HealthShare Exchange covers a large, complex, densely populated healthcare market. More than a half-dozen national and regional health insurance plans serve the population with no single dominant insurer. Southeast Pennsylvania includes more than 15,000 practicing physicians and has 40 licensed acute care facilities with 38 emergency rooms, but no single hospital healthcare system with a majority market share. Furthermore, the greater Philadelphia area and Delaware Valley region encompasses a diverse and varied line-up of long-term care providers, behavioral health organizations, rehabilitation and other specialty hospitals, a mixture of both owned and independent practice groups, and a number of accountable care organizations.
The quality of healthcare delivered in this marketplace is exceptional and often world class. However, the sheer number and range of entities providing acute care creates challenges for care continuity and collaboration. With so many facilities and providers, some within a mile of each other, healthcare consumers frequently receive services from multiple organizations regardless of system affiliation and often outside of the system they use most often for their healthcare. Their primary, specialty, or emergency care, for example, may end up coming from different hospital systems or from other types of entities from across the continuum of the healthcare environment. The resulting challenge for patients and providers in coordinating care is what HealthShare Exchange is solving by establishing interoperable patient record and healthcare-event information.