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QUALITY AND STARS
RISK ADJUSTMENT

White Paper: Executing high-performing interoperability programs to enable clinical data

Interoperability is a complex topic that can be challenging for quality and risk adjustment teams. Numerous obstacles have impeded progress to date, including but not limited to legacy infrastructure, stakeholder alignment, provider buy-in, and managing multiple vendors. However, with the advent of the Trusted Exchange Framework and Common Agreement (TEFCA) and the Centers for Medicare & Medicaid Services (CMS) recently finalizing the Interoperability and Prior Authorization Final Rule, the entire healthcare industry has a significant incentive to rapidly invest in interoperability within the next few years.

For payers, true clinical data enablement is a multi-step process that includes data acquisition, ingestion, standardization, and integration with downstream applications. Clinical data enablement requires a long-term strategy and a comprehensive team composed of interoperability, informatics, and regulatory experts.

Read our latest white paper as we define the key steps and provide guidance for payers to build and execute a high-performing interoperability program, including best practices to consider when working with both internal and external partners.

You’ll learn the critical elements of:

  • Acquiring data from providers and data partners
  • Ingesting data and performing normalization and enrichment
  • Executing data standardization and storage
  • Integrating data with downstream applications

Read the white paper

Don’t miss this opportunity to learn the fundamentals of a high-performing interoperability program to empower your organization’s risk adjustment and quality improvement programs.

WRITTEN BY

Katie Devlin, DHSc, MS, CPHIMS
Katie is responsible for creating an enterprise-wide health data exchange strategy to address our clients’ unique business needs while reducing provider abrasion, maintaining regulatory compliance, and optimizing value. She oversees all initiatives related to digital health data acquisition, ingestion, storage, and normalization, including the expansion of Cotiviti’s electronic health data networks and strategic partnerships. Drawing on her extensive informatics and health information exchange experience, Katie is an advocate for ensuring health information is delivered in a way that enhances the member, provider, and payer experience.

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