Why a consumer-first mentality may be the best way to comply with Information Blocking rules.

If we were to ask you what your health plan’s digital strategy is, would you have a ready answer? Don’t worry: this isn’t a pop quiz and we aren’t grading you. We can’t say the same, however, for the GAO. In a  push for increased data transparency, the Information Blocking Rule will affect how health plans operate. But let’s not lose sight of the true goal of this initiative: easier consumer access to their own healthcare data. We know your organization is already passionate about member satisfaction. But here’s why approaching your information sharing strategies from a consumer-first mentality may put you ahead of the curve.

Don’t forget: Pareo® is your key to successfully complying with this and other transparency initiatives as it can integrate with varied healthcare stakeholders through API.

Digital Strategy Relies on the Big Picture

Your response to the proposed Information Blocking Rule will depend on your health plan’s roadmap to digital transformation. Though the proposed rule may motivate or change your health plan’s response to the digital age, chances are you’ve already begun to introduce new technologies into your IT ecosystem. Unfortunately, healthcare as a whole is woefully behind other industries when it comes to digital transformation: A 2018 survey by Ecoconsultancy and Adobe found that healthcare companies were digitizing at half the rate of other industries (7% compared to 15%). 

Even though health plans are entering a sphere where their success will become increasingly reliant on their digital strategy, no one seems to have the key element needed for digital transformation: access to the bigger picture. As in, not one stakeholder in the healthcare continuum has a full grasp on the data. Instead, health plans only have health information related to claims data (at best). Providers don’t have point-of-care access to health information. And consumers – the group driving digital transformation – are having a hard time getting their records at all. 

Consumer access to patient data is the entry-point into this problem. It is the goal that the proposed Information Blocking Rule was built on, and it correlates nicely with other industry goals (improved care, member satisfaction, value-based models). What role, then, do health plans play in providing members access to their data? A big one, according to the GAO. 

The proposed rule “calls on the healthcare industry to adopt standardized application programming interfaces (APIs), which will help allow individuals to securely and easily access structured EHI using smartphone applications.” APIs, like those used by your technology vendors, integrate with components of your health plan data to work effectively. 

Currently, most health plans have no digital management tool to take advantage of available API integrations. But Pareo is the first and only payment integrity technology solution that can plug in to every API in your ecosystem to provide an unparalleled advantage: real-time access to the bigger picture. 

 

How Pareo Enables Consumer-First Digital Strategy

Health plans are being asked to do a lot. Healthcare is bracing for an unprecedented level of disruption that will require health plans to innovate, and quickly, all while complying with a level of transparency previously unachievable, maintaining strict data security standards, and cutting costs. The concerns and demands surrounding technology can easily send a health plan down a rabbit hole. 

It’s easy to say that the success of technology in modernizing other industries needs to be applied to healthcare. But healthcare is both a public service and a business, highly regulated and running on tight budgets, which means many in the industry wait to implement solutions until they are demanded to do so. It doesn’t have to be that way. 

Consumers require access to their electronic health information. In order to participate fully in the new era of data access, health plans will need secure, free-flowing integrations with providers, payment integrity suppliers, and technology vendors. More importantly, a health plan will need a secure way to manage these digital relationships. At its core, Pareo was designed to do just that, to help health plans swiftly move from having a very narrow view of information, to seeing data visualizations in real-time. This single, powerful transformation will affect every aspect of your payment integrity operations. 

Tracking the proposed Information Blocking Rule

The public comment period for the Information Blocking Rule has closed and lawmakers have suggested delaying a vote on interoperability rules. We are tracking the subject closely and will continue to publish relevant commentary as new information is released: 

 

Full access to your health plan’s data and digital relationship management primes a health plan for greater success. Pareo is a technology solution that also allows health plans to innovate on existing technologies, applying AI and machine-learning intelligence to data reporting functionality. It also reduces administrative complexity by automating tasks and intelligently flagging claims, freeing up your employees to focus on other, higher-value tasks. Like making members happy, shifting claims to pre-pay rather than post-pay and adding more technology vendors to maximize recoveries. 

That’s the power of Pareo. 

Talk to ClarisHealth about how Pareo®advanced payment integrity technology is helping health plans deliver on their most advanced digital strategies.