There is a natural alignment between health information exchange (HIE) and payer (health plan) incentives. The benefits of effective HIE result in organized care coordination and accurate patient information across the continuum of care. Health plans in Michigan and nationwide are participating in HIE efforts which ultimately improve the efficient delivery of quality care for their members.
Health plan contributions to HIE include sharing patient-provider attribution data for routing patient notifications to their attributed physician, and distribution of quality metrics to providers based on claims analysis. Health plans are utilizing HIE to receive clinical quality measures (labs, medications, diagnosis codes) traditionally captured via chart audits at the provider location.
Additionally, payers are realizing the benefits of receiving transition of care notifications for their members, to enhance utilization management and care coordination activities. As market demands including quality ratings, performance incentive programs, population health, and accountable care organizations increase the importance of generating a holistic picture of a member’s clinical information, health plans are realizing the opportunity to leverage HIE in meeting this demand.
For more information on health plans participating with MiHIN in Michigan’s HIE efforts, please contact firstname.lastname@example.org.