In today’s healthcare landscape, payers and providers are equally responsible for addressing the needs of members, who expect high-quality, coordinated care experiences. Outreach campaigns, educational resources, and medication adherence can go a long way toward improving clinical outcomes and member satisfaction—two key factors of plan performance.

A leading health network was using various technology vendors and disconnected electronic health record systems. Management was dissatisfied with both the user experience and the outcomes of its existing population health and analytics solutions, and the organization lacked the budget to support its existing data management initiatives.

One of the largest and most successful independent multispecialty physician groups in Illinois has grown exponentially since its formation in 1999. The system has more than 100 locations and 700 primary care and specialty physicians. Its physician-governed board works to improve patient outcomes and provider performance, manage at-risk populations, reduce healthcare expenses, and increase patient access to care.

An Arizona-based health network with more than 30 hospitals, 10,000 providers, and 3 million patients across six states had disconnected electronic health record systems and used various vendors for population health, hospital analytics, risk adjustment, quality reporting, data warehousing, and engagement. The network was spending $15.3 million annually on data management and population health strategies.

A leading primary healthcare provider in Florida, New Jersey, Connecticut, and Texas, offers services including patient-centered primary and urgent care to more than 250,000 patients in more than nine value-based contracts.

A leading healthcare system serving more than 2 million patients across nine states recently partnered with Innovaccer to streamline its care management workflows and enhance its population health management strategies.

Payer compliance deadlines for the CMS Interoperability and Patient Access final rule are fast-approaching. The rule, which CMS hopes will create industry-wide, barrier-free data exchange, will require payers to give patients easier access to their healthcare data as well as implement provider directory APIs that third-party programmers can use to create applications for members. In addition to true data transparency, the rule will help payers leverage data to identify gaps in care, execute timely interventions, and get new insights for population health management.

Members are at the core of any health plan. However, the aftermath of COVID-19 poses new challenges for payer organizations when it comes to member enrollment.

Over the past decade, payers and providers have made significant improvements in the safety, effectiveness, and efficiency of medical care, and the shift to member-centered, value-based care models has only increased the need to deliver high-quality care.

One of the nation’s largest healthcare systems approached Innovaccer with the goal of improving its care management technology. Its mission is to provide high-quality, cost-effective care to enhance community health. It operates in 19 states and is comprised of 105 hospitals, including four academic medical centers and teaching hospitals; 30 critical access facilities; community health services organizations; accredited nursing colleges; and home health agencies; and other services.