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Power interoperability for member data with Verato hMDM

Frictionlessly integrate data across disparate, siloed systems by solving the problem that drives everything else—knowing who is who

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Why is identity data management critical to interoperability?

A complete and accurate understanding of each ‘belly button’ is fundamental to your interoperability strategy. Without understanding who is who across your siloed and disparate data, your interoperability strategy won’t work — risking member churn and business operations.  Across every aspect of data exchange, whether you are trying to share data across internal silos or receiving clinical data from provider partnersmanaging person data depends on accurate identity data management

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How does Verato enable interoperability for health plans?

Verato hMDM is the next-generation identity data management platform purpose-built for healthcare to be the single source of truth for identity across the care continuum.  Our frictionless, end-to-end platform connects to all your data sources to identify and link your data to the right belly button with the highest accuracy in the industry, in real time, and provides you with a modern user interface to help you understand and manage identity data.   

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hMDM in action: Large payer tackles interoperability challenges to drive revenue

A large national health plan struggled to match supplemental clinical data to its membership data for its quality measurement process (HEDIS). This incomplete matching obstructed HEDIS measures for over 25% of its membership. By leveraging Verato within its existing HEDIS process, the organization saw dramatic improvement in the matching success rate despite errors and omissions in the supplemental data. Verato matched 3.1M more lab results to membership profiles. 98% of members with newly matched labs saw improvement in HEDIS measures, leading to $10M incremental incentive revenue. 

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3.1 million

additional lab results matched to member profiles

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98%

of members with newly matched labs saw improvement in HEDIS measures

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$10 million

in additional incentive revenue

Customer snapshots: Improving interoperability with Verato hMDM

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Reduce duplicate records

Verato partners with a regional health plan to: (1) reduce duplicates in their EDW by nearly 470K, (2) reduce duplicates by 78K in their FACETS systems, and (3) reduce potential false positives by over 650

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Improve care delivery

An organization that partners with payers and providers to create Medicare Advantage plans uses Verato to rationalize all information about a person to develop care plans, close gaps, analyze outcomes, and coordinate care.

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Identify members with multiple enrollments

A regional health plan, after having some challenges with consent management across their membership with CMS, leverages Verato to augment their membership matching process to identify members across multiple enrollment sources and their member management system, FACETS.