Announcing Omni-Payer: Member Information Management for Health Insurers

Jake Freivald's picture
 By | september 28, 2015
in Omni, Insurance, health insurance, MDM, omni-payer, Data Integrity
september 28, 2015

Omni-Payer onboards clinical data and manages member information along six business domains.

Last week, at the Blue Cross Blue Shield IM Symposium in Florida, we announced a great product for the health insurance market: Omni-Payer. 
In his opening keynote remarks, Joe Gregor (VP Commercial Markets, Florida Blue) said: “to grow membership and increase profitability, best-in-class member engagement is our crucial, first, priority – beginning with radical improvements in the capture, synthesis and use of member-focused information”.  
Absolutely. "Capture, synthesis, and use of member-focused information" describes Omni-Payer as well as anything in our marketing materials. 
He went on to note that, although we capture millions and millions of transactions, we derive very few actionable insights from them -- even as our member retention outlook sits at 50-55%, and member churn continues to kill margins. 
What do do? He said, 
We need integrated, actionable, member-centric information that is easily accessible by all key activities, in real time. 
Why? The key to success in the retail business is to build cost effective relationships with members that result in greater satisfaction, improved health, greater retention, and better earnings! 
How? Since we can’t give everyone there own RN or “concierge”, the answer has to be through electronic engagement based on improved data and information!
Then, no surprise, he talked about moving to integrated, synthesized consumer information.
Omni-Payer is an application that assembles a lot of provider data coming in a lot of formats from a lot of places. To be useful, this data needs to be seamlessly integrated, cleansed, and correlated with claims information and data from other domains. In other words, it must be mastered.
At our first implementation, we mastered the business domains and onboarded four providers in just seven months. Not to brag, but that's a hard target to hit, and we did it well. 
Integrated, mastered data will help health insurers enhance member experience and retention. It will enable them to prove that they deserve higher HEDIS and CMS Star ratings -- and subsequent reimbursements. It will help drive toward value-based healthcare, by helping payers achieve a member-centric business model.
We're very proud of what we've done with Omni-Payer. If you'd like more detail, please check it out -- and save the date for a webcast that we'll be providing on October 15.