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BlueCross BlueShield Will Contribute Claims Data to HEALTHeLINK

BlueCross BlueShield will share data through New York-based health information exchange HEALTHeLINK to improve care coordination.

BlueCross BlueShield will begin contributing claims data to HEALTHeLINK.

Source: Thinkstock

By Kate Monica

- BlueCross BlueShield in Western New York recently announced plans to contribute claims data to New York-based health information exchange (HIE) HEALTHeLINK to improve health outcomes and care coordination for BlueCross BlueShield members.

Through HEALTHeLINK, participating physicians will have access to specific claims data through the secure health data exchange platform beginning in 2019.

BlueCross BlueShield is the first local plan to share full claims data with HEALTHeLINK.

“The spirit of collaboration in which we were formed continues as we explore the next steps in leveraging HEALTHeLINK to support the health of our community,” said HEALTHeLINK Executive Director Daniel Porreca. “Combining clinical and claims data from across the community gives treating providers a more complete picture of their patient’s health using input from all care settings.”

“Bringing in the first stream of claims from BlueCross BlueShield represents a significant step to enhancing our ability to support the community for quality of care reporting,” Porreca added.

HEALTHeLINK supports health data exchange to boost clinical efficiency, improve care quality, and reduce healthcare-related costs.

With patient consent, physicians participating in HEALTHeLINK can send and access patient clinical data to enable care coordination no matter where the patient receives care in Western New York.

“By sharing data in this capacity, we can strengthen physicians’ ability to provide well-coordinated, high-quality care to our members,” said BlueCross BlueShield Senior Vice President and CMO Thomas Schenk, MD. “We are proud to be the first health plan in the region to take this step, and believe it’s reflective of our commitment to the overall health of our members and community.”

The initiative to connect BlueCross BlueShield with HEALTHeLINK is part of the health plan’s strategy to improve care delivery and support Western New York’s transition to a more patient-centered care model.  

“The more transparency that we can have between payers and providers, the more effective we can be in making a long-term impact on the overall health of Western New Yorkers,” said Schenk.

Western New York is one of four markets CMS recently selected to participate in the Comprehensive Primary Care Plus (CPC+) initiative. The CPC+ program is designed to improve primary care and care quality through regionally-based multi-payer payment reform.

Enabling the exchange of claims data through HEALTHeLINK will help to position Western New York for success under the program.

BlueCross BlueShield is one of the founding members of HEALTHeLINK, along with Western New York’s major hospital systems and regional health plans.

In October, two other New York-based HIEs — HealthlinkNY and HealtheConnections — entered into a strategic partnership to boost HIE use among area providers and optimize the cost and efficiency of care delivery.

The partnership is the result of months of collaboration after HealthlinkNY announced plans to seek a strategic partner in 2017. HealtheConnections and HealthlinkNY cover the northern border of New York City, the Hudson Valley, the Southern Tier and central New York.

The partnership was partly inspired by a statewide effort to optimize hospital savings and increase clinical efficiency for providers by promoting widespread use and adoption of regional HIE services.

Together, HealthlinkNY and HealtheConnections will cover 66 hospitals in 24 counties. HIE leaders will also work to promote customer engagement, outreach, training, and support services.

HealthlinkNY plans to begin migrating its HIE interface to HealtheConnections’ platform in early 2019 to enable its providers to set up advanced alerts, results routing, and data filtering.

HealthlinkNY and HealtheConnections are both qualified entities (QEs) part of the Statewide Health Information Network of New York (SHIN-NY), along with HEALTHeLINK, Hixny, NYCIG, Bronx RHIO, Healthix, and Rochester RHIO.

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