3,000+
network participants
NCQA
validated
38 million
Longitudinal Patient Records
2.3 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
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.
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
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
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.
Related Case Studies
