How an HIE and a Health Plan Innovated to Improve Medical Reconciliation
3:00pm - 4:00pmTuesday, March 6
Las Vegas - Venetian Convention Center
Newly evolving HIE services are creating opportunities for health plans and providers to improve transitions in care, particularly for underserved populations. A next-generation HIE offering CCDs post-discharge from hospitals in a large metropolitan area collaborated with the leading Medicaid managed care plan to improve timely medication reconciliation. Patients facing the challenges of low health literacy and social determinants are more likely to fall through the cracks for transitions in care. Using risk stratification to target the most-needy members, high-quality data delivered by the HIE, and automated matching of the CCD data with other medication sources, the plan was able to identify patients needing immediate follow-up. Insights around HIE and health plan collaboration, data consistency and quality in a multi-hospital environment, medication matching, HIE design, and plan-provider communication offer lessons learned for this and similar use cases.