven by claims data. To support care-based operations and optimize revenue, payers need to efficiently tap into external clinical data from provider practices, laboratories, hospital systems, immunization registries, and other sources to get a holistic view of care.
Leveraging Clinical Data
Broader access to clinical information increases the efficiency of the healthcare supply chain – for example, by reducing redundant clinical procedures or unnecessary laboratory tests – while enabling precise measurement of provider performance in key areas such as member outcomes, patient satisfaction, and provider trust.
Harnessing so much data from so many sources presents tremendous challenges. It’s difficult to collect clinical data from siloed, incompatible systems and unify it with claims and operational data from internal sources – and, at the same time, optimize the consistency, completeness, and accuracy of that information.
Omni-HealthData: Harnessing data to support member-centric strategies
Omni-HealthData Payer Edition from Information Builders is a member information management solution that enables the integration, optimization, and bi-directional exchange of complete, trusted, and timely clinical data across providers and facilities. Payers get a 360-degree view of their members, giving them the insight they need to optimize the payment efficiency and foster collaboration with provider groups, while helping to manage risk, drive quality improvements, and minimize costs.
Key features include:
- It integrates data from physicians’ offices, hospitals, nursing homes, and telemedicine sources, among many others
- It easily on-boards data in diverse forms, including CCD documents, EDI, HL7, Excel, and flat files
- It cleanses and enriches data to provide a complete, accurate picture of transactions
- It relates all data to seven business domains: members, patients, facilities, providers, organizations, clinical, and claims
- It creates an environment for sharing timely clinical information with providers