Blues insurer Regence has launched partnerships with two providers aimed at boosting interoperability to improve care.
Regence is teaming with Tacoma, Washington-based MultiCare Health System and Oregon Health & Science University for the initiatives, which are a part of the HL7 Da Vinci Project, a global effort to assist in the push for value-based care.
The goal, Regence said, is to reach a value-based care model that allows for seamless data exchange to more effectively coordinate care.
“The more we are able to simplify provider workflows and lighten the administrative load, the more quickly we can accelerate successful value-based care programs for patients, providers and payers alike,” said Kristie Putnam, Regence’s vice president of provider partnership innovation, in a statement. “These innovative partnerships are offering a more complete view of patient history, resulting in a better outcome and more affordable care for patients and increased efficiency overall.”
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Interoperability has long posed a challenge in healthcare, and experts such as Centers for Medicare & Medicaid Services Administrator Seema Verma arguing that the COVID-19 pandemic is making the case for it even clearer.
Health plans are also required to adopt open systems to share data beginning on Jan. 1, though CMS has delayed enforcement of the requirement for six months due to the pandemic.
With MultiCare, Regence is harnessing data sharing to address medication safety in conjunction with its accountable care organization, MultiCare Connected Care. MultiCare submits data daily to Regence directly on a patient's medication history to more safely conduct medication reconciliation, ensuring there are no discrepancies when considering a change.
The initiative also reduced reporting burden on the provider substantially, according to MultiCare.
“By working together, we were able to quickly reduce labor-intensive administrative work so that our providers can dedicate more time to caring for patients," said Anna Taylor, director of operations, MultiCare Connected Care.
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In partnership with OHSU, Regence is aiming to ease the prior authorization process, which is a frequent pain point for docs. Prior authorization tools will be embedded directly into the electronic health record, allowing for automated decisions.
Automating the process avoids potential care delays associated with more traditional prior authorization, Regence said.
"Treatment decisions at the point of service help ensure patients receive the right care when they need it most, reducing disruptions to care and improving outcomes," the payer said in the announcement.