How Streamlined Data Leads to a More Seamless Healthcare Experience
Contributing experts: Adrienne McFadden, MD, JD, and Jeff Plante
Building a reliable, secure digital platform is vital to creating exceptional experiences for care providers and their patients. We are increasing care provider control over health and financial outcomes with bidirectional data sharing that delivers clarity and decisions at speed.
Health OS, our digital interoperability platform, connects care providers, payers, and consumers to reduce administrative tasks and drive improved health outcomes.
Central to the platform’s value is its robust data infrastructure. Health OS gathers data from strategic partners, structuring that data to provide a comprehensive, longitudinal view of a patient's care that is then prepared for analytics at scale and integrated into payer-provider workflows for a more seamless and integrated healthcare experience.
The platform is integrated with four of the largest electronic medical record systems (EMRs), 10 state Health Information Exchanges (HIEs), and 11 major admit-discharge-transfer (ADT) vendors.1
Additionally, it connects directly with more than 170 large health systems, 181 sizable physician practices, and 20 immunization registries.2
Health OS combines traditional data such as claims, consumer eligibility, and care provider demographics with innovative data sources like real-time ADT data, in-depth clinical information, social drivers of health data, and input from clinical registries and patient screenings. These diverse data sets are used to develop agile and scalable digital solutions that streamline and accelerate processes for both care providers and payers.
Collaboration Leading to Better Experiences for Patients, Care Providers, and Payers
Our collaborations with prominent care provider practices demonstrate the Health OS platform’s effectiveness.4
Case studies highlight significant achievements, including working with a major academic health system in Virginia to reduce chart chase requests.5
EMR Integration Allows Care Providers More Time to Focus on Patients
There are times when requests for inpatient admission authorizations are missing needed information and result in a Lack of Information denial (LOI).
However, with the connectivity enabled through Electronic Medical Record, our affiliated health plan staff can automatically find the necessary information, confirm medical necessity, and approve the authorization allowing care providers to focus more on their patients.
For one large New York hospital system that connected with us via Epic Payer Platform, this automation resulted in a 73% reduction in LOI denials for patients enrolled in Medicaid in 2024.6
With as much as 15 minutes of nursing time spent on each LOI denial, this resulted in up to 300 hours of time saved annually — time that could be spent with patients.6
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Delivering high-quality care efficiently and at scale requires payer and provider collaboration. Payers have the power to supercharge population health by offering actionable data to care providers like Yale. That data allows us to direct our attention and time where it is most needed. Elevance Health data, combined with a value-based payment model and Yale's high standards for clinical excellence, ensures the success of not only individual physicians and their patients, but the whole community we serve.
Chief Population Health Officer, SVP at Yale New Haven Health System and Associate Dean for Population Health, Yale University School of Medicine, Connecticut
To improve the healthcare experience for patients, care providers, and payers, we’re further developing our unified platform and sharing our technology to ensure data consistency across multiple payers' systems.
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1 Elevance Health, internal Health OS reporting (January 2025).
2 Elevance Health, internal Health OS reporting (January 2025).
3 Elevance Health, internal Health OS reporting (January 2025).
4 Elevance Health, care provider case studies (January 2025).
5 Elevance Health, care provider case studies (January 2025).
6 Elevance Health, care provider case study (2024).