Benefits for Payors

Proven Return on Investment (ROI)
Payors have already discovered the benefits of health information exchange (HIE), including fewer duplicate tests and better coordination of services.

The July/August 2011 edition of American Health & Drug Benefits featured research focusing on a Humana pilot project, which concluded that:

  • When clinicians utilize HIE in the care of patients who present to the emergency department, the costs borne by a health plan providing coverage for these patients decreases by an average savings of $29 per emergency department visit compared with a control group.
  • Decreased utilization of imaging procedures and diagnostic tests drove this cost savings. This savings is primarily achieved because the HIE puts patient information in the hands of emergency providers that they would not otherwise have had when making treatment decisions.

According to an October 2013 article in the online journal Healthcare Informatics, “HIE Saved $1M in Emergency Care Costs for Medicare,”  a study conducted by emergency physicians at the Medical University of South Carolina looked at 325,740 patient encounters in 11 Emergency Departments across South Carolina.  The research conducted over a 12-month period (starting February 2012) found that:

  • Nearly 90 percent of participants said that quality of patient care was improved, and 82 percent of participants said that valuable time was saved, reporting a mean time savings of 105 minutes per patient. Providers using HIE to access data improved emergency care quality and saved more than $1 million in patient charges, nearly $2,000 per patient.
  • Almost 90 percent of the 532 participants said that the quality of patient care improved while 82 percent said they saved time.

Reliance Payer Services
Reliance provides care management teams with their member information to coordinate care across physical, behavioral and dental health via a web-based application or through automated delivery of clinical results for use within an authorized user’s existing care management systems.  Reliance can support care coordination, hospital notifications, discharge management, HEDIS reporting, clinical quality measurement, and more.

Learn more about how Reliance services for payer organizations can help create efficiencies and improve quality of care, while affecting the cost of care. Contact Reliance today and begin to experience the benefits.