In healthcare, "gaps in care" refers to the gaps that exist between best practices and actual patient care. Closing these gaps is important to deliver value-based care and quality of care. Additionally, care gaps, when not properly managed, can be both harmful and costly. Reporting of open care gaps and closing care gaps is a core component of value-based care between payers and providers.

Health Level Seven International (HL7), the not-for-profit, ANSI-accredited standards developing organization, introduced Fast Healthcare Interoperability Resources (FHIR), to address interoperability challenges as "a new standard for exchanging healthcare information electronically. The HL7 FHIR standard is well-suited to form the basis of real-time API data exchange between applications, devices, and systems. The HL7 Da Vinci Project was born out of the need to accelerate FHIR adoption" to support and integrate value-based care and payment model data exchange.

Join this webinar to learn about leveraging claims and clinical history to inform potential care gaps that can be closed to improve HEDIS/STAR ratings and non-HEDIS measures.

As part of the 21st Century Cures Act, the interoperability rule seeks to drive patient access to personal and medical data, and support the ability to share that data, allowing patients more power to coordinate their own healthcare. The rule bolsters the existing trend toward a more patient-focused model, empowering patients to participate more effectively in their own medical care and improve public health services. 

Payer organizations need to able to gather and share data around member costs and coverage, clinical interactions and other data points. All of these efforts aim to prevent information blocking and improve the flow of easy member access to or transfer of data. As payers plan for the future, they should look beyond current system data and consider use cases that may become possible with enriched data sets.

Watch this webinar to learn about the 21st Century Cures Act interoperability and what it means for data exchange for payers. As payers stand up their “Patient Access” APIs, there is an opportunity to look beyond compliance and embrace this new data standard to improve outcomes for their members.

Join this webinar to learn about the No Surprises Act and what it means for provider data accuracy. As payers are grappling with payments and billing process changes, they might be missing the new rules about provider data accuracy that go into effect in January 2022. 

• New directory accuracy requirements
• What we might expect after January 1, 2022
• How this bill creates risk for payers and the best strategy to mitigate it

Providers move, stop accepting patients and leave insurance networks – causing provider directory inaccuracies. 30% of provider data changes every year and studies found over 45% of provider directory locations had at least one error. Health Plans need to bring their provider data into clearer focus – with greater accuracy - to comply with the new Federal No Surprises Act requiring constant continuous provider directory verification.

Health plans need to focus on their population health management initiatives. Combining social determinants of health (SDOH) data with existing care management programs can bolster the effectiveness of those programs and help improve health outcomes. Rich Morino, Senior Director, Solutions Consultants, LexisNexis Risk Solutions discusses using Social Determinants of Health (SDOH) data to turbo-charge population health management initiatives in a post-pandemic world, in the HealthcareWebSummit event co-sponsored by LexisNexis Risk Solutions.

Leaning objectives include:

• Identify which members should have their care prioritized post pandemic
• Understand why select members are at risk for poor health outcomes
• Examine risks that can be mitigated by interventions or community/social services

The COVID-19 pandemic has put tremendous stress on the US healthcare system. In this 60-minute webinar learn how both LexisNexis Risk Solutions and Blue Health Intelligence are contributing innovative solutions that healthcare leaders can use to better predict and prevent public health risk.

Topics Include

• Data for Good: Using data to identify vulnerable populations and care resource gaps
• Leveraging SDOH data, along with provider and claims intelligence to help healthcare organizations sharpen their focus
• Getting ahead of covid-19 using advanced analytics and reporting
• Combining a range of data and analytic assets to more accurately assess risks and key population vulnerabilities

Several of the organizations who collaborated on the Guiding Principles for the Ethical Use of Social Determinants of Health provide an overview of the guiding principles, bring clarity to what the industry views as the appropriate use of SDOH, and offer examples of how SDOH can and should be leveraged to help patients achieve optimal health outcomes and wellness.

A discussion on ways for health plans to reduce the risk of a data breach, the necessary steps to validate and verify member information, and ingredients for a strong multi-factor authentication strategy.

The industry is buzzing with exciting words like Machine Learning, APIs, Blockchain and more. This session helps to understand the promise that these and other technologies hold as it relates to solving one of the industry’s greatest challenges: provider data management. Leveraged appropriately these technologies can help automate efforts, create transparency and reduce friction between health plans and providers.