This is all about sharing patient medical records and claim information and as you can read from the quote below, NaviNet has been in this business a long time.  If you read the news about United today with their up and coming cloud operation it’s race to the finish line for the money.  image

NaviNet HealthCare Communication Network – Transactional Portal Information Exchange

Big health insurers like Blue Cross Blue Shield, Aetna, and UnitedHealthcare are attracted to and use NaviNet’s services because they save money by accessing sharing information via the company’s Web portal rather than through costlier call centers, Waugh says. NaviNet makes the bulk of its money, he says, on transaction fees that insurers pay the firm to connect with doctors.”

The overall process here is to use aggregated data, which we hope is accurate to give doctors a faster response with the claim and transactional side of the business for payments, etc.  When presented with both clinical and claims information the desire here is to give MDs more information in which to base their decision making processes with patient care.  The sale amount was not disclosed but you can bet these were some high valued algorithms for healthcare imagetransactions. 

Guess what, they also have and EHR medical records system they sell so again like the United announcement, who has 3 EHR system they can sell, health insurers are now getting into both the transactions and the medical record business, which I said about a year ago would be the next frontier with mergers and acquisitions.  So with this part of the Blues system now has an EHR to sell as well that is software as a service.  image

Aetna is one company who uses Navinet and with this acquisition it will be interesting to see how this works as now we are seeing more and more health insurers with their technology investments paying each other for IT services so it appears the “best dealt hand” at Health IT will move towards the top.  There are other partners here such as McKesson Relay Health and CVS Caremark for e-prescribing.  The race is definitely on for health insurers to scoop up all the technology companies they can to keep those big profits coming in via analytics and the best crafted algorithms on the market.  BD 

BOSTON – In a deal that aims to create a technology company focused on providing real-time data to doctors from both medical records and private payers, Lumeris and payers Highmark Inc., Horizon Blue Cross Blue Shield of New Jersey and Independence Blue Cross announced they will acquire NaviNet for an undisclosed price.

According to the companies involved in the acquisition, joining the strength of NaviNet’s healthcare communication network, used by more than 75 percent of the country’s physicians, with Lumeris’ suite of services, which provide real-time health and claims data, will allow the combined company to deliver critical information and applications to drive accountable, value-based healthcare.

“With Lumeris, they have spent the past five years building this capability for accountable delivery,” Waugh noted. “If we were to build this out ourselves, given the amount of time it would take, we would miss the market opportunity.”

At the heart of the combination, the companies see the ability for doctors to have for the first time real-time data that combines both medical information in the doctor’s office with claims data – all the information needed to provide for effective care coordination of the individual patients as well as broader population health management.


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