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Unlikely Allies

Les Masterson, for HealthLeaders Media, July 15, 2010
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"If you are going to make your data useful in a clinical environment, you have to have a laser focus on the timeliness of the data. Claims data is not typically timely. That's OK for operating a health plan to some degree, but not OK if you're going to use that data to manage patients," says Kennedy.

Through quality initiatives and pay-for-performance programs, health insurers have been pushing providers to improve the quality of care.

Meaningful use will allow health insurers to build an all-electronic environment upon their utilization management, case management, disease management, and radiology management, says Kennedy.

These infrastructure improvements could result in system improvements through projects such as Accountable Care Organizations.

Of course, there are also barriers between a cynical provider community and health insurers.

The first step for insurers is to look inward. Klein suggests insurers ask the following questions and get started on reaching out to providers to find out what they need to comply with meaningful use:

"Do they have systems to clinically integrate with providers? Do they have the collaboration and clinical tools that they can provide to their provider networks as a benefit, and do they have the core systems in place to track the execution of meaningful use in the provider network?"


Les Masterson is an editor for HealthLeaders Media.

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