Philadelphia, Pa. – January 13, 2018 — Aetna has become a member of HealthShare Exchange (HSX), permitting the national insurer to support more-informed care of its Medicare and Medicaid members in the Greater Philadelphia region. Aetna joins other health plans — including founding HSX members Independence Blue Cross, Amerihealth Caritas, and Health Partners Plans — in taking advantage of electronic receipt and transmission of information with medical providers when member patients receive care at healthcare facilities.
“Joining HSX aids in our ability to quickly and more proactively interface with our Medicare and Medicaid members and their care coordinators with important, timely information when they receive medical care,” says Remy Richman, Aetna vice president, executive director, Pennsylvania/Delaware. “Sharing information in more real time helps all involved in the health ecosystem achieve our value-based care goals, to eliminate redundancies, control costs, and improve patient outcomes.”
HealthShare Exchange is the regional health information exchange that enables data sharing from the electronic medical records (EMR) of hospitals, health systems, and other healthcare providers — and the encounter data of insurers — to make this information accessible at inpatient and outpatient locations (including medical practice offices). HSX services provide recent clinical care information, and notify providers and health plans of care events.
“This welcome addition of Aetna to the exchange will give HSX more complete representation by the insurers in this marketplace, expanding data coverage in both directions — between healthplans and those who deliver care,” says Richard Snyder, MD, founding board chair of HealthShare Exchange, and Senior Vice President and Chief Medical Officer at Independence Blue Cross.
Says Martin Lupinetti, President of HSX, “Aetna’s membership is great news for the healthcare system in our region, including for all of our provider members and the more than six million patients in our regional data repository. It broadens the exchange benefits for all of our participants and for consumers.”
HealthShare Exchange services promote continuity of care, reduce the need to transmit or transport medical information by patients or by fax, and help to reduce duplicate medical services. HSX receives alerts when a medical facility in the region admits, discharges, or transfers a patient. Matching these notifications to Aetna’s member roster, HSX will employ its Encounter Notification Service (ENS) to apprise the insurer when one of its members interfaces with the care system.
HSX’s Clinical Activity History (CAH) service collects recent clinical history about a patient from the patient’s healthcare insurer, based on member identification within the health plan, and translates this claims/utilization data to a clinical care document –– returning this information to the requesting provider or emergency department. Aetna will also support HSX’s Automated Care Team Finder (ACTF) service, which uses the patient’s member ID with his or her healthcare insurer to identify providers involved in the patient’s recent medical care and uses this information to route continuity of care (CCD) documents, containing robust discharge information, to the patient’s identified primary care provider, again using Direct secure messaging. This brings the patient’s care-team members in the know on the patient’s status, allowing them to conduct follow-up directly with the patient as needed. Aetna will also be able to look-up recent activity of its members by querying HSX’s Clinical Data Repository (CDR).
“With Aetna as another major insurer participating in ENS, CAH, ACTF, and the CDR, we expand our provision of these services to cover an even larger majority of the population in our regional service area,” says Pam Clarke, HSX’s Senior Director of Member Services. “In this way, we will be assisting another large insurer in improving their members’ care and will expand our success in pushing timely medical updates to downstream providers.”
HealthShare Exchange is a membership-dues-supported organization that links electronic patient-care information in these ways across its medical service area. Such exchange is part of the future for providers, payers, and consumers seeking better, more cost-effective care. Health information exchange makes patient care more informed and reduces unnecessary care and readmissions. An Aetna representative will now serve on the HSX Board of Trustees.
About HealthShare Exchange
HealthShare Exchange (HSX) is a non-profit health information exchange organization serving the greater Delaware Valley region, including the southeastern Pennsylvania and southern New Jersey. Founded in 2009 and incorporated as a nonprofit organization in 2012, HSX was formed as a collaboration among major healthcare stakeholders, including health plans and acute-care hospitals to enable the electronic exchange of patient information to improve patient outcomes and to manage and lower healthcare costs. For more information, please visit https://www.healthshareexchange.org/.