National HIT Week: NaviNet Honors Local Innovation

This week, September 12th-16th, marks the sixth annual National Health IT Week sponsored by HIMSS. National Health IT Week aims to educate healthcare stakeholders and policy makers on the value and importance of adoption of health IT in the US healthcare system. In honor of National Health IT Week, we'd like to take a moment to honor health IT companies in Massachusetts dedicated to innovation.

American Well: Founded by two brothers, American Well connects physicians and patients immediately for online appointments through their product Online Care. Physicians are able to see patients from anywhere and, through arrangements with health plans, are compensated for their services. In fact, American Well was even recognized by President Obama in his State of the Union address in January.
 
Healthrageous: Healthrageous believes that when people are healthier, it benefits everyone, particularly their employers who realize increased productivity and higher financial performance. Healthrageous collects patient information, like blood pressure and other biometric information, helps create personalized health goals and monitors patient progress. Users are encouraged to share success stories with other users.

Verisk Health: Waltham-based Verisk Health provides risk assessment services, aiming to help clients measure and mitigate risks in an effort to contain costs and improve quality. Their product Sightlines provides clients a clearer picture of their data through powerful analytics and informs better decision-making. With a robust client base including the Commonwealth of Massachusetts and the Center for Medicaid and Medicare Services, we know they are onto something special over there.

NaviNet: At NaviNet, we've spent the past 13 years building America's largest real-time healthcare communications network and have evolved to offer a premier suite of products for unified patient information management (UPIM). We've integrated NaviNet EMR, NaviNet PM, NaviNet Mobile Connect, and most recently, NaviNet Doc Xchange into the NaviNet solution suite. From our integrated set of products, we bring patient information together so all healthcare stakeholders may access it securely and easily when they need it most, ensuring they all have a holistic view of the patient. With NaviNet and UPIM, health plans and providers are able to offer more comprehensive patient care.

Massachusetts is ripe with innovation in the health sector. Did we cover your favorite Massachusetts company?

About the Author

NaviNet is America's largest real-time healthcare communications network.

Aetna and BCBS Florida: Notable Health Plan Innovators

'Healthcare Innovation' is quite the buzzword lately. Between Todd Park encouraging innovation in health IT by opening a government data API and the mHealth app market set to triple by 2012, it's staggering how quickly technology in the industry is advancing. We'd like to take this opportunity to highlight one stakeholder group that is rapidly innovating to overcome today's challenges: health plans. By using web-based tools to connect with and service physicians and granting patients access to information through mobile apps, there are many organizations that we are proud to work alongside as our industry continues to evolve.

There is no doubt that health plans are an integral piece in the care delivery puzzle. As Dave Kerrigan suggested in his blog post The Payor (R )evolution, payers are in the driver's seat for disruptive innovations.

One of the greatest sources of inefficiencies in our healthcare system is around financial transparency and expediency of reimbursements. Unknown financial and clinical variables in the care process put patients and physicians at risk for high bills and low reimbursement. Advances in revenue cycle management lead by leading health plans such as Aetna are changing that. Aetna built a solid system of communication, a process for which they were recognized in the 2011 PayerView Rankings, which evaluated data from 132 national, regional and government payers in the US in efficiency, clarity and effectiveness of their client transactions. Aetna was noted for their ability to engage with doctors thanks to simplifying key business and financial operations. They scored a spot in the top percent of health plans able to resolve claims upon submission, clear and accessible policies that resulted in low denial rates and electronic remittance advice transparency. Aetna's ability to educate physicians around what medical expenses the plan will cover is crucial to driving down the cost, frustration and anxiety within this industry.

The back office is not the only side of the industry where health plans are making a difference. According to the Wall Street Journal, there will be a shortage of 150,000 PCPs over the next 15 years. With doctors strapped for time in the exam room and medical practice waiting rooms growing crowded, the industry will have to tackle this physician crunch in an innovative fashion. Health plans such as Blue Cross Blue Shield Florida have found their own ways to provide patients with the support they need in case they cannot reach their doctor. With the launch of their mobile app, patients may now access information about their deductable, Health Savings Account (HSA) balance and claims data. The app will also decrease the amount of time patients spend on the phone, as it can help locate local in-network physicians and compare drug prices at the nearest pharmacies.

Another key driver of healthcare costs, on par with clinical and revenue management costs, lies in administrative inefficiencies. According to a Milliman report, manual transactions and the use of paper records cost our country an estimated $70,000 per physician per year. And in her recent blog post, Janice McCallum of Health Content Advisors explained that the lack of seamless exchange of health care information between stakeholders is a major barrier to managing these costs. She suggests, however, that we don't need to start from scratch, but instead build upon the platforms and applications that already exist. For example, with the help of our health plan-sponsored insurance portal, NaviNet Insurer Connect, physicians and healthcare professionals can easily access patients' benefits, eligibility and other financial health information all in one secure, robust interface. Several health plans have also leveraged mobile devices to connect with their members by building applications that offer important health data and resources. The health system benefits greatly as payers make information more accessible-filling care and communication gaps that cost time and money.

About the Author

NaviNet is America's largest real-time healthcare communications network.