Press Releases: 2009

AmeriHealth Mercy Family of Companies Using Health Information Technology to Help Doctors Identify Gaps in Care

Leading Medicaid Managed Care Plan Leverages NaviNet Clinical Messaging to Deliver Member Clinical Information to Health Care Providers

April 30, 2009
Philadelphia, PA - The AmeriHealth Mercy Family of Companies, the largest organization of Medicaid managed care plans in the country, recently implemented a new service in two of its health plans that will help doctors in their networks identify gaps in their patients’ care. In 2008, AmeriHealth Mercy implemented NaviNet, the country’s largest real-time health care communications network, across the plans, enabling providers to check a patient’s insurance eligibility prior to an appointment. Now, with the addition of NaviNet Clinical Messaging, clinical information on unmet health care services is displayed to providers along with the patient’s eligibility information. This innovative use of health information technology allows providers to know immediately what preventive and recommended health care services a patient needs and are able to act on that information during the upcoming appointment.

In line with President Obama's push for preventive care and electronic medical records, this innovative NaviNet solution puts information in the hands of providers at the point of care. Linking the clinical information delivery to a routine office function alerts the provider to gaps in recommended care at a time when the provider can take action with the patient. For example, when AmeriHealth Mercy network providers check patient eligibility via NaviNet, the system not only checks eligibility but also determines if there is an unmet care need or care gap, such as an overdue mammogram – a test that could save the patient’s life.  The provider can then print the care gap information and put it into the patient’s chart for discussion and scheduling during the office visit.  

Dr. Stephen Diamantoni, who manages a multi-office primary care practice in the Lancaster, PA area, said, "This is a perfect example of how the health plan and the provider can use technology to improve patient care. I wish all the health plans were doing this." 

In addition to the care gap alerts, NaviNet Clinical Messaging reporting features allow Primary Care Providers (PCPs) to manage their patients from a population perspective. PCPs can use the information to identify all of their patients with a specific condition, such as diabetes or asthma. PCPs can retrieve the information as a printable report or an electronic download.  This information technology will help save lives by reducing medical errors, increasing quality and lowering the costs of health care. Other physician practices have begun to use the report capability to support their own internal quality improvement efforts as well.

About NaviNet
NaviNet (formerly NaviMedix) is America’s largest real-time healthcare communications network, securely linking over 700,000 providers and the nation’s patients, industry partners and leading health plans. NaviNet’s advanced solutions, services and expertise streamline business processes and drive industry-leading innovation. In a time when access to healthcare is a critical issue, NaviNet fosters collaboration and helps government, plans and providers improve quality of care and reduce costs. For more information, or to sign up for NaviNet, please visit www.NaviNet.net or call 617-715-6000 or 800-805-7569.