3,000+

network participants

NCQA

validated

38 million

Longitudinal Patient Records

1.6 million

ADTs per Month

Supporting health plan priorities

Manifest MedEx enables California’s leading health plans to better coordinate care, improve patient outcomes, manage population health, and improve efficiency.

MX’s solution suite, which includes MX Notify, MX Access, MX Analyze, provides a variety of ways that your health plan can share and access member information based on your data sharing standards and technology.

With Manifest MedEx, health plans can:

  • Start concurrent review and coordinate care right away with admission, discharge, and transfer (ADT) notifications
  • Optimize utilization management and quickly learn new member medical histories with longitudinal patient records
  • Save time and reduce the burden of HEDIS® reporting with NCQA validated primary source data
  • Identify care gaps to improve quality
  • Simplify risk adjustment with easy-to-consume, clinical chart notes
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NCQA Validated Data

With Manifest MedEx, the only data aggregator in California with NCQA validated data, health plans have access to standard supplemental data for Healthcare Effectiveness Data and Information Set (HEDIS®) reporting instead of needing to obtain it from individual providers on an at-need basis.

Without the need for any additional primary source verification, health plans reduce the time they spend assembling patient charts and confirming accurate data and instead dedicate more time and energy to supporting and caring for their members.

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Putting MX data to work for health plans

Health plans across California utilize the Manifest MedEx network to accelerate time-to-value for members, improve care coordination, fuel quality improvement, and more. The health data provided by MX is a key resource for health plan teams to take quick action and provide responsive, personalized, and proactive care to members.

Through using MX, certain participating health plans have been able to:

  • Reduce outbound calls to hospitals by 15-20% per month
  • Reduce “chart chases” by 54%
  • Assess hundreds of records each month to perform concurrent reviews and provide authorizations for their members’ surgeries, scans, and more
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Succeed under CalAIM

With Manifest MedEx, Medi-Cal MCPs can: 

  • Meet the Memorandum of Understanding (MOU) data sharing requirements of All Plan Letter (APL) 23-029 with Third Party Entities as required 
  • Manage population health and improve health equity and quality outcomes with insights gained from population health reporting and data services 
  • Accelerate Enhanced Care Management (ECM), address health-related social needs with longitudinal health records, and ensure eligible members receive their ECM benefits by populating enrollment data in MX Access 
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Supporting health plans in meeting AB 133 data sharing requirements

Most California health plans are required to share health information in real-time  by 2024. 

Manifest MedEx is a CalHHS Qualified Health Information Organization (QHIO) and one of the only nonprofit health information organizations (HIOs) in California that regularly aggregates, normalizes, matches, and shares claims, encounters, and clinical data – as required of health plans/IPAs by AB 133.

By joining Manifest MedEx, health plans can participate in this exchange and meet most of their requirements under AB 133.  

We can help health plans meet their data sharing requirements by exchanging: 

  • Adjudicated claims
  • Encounter information from capitated providers
  • Clinical data as defined by USCDI v2, including laboratory results when maintained by the impacted payer

Manifest MedEx also connects with national networks to help participants share and receive data more broadly as needed. 

Questions about AB 133? Read our AB 133 FAQs for health plans. 

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Related Case Studies

Optimizing and Streamlining HEDIS® Reporting With Health Information Exchange Data

How an innovative health plan saves time and improves quality scores with data from Manifest MedEx As part of its quality improvement efforts, Health Plan of San Joaquin uses HEDIS® to measure performance and gauge quality and effectiveness of care provided to their members. Developed and maintained by NCQA, the performance measures in HEDIS® are related to…

Read Our Case Study

A Commitment to Optimal Care and Vibrant Health

How one of the largest Medi-Cal plans in California improves quality and care for members through partnerships and data sharing Inland Empire Health Plan (IEHP) is one of the 10 largest Medicaid health plans and the largest not-for-profit Medicare-Medicaid plan in the country, serving more than 1.4 million residents in the Inland Empire and nearly 90…

Read Our Case Study

Health Plan of San Joaquin Drives California’s Mission to Vaccinate Vulnerable Populations

As California’s Covid-19 vaccination distribution began, a leading Medi-Cal health plan focused on innovation and strategy to support its highest-risk and underserved members Located in the heart of California’s multicultural Central Valley, Health Plan of San Joaquin (HPSJ) is the leading Medi-Cal managed care provider in the region, serving over 91 percent of Medi-Cal recipients…

Read Our Case Study

Inter Valley Health Plan Uses Manifest MedEx To Access Longitudinal Patient Records and Streamline Concurrent Review

As a non-profit Medicare Advantage organization, Inter Valley Health Plan (IVHP) has been serving members throughout the Los Angeles, San Bernardino, Riverside, and Orange counties since 1979. IVHP’s mission is to provide exceptional health coverage by providing high-touch care to its member population, which includes health education and wellness programs for the community and dedicated…

Read Our Case Study

Manifest MedEx and Anthem Blue Cross Partner to Improve Care Coordination, Streamline In-Patient Utilization Management Review, and Provide a Seamless Member Experience

Health plans increasingly rely on a broad scope of clinical data to help improve care transitions, identify and address gaps in preventive care to improve quality, and provide more seamless and personalized care for their members. Anthem BlueCross (Anthem), California’s second largest health plan serving more than 8 million members, and Manifest MedEx (MX), California’s…

Read Our Case Study

How Health Plans and Manifest MedEx Partner to Improve Care, Enhance Coordination, and Increase Efficiency

PDF: In this case study, we’ll review compelling examples of how health plans are using information from MX to improve coordination, increase efficiency, and provide better care, including: Receiving real-time notifications when members are seen in the emergency room, admitted to the hospital, or discharged. Accessing data to streamline HEDIS quality reporting and risk-adjustment. Identifying…

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“I am happy about the speed with which HPSJ and MX were able to create a comprehensive report to prioritize outreach to our members...We continue to find ways that the HIE can supplement and complement our efforts to ensure timely and effective care for our members.”

Cheron R. Vail, PhD
Chief Information Officer, Health Plan of San Joaquin

“I have seen firsthand how invaluable robust data-sharing can be. Each of our patients deserves the highest-quality care — which necessitates a high-quality data structure — so that nothing, and no one, falls through the cracks.”

Jarrod McNaughton
Chief Executive Officer, Inland Empire Health Plan

“Leveraging MX discharge data has enabled us to eliminate a really significant number of outbound calls to hospitals to confirm inpatient status. We’re leveraging all of the discharge data from the hospitals that are participating with MX. It’s already making such a big impact, and we’re just getting started.”

Medical Management Leader,  Large California Health Plan

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