The management of accounts receivable (A/R) is a critical aspect of running any healthcare organization. It is challenging enough to keep up on collection lag times from patients and a wide variety of payers, but add to that a revenue cycle management software upgrade or replacement and the challenge becomes even more difficult.

One of the first questions a financial system replacement should prompt is how to manage legacy A/R. Addressing this question prior to the implementation of the new RCM system will ensure that the collections transition runs more smoothly. Begin by identifying which accounts are the most beneficial to keep active versus which should be written off, and then put a strategy together on winding the active accounts down.

A/R Wind Down Strategy

Although keeping the legacy financial system up and running for collectors to work the A/R down is an option, this solution often comes with costly vendor support contracts and requires maintenance resources from IT. As it ages, that legacy system can also open the organization up to vulnerabilities and increased cybersecurity risks – not to mention a potentially complicated workflow. Few collections teams want to navigate a swivel-chair strategy, working two concurrent systems at once to wind down A/R.

So, what’s the alternative?

You can decommission the legacy system and build your legacy data management strategy around an archiving solution that allows staff to continue collection efforts with complete billing functionality.

This A/R wind down approach:

• Reduces costs of legacy system support and maintenance
• Fortifies defenses against cybersecurity threats
• Ensures HIPAA-compliant record retention and compliance
• Helps maintain continuous account resolution during the system transition

If your organization is going through a financial system replacement and there are outstanding accounts receivable records you’re not sure how to handle, let’s talk.

October is National Cybersecurity Awareness Month (NCSAM), a collaborative effort between government and industry to raise awareness about the importance of cybersecurity.

This year, NCSAM is focusing on personal accountability for cybersecurity and the importance of taking proactive steps to fortify it. And with healthcare holding the top spot in 2018 for the industry with the most cybersecurity breaches, this message of diligence should be one that isn’t ignored.

The trend of breach attempts within healthcare has remained a constant – hackers continue to target individual workers at healthcare organizations to gain access to the valuable health and personal data housed within the networks. In fact, healthcare providers weathered a 300% increase in imposter email attacks during the first quarter of 2019 as compared to the same time period the year before, and made up approximately 79% of ransomware incidents within all industries between Q1 and Q3 2019.

Spotting Cyberhacking Efforts

The best way to provide an individual contribution in warding off cyberattacks is to be aware.

Online scam artists use three main types of attacks, which account for nearly 30% of cyberattack incidents:

• Phishing – an attempt to trick victims into sharing sensitive information such as passwords and usernames for malicious reasons. Often, phishing emails are sent to masses of people in hopes of luring in a few who “take the bait”
• Spear phishing – a personalized attack that fraudulently sends emails from a known or trusted sender in an effort to entice targeted individuals to reveal confidential information
• Malware – malicious software aimed at damaging devices or stealing information. The software is installed after access to the network is gained

What’s more, the 2019 HIMSS Cybersecurity Survey found that email is the most common official point of compromise for significant security incidents.

Often malicious emails will arrive with a spoofed URL, making it difficult to tell it wasn’t from inside the organization. Terms such as “urgent”, “request” and “payment” are used to lure the recipient into opening the message, clicking the link, and unlocking the door to the entire network. And in 2018, the three most common types of healthcare phishing emails were:

• Fake payment notifications
• Alerts of new messages in a mailbox
• Fake invoices

As you monitor your daily emails, a few additional cybersecurity tips to keep in mind include:

• Avoiding automatically clicking on hyperlinks – instead, hover over them to verify their authenticity and ensure the URL begins with “https”
• Being wary of emails from unknown users – if you’re unsure who an email is from, even if details seem accurate, investigate the legitimacy of the email before clicking any links or responding
• Routinely updating your password – consider using the longest password or passphrase permissible and get creative, customizing your standard password for different sites

Although one of a healthcare organization’s best defenses is to establish a legacy data management plan and limit the number of systems it needs to protect, every healthcare employee has personal responsibility to be cognizant of the contribution they play in either strengthening cybersecurity defenses or opening the organization up to potentially devastating risk.

#BeCyberSmart, stay #CyberAware.

What’s worse than a healthcare organization getting attacked by a cybercriminal?  That same healthcare organization getting attacked for a second time – by the same cybercriminal.

Ranking as the third-highest industry to be retargeted following a cyberattack, healthcare is facing some serious security concerns. Although providers continue to fight the recurring fight, they don’t seem to be showing many signs of winning.

A recent report notes that a third of healthcare organization employees who experienced a ransomware attack said it wasn’t the first time. And there have been at least 200 breaches of more than 500 records reported since January, setting 2019 up  to be another record-breaking year for healthcare data breaches.

Surprising? Maybe not when you read articles suggesting that hundreds of servers storing patient X-rays and MRIs for more than 5 million patients in the U.S. lack even baic security protocols like passwords, and are so insecure that anyone with fundamental computer skills and a few lines of code could access them.

Playing Defense Against Cyberattacks

The continuous uptrend and repeat cycle in cyberattacks has led to many healthcare organizations bulking up their security teams. Currently, there are 313,000 open cybersecurity jobs nationwide according to cyberseek.org. Looking ahead, it’s estimated there will be 3.5 million unfilled cybersecurity positions globally by 2021, according to Cybersecurity Ventures.

But the job of securing PHI doesn’t fall only to the medical organization’s security team. It is critical to ensure that each employee within the organization has sufficient training to prevent breaches. The highest risk within a healthcare practice or enterprise is the unsuspecting employee who makes the wrong fateful click and inadvertently opens the door to the entire operation.

Concurrently, it is important to utilize updated technology and maintain best practices for healthcare networks and software to ensure PHI stays protected.

One of the biggest areas for improvement relates to legacy operating systems that are more prone to cybersecurity vulnerabilities. Of those who participated in the HIMSS2019 Cybersecurity Survey:

• 69% indicated that they had at least some legacy operating systems in place at their healthcare organizations
• 83% of those still operate with Legacy Windows Servers (e.g., 2003, 2008, 2012, 2016 and XP)
• 14% of respondents said over 10% of their systems qualify as a legacy operating system

Couple the outdated operating systems with legacy EHR and ERP applications, and security risks are greatly amplified. Facing ever-increasing cyberattacks, and breaches that could have massive implications for patients, organizations with unprotected legacy systems must find a better way.

It’s time to archive.

Regularly called on to help clients address their long-term EHR and ERP data lifecycle management strategies, Harmony Healthcare IT offers a legacy data archiving solution  that consolidates data stores, reduces out-of-production system maintenance costs, mitigates technical risk, and complies with record retention mandates. More importantly, it provides increased security from cyberattacks, protecting both healthcare organizations and  patients.

Ready to make the move toward protecting your legacy data from cyber crimes on repeat? Let’s talk.

Jackson Parish Hospital was in the process of transitioning from CPSI/Evident to Cerner. Making the transition to a new electronic medical record (EMR) can result in a wide range of challenges including difficulty reconciling data between the two and problems with extraction from the legacy EMR.

Dr. Jason Thomas, COO/CIO at Jackson Parish Hospital, knew he needed an experienced company to manage the data extraction–one that could help him manage any potential issues.

Solution

Thomas opted for Harmony Healthcare IT to handle Jackson Parish Hospital’s data extraction. The primary reason for this choice was the trust and relationship that his Harmony sales rep took the time to establish and cultivate.

“We had been in talks with Harmony to have them handle our data archival post conversion so that we could shut down the legacy system when we were ready, but still retain access to that full dataset afterwards. When our sales rep asked us if we’d thought about bringing some of that data over directly into the new production system, he said they had experience in both platforms and could handle that extraction and import of the data too. We knew of no one at the time that could do what we needed short of CPSI and had pretty much written off that option. His suggestion was a no brainer – I have so much trust in him and Harmony. They are never just trying to sell me something. They are a true partner.”

Harmony was able to help navigate the sensitive extraction process, ensuring that there were no issues transferring data from CPSI/Evident. “Harmony told us exactly how to approach [our existing EMR], what questions to ask, and how to prep the system to get the data out. All the pieces lined up and the extraction was executed perfectly.”

In the process of preparing the data from CPSI/Evident and uploading it to Cerner, some reconcilability issues arose. “We have had a few issues during the process. Harmony has had to massage the data so it fits perfectly to the format that Cerner wants it. Every time there has been a road bump, we let Harmony know. They never point fingers or complain. They just fix the problem the same day, every time,” Thomas said.

The question of how to best incorporate the patient into the interoperability and accessibility of the health record has challenged our industry. But, are we finally getting somewhere?

Signed into public law in 2016, the 21^st Century Cures Act, Rule 4006, calls for empowering patients and improving patient access to their electronic health information.  That has happened — and will continue to get better — through the sharing of data from electronic health record (EHR) portals and personal health records (PHR).

Over the past few years, more EHR vendors and payer organizations have incorporated patient portals into their offerings. As a result, by 2018 51% of individuals had access to view their medical records through an online portal. That’s 166.7 million people, an increase of about 30% over the prior year.

PHRs are a different story. In 2012, the Google PHR platform, Google Health, was discontinued because they couldn’t find “a way to translate limited usage into widespread adoption in the daily health routines of millions of people.” Seemingly, that challenge still remains today as Microsoft recently announced it is pulling the plug on its PHR platform, HealthVault.  But, perhaps the answer lies in tying the PHR to the EHR.

Apple Health^™ is picking up steam with a solution that allows patients to aggregate their health records from multiple institutions alongside their own patient-generated data – right on their iPhone Health app. Apple’s approach has the potential to drive further awareness and adoption of EHR patient portals because authentication through the Health app can be set to use the same patient login credentials as the EHR portal offered from a provider. Apple has worked with Epic, Cerner, athenahealth and other EHR vendors to make it easy for this feature to be enabled. That’s progress.

A similar advancement comes from CommonHealth, an open-source, non-profit public service that will leverage data interoperability standards, including HL7 FHIR to offer functionality analogous to Apple Health^™ to users of Android^™ phones. This platform is being piloted at several academic medical centers and health systems. That’s even more progress, spearheaded by a non-profit organization established to build and operate digital services for public good. Impressive. But wait, there’s more.

We’re seeing other traditional players in healthcare, like payers, innovating.  UnitedHealth Group and its IT division, Optum is trying to position itself at the center of patient and doctor interactions by also entering the EHR/PHR arena. According to Healthcare Dive: UnitedHealth Group will launch an integrated and portable EHR system for its 50 million fully benefited members by the end of 2019. It will leverage its existing consumer digital health platform, Rally, to outline a customer’s health record and determine whether there have been gaps in care. Innovative, indeed.

As our industry continues to tie EHRs and PHRs together in the push for patient inclusivity in the accessibility to medical records, there will be a continued need for keeping the clinical narrative connected and comprehensive. While the EHR manages current clinical data, a solution must also be considered for the entire patient data lifecycle. Oftentimes, due to system replacement, merger and acquisition or the cost and complexity of data conversion; historical patient data is not always readily available in the go-forward EHR. So, what about these older patient records? Shouldn’t that data be just as accessible as the current data to ensure the best transitions and outcomes over a lifetime?  We say yes.

At Harmony Healthcare IT, data availability for the full clinical narrative of the patient is a top priority. We feel it is imperative that medical records are complete, accurate, and accessible – all the time, to all of the Healthcare ecosystem — including patients.

September 23-27, the Harmony Healthcare IT team will take some time to recognize U.S. National Health IT (NHIT) Week – a nationwide action week focused on supporting healthy communities across the U.S. through the application of information and technology.

Participants from across the country – including market suppliers, provider organizations, payers, pharmaceutical/biotech companies, government agencies, industry/professional associations, research foundations, and consumer protection groups— all work together to elevate national attention to the advantages of advancing health IT.

We believe that comprehensive healthcare reform is not possible without system-wide adoption of health information technology (HIT). HIT improves the quality of healthcare delivery, increases patient safety, decreases medical errors, and strengthens the interaction between patients and healthcare providers.

As stewards of the ever-growing volumes of health data that must be kept accessible for up to 25 years or more, health IT teams are faced with many issues, including the best practices for retaining and protecting legacy data throughout its entire lifecycle.

The continuous sunsetting and replacement of EHR systems has led to the need for smooth and accurate data migrations, expertly decommissioned legacy systems and secure archives that provide access to historical records from multiple former data sources.

At Harmony Healthcare IT, we take pride in our contribution to advancing heath IT through the work we do to preserve access to historical patient and business records through HealthData Archiver^®.

The innovations around HIM workflow management and legal eDiscovery built into this lightweight, browser-based application are just a couple of ways we continuously celebrate the mission of healthcare IT and support healthy communities.

Initiated in 2006 by the Healthcare Information and Management Systems Society (HIMSS), NHIT Week has emerged as a landmark occasion for using health IT as part of the overall solution to improve U.S. healthcare as a bipartisan, federally led, market driven initiative.

View the full list of partners and updates on NHIT week events. Working together with a growing coalition of stakeholders, our team is committed to helping to transform healthcare for all.

It’s Saturday night, you’re achy with an intense sore throat, and strep has been going around. Do you tough it out until Monday, when you can get in to see your family doctor? Or, do you take a quick trip to a more readily accessible health clinic at a local retail store to see a nurse practitioner or physician’s assistant within the hour?

For many people, access to quick service, quality care and upfront pricing – which often is 30%-80% less expensive than other providers – are key factors that support the rapid growth of retail health clinics.

The first retail-based clinics opened in Minnesota in 2000. Today, there are more than 2,700 such clinics in operation in 44 states and Washington, D.C., who have served up more than 40 million patient visits.

It’s been reported more than half of clinic visits were on weekends or weekday hours when physician offices are closed. It’s also been estimated that up to 20% of emergency department visits for a nonemergency condition could take place at a retail clinic or urgent care center, potentially generating cost savings as high as $4.4 billion annually.

A lot of major healthcare insurance payers are considering or already including retail clinics in their healthcare provider networks, motivating people to opt for these clinics for convenience and quality of care.

The retail health clinics most often are staffed with a nurse practitioner or physician’s assistant and can treat minor conditions like strep throat, pink eye, or ear infections, as well as administer vaccinations and flu shots.

And the service is good too. Visits are usually kept to around 15 minutes, and according to a recent Walmart Survey, nearly 90% of the customers were satisfied with retail clinics. These satisfaction levels have been attributed to cost transparency, overriding the conventional benefit of cost efficiency.

Electronic Health Records and the Convenient Care Clinic

Given the uptick in the use of retail health clinics, it’s important to consider how they play into the necessary documentation of a complete electronic health record.

The industry association, Convenient Care Association (CCA), focuses on sharing best practices and common standards of operation for Convenient Care Clinics (CCC)s which include 97% of all retail clinics.

CCCs use electronic health records – with patient approval/request, these records can be shared with their primary care provider to promote continuity of care.

As EHR platforms continue to evolve and there are system changes within the CCC data management platforms, it will be increasingly important to remain compliant with record retention regulations.

That’s where we can help.

HealthData Archiver^®, our data management platform, provides a single point of access to historical patient, employee or business data for all types of healthcare organizations. The web-based solution, with its release of information workflows, Single Sign-On integrated clinical views, revenue cycle features and eDiscovery capabilities, provides a significant return on investment for retail health clinics that are changing systems.

The solution consolidates data stores, reduces out-of-production system maintenance costs, mitigates technical risk, complies with record retention mandates, and offers both interoperability and data analytics capabilities.

It’s convenient, cost effective, and as the top data extraction and migration healthcare IT company according to Black Book^™ Rankings, we hit the same high notes as the convenient care clinics.

Are you responsible for data management and HIM at a retail health clinic? Do you need support for your long-term data management and record retention strategy?

Let’s connect.

Nearly 1 in 5  U.S. adults suffer from some form of mental illness, while over 19 million battle a substance use disorder (SUD). 8.5 million are afflicted with both.

With such resounding statistics, it’s not surprising that failures in care coordination can increase medical industry costs by $25 to $45 billion annually. The question is, what’s the solution?

The regulatory environment for mental healthcare providers is vastly different than that of their clinical counterparts. This creates significant challenges, one of the most difficult being sharing patient data between the two types of providers. A portion of that difficulty comes from the fact that many mental health providers don’t use electronic health records (EHR)s.

The EHR Challenge for Behavioral Health Records

EHR adoption among behavioral health providers has lagged behind other medical providers primarily because the government incentives don’t apply. Although the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) provided billions of dollars in subsidies for medical providers to purchase and maintain EHRs, the act did not make incentive payments available for mental health and SUD providers.

Privacy concerns also impact electronic record adoption rates. Years ago, mental health records were kept in separately locked filing cabinets to ensure privacy. That expectation of privacy doesn’t go away with the implementation of an EHR, and it’s also still expected that complete medical record documentation will be maintained. This can lead to double charting or separate record keeping, both of which are extra work in what can be an already exhausting process.

Interoperability of Behavioral Health Records is Possible

Regardless of the challenges, integration of, and interoperability between, clinical and mental health data is still viable.

Back in 2014, a coalition of seven states – Alabama, Florida, Kentucky, Michigan, New Mexico, Nebraska, and Iowa – along with the Office of the National Coordinator for Health Information Technology (ONC) and the Substance Abuse and Mental Health Services Administration, successfully completed a pilot project for the interstate exchange of electronic behavioral health data using an electronic data management platform called Direct. Although this initiative highlighted both technical and operational challenges with using Direct, ultimately it demonstrated that such exchanges can be performed.

As more guidelines are put in place for care delivery, there also needs to be a focus on funding, and long-term integration of behavioral health records, with proper privacy protocols built into the EHRs.

According to a report by The Bipartisan Policy Center: Integrating Clinical and Mental Health: Challenges and Opportunities, there are several options for policymakers to increase care coordination within mental health care:

1. Expand the substance use report (mandated by the 21st Century Cures Act) to make future recommendations to Congress.
2. Direct federal funding to mental healthcare facilities.
3. Permit funding from the HITECH Act to go to mental health and SUD providers, then encourage or require those providers to adopt EHR systems.
4. Provide more guidance on HIPAA updates.

It is encouraging to see efforts like the Patient Protection and Affordable Care Act from 2010, which mandates coverage of mental health services as an essential health benefit, as well as the 21st Century Cures Act of 2016 that requires greater accountability and coordination for federal mental health programs.

Now it’s more than time for behavioral health record management to take a step forward and be fully included in the EHRs of today and tomorrow.

Legacy Data Management Key to Maintaining a Complete Patient Record

One important component of a more thorough healthcare experience in the United States is the move toward the comprehensive health record (CHR), a term coined by Epic, an industry leading EHR. While there are numerous HIPAA guidelines that must be followed regarding sharing mental health information, the bottom line is that complete care is extremely difficult to provide without access to a complete patient record.

It makes sense that to expect better healthcare outcomes, there needs to be a focus on improving access to the complete patient narrative, including legacy data. HealthData Archiver^® is a secure solution that seamlessly integrates legacy records into a searchable and simple to use format so that important records are at your fingertips anytime you need them.

Privacy and security are key ingredients in our archive solution. We help you ensure that archived data within HealthData Archiver^® is monitored for unusual activity and compliance through an integrated third-party monitoring platform like FairWarning. Audit activity from login to logout is captured so administrators can rest assured the privacy and security of protected health information is covered.

Is your mental health organization considering implementing a new behavioral health EHR – such as Netsmart, myAvatar^™, Credible, Accumedic, Mindlinc, NextGen, or Valant – but you’re not sure how to handle old patient records that won’t convert? Have you already adopted a mental health EHR but need help executing a legacy data management plan?

Increase efficiency, contribute to industry access to the complete patient record, and alleviate your own headaches about outdated, vulnerable legacy systems.

Give us a call. We’re ready to talk.

Hospital closures have become a steady trend in healthcare. Not surprisingly, the impact seems to be lying squarely on the proverbial shoulders of rural healthcare. Of the estimated 6,000 acute hospitals in the U.S., about 1/3 are considered rural with at least 200 of those considered to be at immediate risk of closing. Although rural hospitals are critical to their communities, they’re often hit the hardest regarding cuts to reimbursement, lower patient volumes and overall financial struggles, leaving them more prone to closure.

While rural hospitals are victims of the perfect storm of declining rural economies, shrinking populations, labor shortages and increasing costs, there are some rural providers that won’t go down without a fight. Such is the case with a rural hospital in Bowie, Texas that after closing twice is reopening with a partnership with a hospital system in Jacksboro, about 30 miles away. The revived Bowie Memorial Hospital will offer 24-hour emergency and observation services which will help local residents avoid needing to go to other towns for urgent care. As Texas is described as the center of the rural hospital crisis, with 26 temporary or permanent closures since 2019, there is hope as other hospitals across the state or considering changing their business models to rescue other failing hospitals.

Meanwhile, solo and small medical practices aren’t without their challenges. They combat new retail-based clinics, patients bypassing their primary doctor to go directly to a specialist or see a physician’s assistant or nurse practitioner, and big hospital groups that are aggressively opening their own urgent care centers. This kind of competitive landscape has led to a 18% steady decline over a four-year period for primary-care physician office visits by adults under 65. Unfortunately, statistics like this continue to make a good argument for single and small practices to sell out and fold their practice into a hospital network.

What happens to health and other business records with a hospital or medical practice closure or acquisition?

If your hospital or practice is at risk of closing its doors, or is being acquired, it’s time to develop or refine your record retention strategy. This entails putting a plan into action for securing electronic records long-term. While this certainly includes protected health information for patients, as dictated by the organization’s medical record retention policy, it also includes other business and employee information like general ledger, accounting and HR record retention.

In terms of medical records management, AHIMA has guidance for what to do with medical records for healthcare providers who are working through plans to close or to acquire a new entity. This includes a recommendation that: If records are not transferred to another healthcare provider, records may be archived with a reputable commercial storage firm.

Our team at Harmony Healthcare IT is uniquely qualified to provide long term record archiving and release of information services. Our broad experience with more than 550 clinical and financial software brands supports our ability to securely manage the future release of information of clinical, financial and business records.

Other important considerations for hospitals or medical practices that are closing or changing ownership include legal and compliance obligations, as well as state regulatory requirements as published by the National Organization of State Offices of Rural Health (NOSOH). Additionally, the American Health Information Management Association (AHIMA) offers a resource specifically addressing state laws, regulations, or guidelines around protecting patient information after a facility closure. For medical practices, a full checklist for closing your practice is available as well.

Not having access to medical records after a facility closing can be a life or death situation for patients. If your practice or healthcare organization is susceptible to closure, let us help you protect patients’ clinical histories.

Harmony Healthcare IT can help you develop a comprehensive legacy data management plan that includes a provision for future records release services. Contact us to learn how HealthData Archiver^®, with its rich release-of-information workflows, can help safeguard and deliver your patients’ data today and in the future.

Updated from the original blog published on Aug 22 2019

Can you imagine a future where health plans are aligned with care delivery teams to enable consumer-centric care models? Deloitte suggests that, by 2040, payers will likely play a much more integrated role in healthcare with technology driving the needed shift from disparate systems to a connected future. Health plans are expected to look beyond claims payment and begin to help drive a data revolution where digital technologies will support reducing the cost of care, streamlining processes, and achieving better outcomes through population health initiatives.

Health Insurance Data Helps Drive Current Preventative and Wellness Programs

While a truly connected healthcare technology network may be years in the future, there are numerous health insurance sponsored initiatives already taking place around the country. Their goal is to use health data to drive program development and aim to reduce overall program costs. These efforts are evidence that more progressive programs and more advanced technology tools are just down the road.

A recent survey indicates that  42% of payers are adding community programs and resources to their population health efforts, while 34% said they use census and socioeconomic data along with clinical data to create new programs. These types of services point toward positive long-term health outcomes for participants along with the reduction of long-term healthcare claims and other expenses. Recent demonstrations include:

• Suicide Prevention – Suicides fell 67% in three months during a 2016 Magellan Health effort with Medicaid patients in Arizona. The program included behavioral health screenings and faster referrals to mental health services. It also addressed other important issues like poverty, food and housing insecurity, and environmental exposures such as homes with lead paint.
• Humana’s Bold Goal – A multi-faceted program from Humana seeks to improve the overall health, and in turn the number of quantifiable healthy days, of the communities it serves by 20% by 2020. The insurance company partners with physicians and community agencies in more than 15 cities with innovative programs that address food insecurity, loneliness and social isolation.

Since research reports that 80% of health outcomes are caused by factors unrelated to better healthcare, it makes sense that our eating and exercise habits, socioeconomic status, and where we live could have a greater impact on health status than the quality of medical care received. That means that insurance companies have an important role in expanding opportunities for people to improve their health, which can also help lower future medical claims and burdens on the system.

The goal here is a win-win.

Like providers, payers face cybersecurity, interoperability and record retention challenges

As health insurance companies continue to grow their role within the industry and their relationships with patients, they also face the tough challenges of cybersecurity and increasing interoperability requirements. Add in record retention mandates and other data management needs, and it’s clear that payers have a lot of balls in the air.

On the cybersecurity front, one of the largest cyberattacks in recent history was the 2015 massive attack against Anthem where an estimated 78.8 million consumer records were exposed. This event, which is thought to have ties to a foreign government, was made possible by one unsuspecting user at Anthem who opened a phishing email which gave the hacker access to Anthem’s data warehouse. Cybersecurity issues continue to plague the entire healthcare landscape and payers aren’t immune.

In terms of interoperability, there are gaps in the availability and transparency of information shared between providers, payers and patients. Providers often struggle to know the level of coverage and copay at point of care. Payers aren’t always able to use coverage determinations to help guide care to better quality or lower cost options, which requires payers to spend even more on process and staffing. Patients remain unsure whether treatments are covered and what their out-of-pocket cost will be.

In general, payers are required to manage vast amounts of data according to HIPAA privacy and security regulations. They also need to retain records of claims and appeals for six years. Insurance records, like health records, are governed on a state by state basis and regulated by specific state retention requirements.

Near-Term Technology Moves for Health Insurance Companies

While the future 2040 vision of the truly connected healthcare landscape may still be years in the making, there are steps payers can take now. The Deloitte article previously mentioned suggests that in the next three to five years, there are two types of opportunities for health plans to manage data more efficiently:

• Coordinating the data and processes with an enterprise-wide strategy
• Automating aspects of data collection and reporting using tools like robotic process automation (RPA), natural language processing, and artificial intelligence (AI)

As the top data extraction and migration healthcare IT company according to Black Book^™ Rankings, our team is on the front lines helping to manage and secure health data to meet cybersecurity, interoperability and record retention best practices. Our data storage solutions support secure, vendor neutral, long-term access to data and provide workflows that fit enterprise-wide data management strategies.

With 90% of Americans currently covered by health insurance, there is a large amount of data that needs to be managed by the HMOs, group health plans, Medicare and Medicaid organizations.

Does your payer organization have the data management strategy it needs in place?

For Payers looking for a reliable partner to help securely and successfully extract, migrate or  store data, we’re ready to get started.