Renton, Washington-based Providence on Monday announced its new collaboration with Humana, focused on value-based care.
The seven-state health system and the Louisville, Kentucky-based insurance provider are embarking on what they're calling a pioneering new project to enable more streamlined and secure information exchange among their provider and payer sites, advancing interoperability in support of VBC models.
WHY IT MATTERS
Together the two organizations say they'll stand up a new scalable ecosystem for "seamless, secure and standardized" data sharing.
Key to the effort will be HL7's FHIR standards, its Da Vinci Project Implementation Guides and open APIs that will enable more free-flowing information to offer clinicians more timely and actionable insights, they say, while also helping reduce administrative burden.
The first phase of the initiative will go live in October and will focus on automated member attribution for Humana Medicare Advantage members, according to Providence and Humana, offering providers easier and more accurate identification of patients under their care, and ideally eliminating manual processes to enable better care coordination.
In the coming months, other phases of the project aim to expand exchange capabilities and enhance clinical decision-making, they say – noting that the new interoperability framework should be "easily replicable, serving as a scalable model that can transform care across the healthcare industry."
THE LARGER TREND
Both Providence and Humana note that the new project is aligned with federal interoperability priorities and upcoming regulations, such as the Centers for Medicare and Medicaid Services' Interoperability and Patient Access Rule.
Another is the White House's recent effort to create a "patient-centric healthcare ecosystem," which began with some five dozen organizations – including five payers and 11 health systems – that pledged to adopt the CMS Digital Health Ecosystem and eliminate paper-based processes.
ON THE RECORD
"The healthcare industry is overwhelmed by fragmented, inconsistent data formats that make care coordination costly and slow," said Michael Westover, VP of population health informatics at Providence, in a statement. "Because we want to be successful in value-based care contracts, Humana and Providence are building a shared foundation of administrative, financial, and clinical data using national standards and modern technology."
"True interoperability should serve clinicians, patients and payers," added George Renaudin, Humana's president of insurance. "Together with Providence, we're enabling providers to deliver more effective care and helping our members spend less time on paperwork and more time on their health."
Mike Miliard is executive editor of Healthcare IT News
Email the writer: mmiliard@himss.org
Healthcare IT News is a HIMSS publication
