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Opala builds trusted payer to provider interoperability on a foundation of accurate identity

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About Opala

Opala helps healthcare organizations exchange the right information with the right people at the right time. Built from a payer perspective, the company focuses on improving interoperability between health plans, providers, and healthcare technology organizations to support better care coordination, lower total cost of care, and improved patient outcomes.

Unlike many interoperability vendors that require organizations to redesign workflows around a new platform, Opala adapts to existing customer processes and integrates into diverse operational and clinical environments. This flexibility allows organizations to improve data exchange while minimizing disruption and accelerating adoption

 

The Challenge

Healthcare organizations increasingly rely on real-time clinical data to improve care coordination, reduce unnecessary utilization, and intervene earlier when members need support. One of the most valuable sources of this information is Admission, Discharge, and Transfer (ADT) data, which provides near real-time visibility into events such as emergency department visits and hospital admissions.

However, turning those notifications into action is often easier said than done. ADT feeds frequently arrive without payer member identifiers, leaving payer organizations to rely on inconsistent demographic information to determine which member record a clinical event belongs to. Without a reliable way to connect clinical events to the correct individual, health plans risk delayed interventions, missed outreach opportunities, fragmented member records, and reduced value from their data investments.

For Opala, whose mission is to enable timely, meaningful data exchange between payers and providers, solving identity resolution was essential to helping customers act on critical clinical information when it matters most.

Why Identity Matters Before Interoperability

As Opala expanded its interoperability capabilities, the team recognized a critical reality: healthcare organizations cannot achieve trusted interoperability without first establishing trusted identity.

When organizations exchange data without accurately matching records across systems, they risk propagating inaccurate information, creating duplicate records, and introducing privacy and compliance concerns. Poor identity management can undermine even the most sophisticated interoperability initiatives.

 

Identity must come before interoperability.

 

Verato recently sat down with Meghan Quint, SVP of Product and Customer Success at Opala, to discuss how the two companies are working together to solve identity resolution for healthcare interoperability. As Quint explains, organizations often focus on moving data first, but if you don’t know with certainty who the data belongs to, interoperability can actually amplify problems rather than solve them—trusted identity is the foundation that makes trusted data exchange possible. Rather than attempting to build and maintain complex identity resolution capabilities internally, Opala sought a proven partner with deep expertise in healthcare identity.

 

“Organizations often focus on moving data first, but if you don’t know with certainty who the data belongs to, interoperability can actually amplify problems rather than solve them.”

Meghan Quint
SVP of Product and Customer Success
Opala

The Solution: Opala + Verato

Opala selected Verato as the identity foundation for its interoperability platform. According to Quint, “We decided that identity resolution wasn’t something we wanted to build ourselves if we could avoid it. Our customers depend on accurate, trusted data exchange, and Verato provided the scale, expertise, and proven capabilities we needed to support that mission.”

Verato’s enterprise-grade identity resolution capabilities enable Opala to accurately match individuals across disparate clinical and payer data sources. By establishing trusted identity connections, Opala can confidently link incoming ADT events to the correct payer member records and route that information directly into care management workflows.

Together, Opala and Verato help healthcare organizations:

  • Reliably match ADT notifications to payer member records
  • Reduce duplicate and unmatched records across systems
  • Improve accuracy and trustworthiness of exchanged data
  • Enable near real-time case management activation following clinical events
  • Deliver a more complete longitudinal view of members and patients

The combined solution transforms clinical event notifications from informational signals into actionable interventions.

The Results

20,000

ADT events consumed daily and matched through Verato

100%

of ADT events successfully matched to the correct payer member

1 hr 40 min–2 hrs

average time from ADT event, through identity match, to care management activation

These results have held steady as volume has grown, giving Opala a matching layer that scales without added overhead.

Faster Care Management Activation

When an ED visit or hospitalization occurs, health plans can quickly identify the correct member and initiate follow-up workflows. The full journey—from ADT ingestion through identity matching to availability in downstream care management systems—takes just 1 hour 40 minutes to 2 hours on average, enabling timelier outreach, discharge planning, and care coordination.

Improved Matching Accuracy

Verato ensures incoming clinical data is associated with the correct individual, reducing identity-related errors and improving confidence in shared information. Across roughly 20,000 ADT events processed daily in 2026, Verato has matched 100% to the correct payer member — giving Opala full confidence that no clinical event goes unmatched.

Better Care Coordination

By connecting data from multiple sources to a trusted identity, care teams gain a more complete view of each member's history and needs, supporting interventions for ED utilization, readmission prevention, care gap closure, and population health initiatives.

Greater Return on Data Investments

Healthcare organizations invest heavily in clinical data feeds and interoperability. By ensuring those assets connect accurately to the right individuals, Opala and Verato help customers maximize the value of their existing technology and data investments.

Reduced Operational Burden for Opala

The partnership's value extends to Opala's own operations. With Verato running at 100% match accuracy and consistent turnaround, Opala's team spends little to no time on manual matching intervention or related support tickets—freeing them to focus on expanding the interoperability platform rather than troubleshooting identity issues.

A Foundation for Scalable Interoperability

Healthcare organizations face increasing pressure to exchange information across a growing ecosystem of payers, providers, and technology partners. As interoperability requirements expand, identity becomes even more critical.

For Opala, Verato provides the trusted identity infrastructure that enables interoperability at scale. Together, the organizations help healthcare customers exchange information safely, accurately, and efficiently—ensuring that real-time clinical data can be transformed into meaningful action that improves outcomes.

 

Looking Ahead

 

As healthcare continues its shift toward more connected, data-driven care, both Opala and Verato believe that identity will remain foundational to success. As Quint puts it, “The future of healthcare depends on organizations being able to exchange information confidently and at scale. Identity is the foundation that makes that possible, and it’s a critical component of delivering better experiences and outcomes across the healthcare ecosystem. That burden should not be on the patient or the provider.”

By combining Opala’s flexible interoperability platform with Verato’s industry-leading identity resolution capabilities, healthcare organizations can build the trusted data foundation necessary to improve care coordination, reduce operational friction, and deliver better experiences for patients, providers, and health plans alike.

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