Selection of leading technology partners and participation of three large California network plans positions IHA well for success and scale
The Integrated Healthcare Association (IHA) announced their selection of Gaine Healthcare and Availity as the technology vendors for the launch of the statewide Provider Directory Utility (PDU). The first of its kind in the state, the PDU will offer a centralized, cloud-based platform for providers and health plans to update, manage, and exchange their provider data. The PDU will simplify burdensome data submission processes for providers and health plans, enabling the plans to publish more accurate and timely provider information in their own directories. Moreover, three of the largest network plans in California – Blue Shield of California, Anthem Blue Cross and Health Net have confirmed their participation in the 2018 launch of the PDU. With additional strong collaboration and support from Covered California as well as state and federal regulators, the PDU is well positioned for gaining critical mass and scale.
IHA will work with Gaine Healthcare and Availity to implement and scale the PDU and provide extensive customer and technical support to help users adopt this new technology. IHA selected Gaine Healthcare and Availity due to their ability to meet robust business and technical requirements, their extensive experience in provider data management in California, and their fit with IHA’s strategic roadmap. Gaine Healthcare and Availity have best-in-class technology and proven business processes that deliver improved data accuracy and greater efficiencies for providers and health plans. The sophisticated data management platform from Gaine Healthcare which enables crowdsourcing and industry-wide collaboration, coupled with the widely adopted provider portal from Availity will allow IHA to address the complex needs of the California healthcare market.
“The technology vendor selection process began in September 2017 and was a thorough canvass of the provider data management industry,” said Eyal Gurion, Vice President of Strategic Initiatives at IHA. “Potential vendors were reviewed by internal and external committees, with oversight from industry leaders and IHA’s Executive Committee. We looked not only at the vendor’s technology, usability, price, and industry reputation, but also at their customer support capabilities and meaningful market traction in California. We are excited about what Gaine Healthcare and Availity bring to this initiative and are confident they have the right expertise to work with our launch participants and ultimately the entire state.”
With the technology vendors in place, IHA will begin testing the PDU with a small number of health plans and providers as well as testing data sharing and integration possibilities with Covered California. During this “soft launch,” IHA will exercise the PDU and its dependent processes to validate the system, test business and technical assumptions, identify risks, and subsequently add necessary enhancements to resolve newly discovered issues.
Lorie Ballendine, Vice President of Provider Services and Operations at Health Net, said, “We have worked with Gaine Healthcare in the past and we are excited to collaborate with IHA during the soft launch where we are implementing and testing this new solution to the provider directory accuracy issue.”
“We have made great strides in building a multi-plan directory for Covered California enrollees,” said Lance Lang, MD, Chief Medical Officer at Covered California. “At the same time, we appreciate the potential in working collectively with the industry to achieve even greater accuracy of the information we are using currently.”
IHA is also working with major California health care regulators including the Department of Managed Health Care, California Department of Insurance, and California Department of Health Care Services to ensure that the PDU will support compliance requirements. The Department of Managed Health Care’s (DMHC) Director Shelley Rouillard commented, “IHA is making great progress in bringing a statewide provider directory to California. It is imperative that the entire industry be actively engaged in this initiative. Not only will the provider utility improve the consumer experience and make it easier for consumers to find providers in their networks, it will also reduce the burden on both providers and health plans as they work to maintain accurate directories. I am pleased the three large health plans are participating in the soft launch.”
The Provider Directory Utility will manage and maintain up-to-date information on provider demographics and participation in health plans’ networks and products in California. For more information, please visit www.providerdirectoryca.org.
About IHA: Founded in 1994 and based in Oakland, Calif., the nonprofit, nonpartisan Integrated Healthcare Association is guided by a 50-member board of industry-leading health plans, physician organizations, and hospitals and health systems, plus representatives of purchaser, consumer, academic, pharmaceutical, and technology entities. As a member-driven organization convening diverse stakeholders committed to advancing high-quality, affordable, patient-centered care, IHA generates data and insights to help forge common ground across California’s health care community. For more information, visit www.iha.org.
About Gaine Healthcare: Gaine Healthcare, a division of Gaine Solutions, was founded in 2010 with offices in San Luis Obispo and Los Angeles, California. Gaine is the developer of the widely deployed Master Data eXchange (MDX) software platform enabling Information Agilitytm and offers an extensive range of provider data management solutions under the Sanator Provider Registry product line. Sanator products enable more efficient data exchange between health plans and their contracted providers to improve provider directory accuracy, optimize provider networks and comply with state and federal reporting regulations. For more information, visit www.gainehealthcare.com
About Availity: Availity is an industry-leading, HITRUST-certified health care information technology company that serves an extensive network of health plans, providers, and technology partners nationwide through a suite of dynamic products built on a powerful, intelligent platform. Availity integrates and manages clinical, administrative, and financial data for its customers that need to fuel real-time coordination and collaboration amongst providers, health plans, and patients in a growing value-based care environment. For more information, visit www.availity.com