More payers take on HIE

By Anthony Brino
03:23 PM

Seven payers in Colorado are collaborating on a new multi-payer online data-sharing service for providers, as part of the Comprehensive Primary Care public-private initiative.

Anthem Blue Cross and Blue Shield, Cigna, Colorado Access, Colorado Choice Health Plans, Rocky Mountain Health Plans, UnitedHealthcare and the state Medicaid program are financing a tool for providers to access their patients claims data from one website, rather than getting reports from multiple payers.

"This initiative represents a major step forward for both providers and payers in Colorado,” said Patrick Gordon, associate vice president at Rocky Mountain Health Plans. “For the first time, physicians will be able to access actionable, patient-specific data across multiple insurers and self-funding employers in a single analytic tool.”

Healthcare data company Rise Health will partner with Colorado's Center for Improving Value in Health Care to build the website. Data aggregation is expected to start in the first quarter of 2015, with additional features available throughout the year.

The significance of this multi-payer collaborative would be hard to overstate, based on the health plans involved. For providers, especially primary care practices, accessing comprehensive information on their patients from payers has historically been cumbersome and inefficient process, and hasn’t improved much in the digital age.

As Kelly Henry, network director at Anthem Blue Cross Blue Shield of Colorado, said, this service “represents an innovative solution to a longstanding problem. Too often, it's feast or famine; providers either lack sufficient information or they are bombarded with too much.”

The collaborative’s insurers include more than half of the major market issuers, who spent the past two years listening to physicians, examining evidence and developing measures of success for data aggregation and sharing. (One of the state’s five largest insurers, though, Kaiser Permanente’s Foundation Health Plan, is not participating.)

Ultimately, it will help physicians spend more time working with patients, and let both providers and payers “benchmark their practices” to track value, the insurers said.

"We are moving into a new era of healthcare and it is exciting to be a part of providing this level of data to the providers of care, especially in rural areas," said Cindy Palmer, CEO of Colorado Choice Health Plans, a non-profit serving southeastern Colorado.

Leaders from Colorado Medicaid’s program, which is in the midst of an accountable care demonstration, believe the new agreement is the sign of further multi-payer collaboration to come.

"We're building on the CO CPC opportunity, but it's just a launching pad,” said Judy Zerzan, MD, chief medical officer and deputy director, Colorado Department of Health Care Policy and Financing. “We believe we've created a program that is the beginning of a long collaboration to help improve Colorado's healthcare system.”

Indeed, the fact that such multi-payer service is being deployed suggests that competition can foster collaboration. While Anthem and UnitedHealthcare represent about half of Colorado’s insurance market, the state is considered to be one of the most competitive.

The state’s ACA insurance exchange (whose first executive director is now working for Cigna) attracted a wide field of issuers, including Anthem Blue Cross and Blue Shield, Cigna, Colorado Choice Health Plans, Colorado HealthOP, Humana, Kaiser Permanente, Rocky Mountain Health Plans and UnitedHealthcare.

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