Visit IPM Pulse, our blog dedicated to the healthcare payer community and Integrated Provider Management (IPM).

Identity Management

The Identity Management solution enables health plans to reduce provider maintenance costs by minimizing provider data duplication and improving the accuracy of provider and member attribution. The solution automates the creation, maintenance and integration of Master Provider and Patient Indexes. Additionally, the solution supports attribution relationships between providers, patients, programs and products.

Business Challenges:

• Multiple/duplicate provider and member records increase operational costs
• Difficulty in targeting specific providers and members for care, payment and quality programs
• Member steerage is impeded due to complexity of correctly attributing members to providers
• Complex provider enumeration schemas and the impact of NPI
• Aggregation of data from disparate sources with differing provider/member identifiers

Key Features:

• Enterprise scale, configurable provider and patient indexes
• Comprehensive duplicate management via probabilistic and deterministic matching techniques
• Complete audit of all provider identity changes along with the contributing sources
• Automation for merge, unmerge and split workflows
• Service-oriented architecture for promoting ease of integration
• Configurable survivorship and exclusion rules to facilitate integration across multiple data sources
• Support for source data pattern and frequency analysis for data quality determination

Key Benefits:

• Improved data quality and reduced data maintenance cycles
• Improved enablement of provider initiatives (e.g., PCMH, ACO and P4P)
• Reduced data integration costs
• Improved member and provider satisfaction through consistent view across the enterprise
• Improved enablement of transparency initiatives as result of increased data accuracy