The Business Case for Integrating Claims and Clinical Data

The path to value-based care is arduous. For health plans, their ability to manage care, assess quality, lower costs, and streamline reporting is directly impacted by access to clinical data. For providers, the same can be said due to their lack of access to claims data.

Providers and health plans are increasingly demanding integrated claims and clinical data to drive and support value-based care programs. These organizations know that clinical and claims information from more than a single organization is the only way to get a true picture of patient care. From avoiding medication errors to enabling an evidence-based approach to treatment or identifying at-risk patients, the value of integrated claims and clinical data is immense — and will have far-reaching influence on both health outcomes and costs of care over time.

On July 30, Medicare announced the Data at the Point of Care pilot to share valuable claims data with Medicare providers in order to “fill in information gaps for clinicians, giving them a more structured and complete patient history with information like previous diagnoses, past procedures, and medication lists.” But that’s not the only example.

Read full article by Claudia Williams, CEO, Manifest MedEx, published in MedCity News.