Transforming raw data into actionable insights is essential for Fast healthcare Interoperability Resources (FHIR) standards and improving HEDIS®1 scores. Learn more from this roadmap on how to achieve scalable efficiencies for managing clinical data at the enterprise level.
The strategic value of clinical data is growing significantly for payers, but finding the right types of clinical data and gaining access to it, is challenging in the current healthcare ecosystem. Whether to ensure members receive timely and appropriate care, ensure regulatory and compliance standards are met or maintain profitability, the ability to access, manage and optimize clinical data is fast becoming a competitive necessity.
Across the payer community, efforts at tackling the access and management of clinical data vary widely and are fraught with siloed approaches, claims-dependent methods and labor-heavy workarounds. Many health plans are leveraging FHIR to simplify data collection and boost revenues by improving their Star ratings. The key success factor is that FHIR–as an exchange format–is dependent on data being well structured in its source system.
Getting there requires new business models for providers, the adoption of a more coordinated and centralized workflow to optimize investments, and the right capabilities to ensure clinical data is properly curated to drive value across the payer enterprise.
Download our whitepaper, A HEDIS® Roadmap for Pragmatic Payer Leaders today!
1HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).