WellPoint deal lets health plan create national HIE

Health plan giant WellPoint announced today that it was striking a deal with health plan portal Availity to create what it's describing as a "multi-payer portal," or HIE. WellPoint is making an undisclosed investment in Availity, which provides a number of administrative functions to physician practices at no charge to the physician.

Availity, which is owned by Blue Cross and Blue Shield of Florida, Health Care Service Corp., and Humana, allows providers to conduct administrative chores, such as eligibility and benefits inquiries, claims statuses inquiries, claim/encounter submissions and remittance advice with more than 1,000 health plans, including Aetna, CIGNA, AvMed, United Healthcare, Medicare and the Medicaid programs.

Another feature offered by Availity that seems fairly neat to this editor is that Availity will allow patients to swipe a member ID card and pull data on patients directly into the Availity system. If the Medical Group Management Association's research is correct, that feature alone may do a lot to drive costs out of the system where this type of solution is delivered.

All told, I don't think this will somehow deliver a death blow to alternate models for HIE building--particularly since it's built around managing claims, not clinical data. Also, I'm skeptical that building a longitudinal patient record around claims data will work, given what we're told are well-documented problems with claims data accuracy. However, this is still an interesting start.

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