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Date:4/25/2008

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8. Value-Driven Health Care: HIPAA led the way through standardization of

electronic transactions and portability of certain plan features. The

President demanded it in his 4-cornerstone plan. Transparency in other

health plan functions, such as simplified adjudication, provider

payment/contracting, employer/purchaser reporting, and member account

management is enabled by emerging new standards. Buyer's coalitions,

government purchasers, provider trade groups, and consumer advocates

will power the push for plans to adopt simplified and common

administrative formats, performance metrics and portable member data

exchange.

9. Database/Warehousing Expansion: Dealing with the enormous database

expansion required for a true consumer-centric health plan of the

future requires planning, strategic investment, and advances in

knowledge management. The Data Warehouse will support multiple

functions throughout the health plan, feed internal decision-support

data marts, and become the source for data extracts to external

organizations.

10. Electronic Health Records: Health Plan-based EHRs bring together data

from disparate electronic medical records and claims to create a

composite from across the health system. Personal Health Records

(PHR's) give individuals access and control over their own medical

information. With the entry of new offerings from companies like

Google, Microsoft, Intel and others, issues of privacy, security, and

standardization of patient data will become even more challenging.


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SOURCE Managed Care Executive Group
Copyright©2008 PR Newswire.
All rights reserved

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