Opala Launches New Attribution API to Streamline Value-Based Contracting for MultiCare Connected Care
API Pilot Deployment Based on HL7® FHIR® Standards Yields Double-Digit Improvements by Providing Complete Patient Information in Realtime
Designed in partnership with MultiCare in
Historically, comparing lists of patients on value-based contracts with those in providers' records has been a time-consuming, error-prone manual process, overly reliant on Word documents or Excel spreadsheets to share information. Without clear visibility into a patient's coverage, providers often are unsure of which patients qualify for comprehensive and preventative care.
"Provider and payer organizations have spent the last 25 years trying to figure out how to unlock the promise of value-based contracting. Today, Opala accomplished this goal," said Opala CEO
Pilot Demonstrates Promise of Value-Based Care
Opala piloted the Attribution API with a multi-state health insurance provider in
"Multi-payer data exchange solutions, like Opala's, are key to delivering high-value care," said
MultiCare providers use the information from the Attribution API to identify patients they are accountable for under value-based contracts with the insurance provider while the patient is in the office. The Opala solution improved patient matching, correctly identifying that the patient in their office is the same as the person on the insurance provider's value-based contract roster. Using this new automated process, the pilot showed a 10% improvement in patient matching between the insurance provider's rosters and patients in MultiCare's EHR.
Building on HL7 Standards to Conquer Real-World Challenges
For payers and providers, patient matching can hit their bottom line. Problems with patient matching cost an average of
Opala joined the
"The addition of the Opala team to Da Vinci membership and their testing and production use of ATR is invaluable to the community. Our ability to enable providers to reuse standards-based APIs is foundational to ensure scaling and accuracy required for value-based contracts. It is critical that partners have accurate matching to increase transparency to real-time information about their patients to improve outreach, interventions, and time to service," said
Opala's Attribution API provides providers with coverage and payer information, all integrated into the provider's existing EHR system, to ensure a seamless process for transferring information. The new solution has played a key role in building on the HL7 FHIR standard to ensure that providers know which patients are part of a value-based care contract and have complete information about patients in real-time.
Founded in 2020, Opala's mission is to vastly improve healthcare information flow in real time. With solutions directly connecting information across the healthcare system, Opala provides a complete longitudinal clinical view, enabling every patient's experience to be optimized through seamless collaboration between payers and providers. In 2021, Opala launched the Opala Data Hub and CMS Interoperability Compliance products – Patient Access API, Provider Directory API, Payer to Payer Exchange - with a multi-state health insurance provider in
MultiCare Connected Care (MCC) is an independent
Unlike the traditional "fee for service" health care model – where each visit, service, test and procedure has a separate cost – MCC's foundation is built first and foremost on providing patient centered quality care at an appropriate cost. Specific measures are used to determine how well doctors, hospitals and other providers are keeping healthy people healthy, effectively treating illnesses, and helping people better manage their chronic conditions. In this way, all the participating providers share the responsibility of providing patient centered, high quality, efficient, cost-effective care.
MCC has established a comprehensive Clinically Integrated Network (CIN) comprised of doctors and other health care providers, as well as hospitals, clinics and other health care services, such as imaging, labs and pharmacies. The CIN includes independent health care professionals in the community, as well as MultiCare employed providers totaling over 5,100 clinicians providing services across the continuum of care. www.multicareconnectedcare.com
About the
As an HL7 FHIR Accelerator, the
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SOURCE Opala
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