Merger Mania

By Adrian Sanabria-Diaz | August 11, 2015

mania

Merger mania is consuming the healthcare industry. We have seen the major insurance companies consolidate into four players, with the latest Anthem/Cigna merger being the largest financial transaction in healthcare history. Hospitals and physician groups are following suit. Almost every day we read about a large hospital system or physician group merger.

It seems as if we are preparing for a battle of giant providers facing mega-insurance companies in a struggle for financial viability.

This merger mania poses a unique challenge for hospitals and health systems. The problem is: how do these large, merged organizations manage their provider information database. This data is critical for billing, revenue cycle maintenance and enterprise-wide care coordination. Even for hospitals that have not merged, this is a challenge, because their provider information is usually stored in disparate silos scattered throughout their IT infrastructures. When a merger occurs the problem is only exacerbated.

However, one provider, Yale New Haven Health System was prepared to meet this challenge when they merged with L & M Healthcare. L & M Healthcare is the parent of Lawrence & Memorial Hospital in New London, CT, Westerly Hospital in Rhode Island, the L& M Group and the Visiting Nurse Association of Southeastern Connecticut.

The Yale New Haven Health System consists of Bridgeport Hospital, Greenwich and Yale-New Haven Hospital. The health system already had the most hospital beds in the state before their partnership with L+M Healthcare.

Yale New Haven plans to extend its Epic electronic medical record system to the newly merged healthcare facilities. The merging and management of this large amount of provider information will not be a problem for Yale New Haven because they use a unified provider management (UPM) Platform that allows them to manage all of their provider profiles (referring and credentialed physicians, nurses, and mid-levels) across all of the health system hospitals’ clinical, financial and operational IT systems.

Yale New Haven‘s UPM platform allows them to unify, manage and share a single, verified, custom profile on each of their providers, regardless of where that data exists in their multiple IT systems. Provider profiles are verified through the UPM and the very latest, accurate information on all providers is synchronized in real time to Yale New Haven’s IT systems and can be shared, based on permissions, across their entire health system via a private portal and mobile apps.

This single, accurate, source for provider information streamlines New Haven Health System’s workflow, improves productivity, speeds up billing, optimizes the revenue cycle and enhances care coordination health system-wide.

Topics: healthcare, revenue, referring provider, Anthem, Cigna, healthcare history, healthcare insurance, IT Infrastructure, healthcare insurance consolidation, billing cycle, Yale New Haven Health System, Credentialed, billing, revenue cycle, Merger Mania, Anthem Cigna Merger, insurance, major insurance, consolidate, Bridgeport Hospital, Greenwich, Provider Profiles, Yale-New Haven Hospital, L+M Healthcare, Epic System

Adrian Sanabria-Diaz

Written by Adrian Sanabria-Diaz

Incorporating his degree in physics within healthcare, Adrian helps facilitate some of the backend processes of our product including data management and front end web development. He likes to keep busy by attaining his pilot license as well as dabbling into Python here and there.

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