One of the nation’s biggest healthcare information networks is to get a lot more use thanks to a mandate from a big health insurance company.
Blue Shield of California, a health insurer with $17 billion in annual revenue and with four million plan members, is writing language into its contracts with California healthcare providers that all providers must now participate in Manifest MedEx, one of the nation’s biggest regional healthcare information networks comprised of 11 million claims records, five million patient records and 200 participating partners.
Mainfest MedEx was created in January 2017 from a merger between the California Integrated Data Exchange (Cal INDEX) and the Inland Empire Health Information Network. The single health information network was created to help competing healthcare organizations in California—a state where annual spending on healthcare is nearly $400 billion—share data to improve cost efficiency and quality of care statewide, says Manifest MedEx.
As one of the main financial backers of Mainfest MedEx, Blue Shield of California, which has a network of 65,000 physicians, is requiring all of its affiliated network providers and providers participating in its accountable care organization to now participate in Manifest MedEx. An accountable care organization is a healthcare organization that ties payments to quality metrics and the cost of care.
Blue Shield of California is asking its ACO providers to sign a participation agreement with Manifest MedEx by Aug. 31, and other network providers to do so as a part of their next contract renewal, the plan says. The major push for mandatory participation overall is to create more universal and integrated health records for California consumers, the plan says.
“Providers have made enormous investments in technology and infrastructure and these investments will be even more valuable when the data they collect is shared and combined with other health information to create a comprehensive patient record that helps improve the quality of care,” says Blue Shield of California CEO Paul Markovich.
The move by Blue Shield of California is meant to tie into a new push from the Centers for Medicare and Medicaid Services and the U.S. Department of Health and Human Services to develop more universal electronic health records, Markovich says.
Last week at the HIMSS conference in Las Vegas, Centers for Medicare and Medicaid Services administrator Seema Verma announced the launch of MyHealthEData, an initiative that let patients electronically receive a copy of their entire health record and can share their data with whomever they want, and Medicare Blue Button 2.0, which will allow a patient to access and share their healthcare information, previous prescriptions, treatments, and procedures with a new doctor.
“Manifest MedEx delivers real-time, comprehensive healthcare data to providers and payers on a secure, open platform. It is a crucial prerequisite to transforming our fragmented healthcare system,” Markovich says.
A priority for Manifest MedEx is beginning to work more closely with Blue Shield of California’s accountable care organization, which is reducing hospital admissions by 19%, decreasing days patients stay in the hospital by 19% and saving an estimated $440 million in costs, says health network CEO Claudia Williams. “We’ll be helping these providers leverage MX data and services to further their work of coordinating care and improving patient outcomes,” Williams says.
The predecessor to Manifest MedEx—The California Integrated Data Exchange—was founded in 2014 with $80 million in start-up funding from Blue Shield of California and Anthem.
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