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Merger Mania Hits Healthcare

By Adrian Sanabria-Diaz | September 30, 2015

The Wall Street Journal reported recently that healthcare providers and insurers are supersizing. They cite dozens of mergers among hospitals, medical practices and insurance payers, and claim this phenomenon is the result of the Affordable Care Act (ACA).

Five years after the enactment of ACA, a frenzy of healthcare mergers and consolidations have occurred, transforming the medical marketplace into a land of giants.

This supersizing, which hasn’t been slowed by signals of regulatory concern about healthcare consolidations, reflects efforts by healthcare providers and insurance companies to gain the scale and heft to succeed amid changes unleashed or accelerated by the ACA health law. Those include growing pressures to constrain costs, and new forms of payment that require providers to meet efficiency and quality care goals. Health systems are adding hospitals, doctor practices and a range of other services that enable them to manage all of a patient’s care.

One of the challenges created by this merger mania is how hospitals and health systems add new doctors and manage all of their physician information in IT infrastructures that employ a myriad of financial, clinical and electronic medical record (EMR) systems provided by disparate vendors. These mergers have spawned multiple data siloes that make it very difficult to unify, integrate and access provider data from all of the information contained in those legacy systems.

A solution is needed that will make the data stored in these siloes accessible, so accurate provider information that is critical to a healthcare organization’s revenue cycle and care coordination can be easily managed and updated across the enterprise.

One of these merged providers, Yale New Haven Health System was prepared to meet this challenge when they merged with L & M Healthcare. L & M Healthcare is the parent of Lawrence & Memorial Hospital in New London, CT, Westerly Hospital in Rhode Island, the L& M Group and the Visiting Nurse Association of Southeastern Connecticut.The Yale New Haven Health System consists of Bridgeport Hospital, Greenwich and Yale-New Haven Hospital. The health system already had the most hospital beds in the state before their partnership with L+M Healthcare.

Yale New Haven plans to extend its Epic electronic medical record system to the newly merged healthcare facilities. The merging and management of this large amount of provider information was not a problem for Yale New Haven because they use a unified provider management (UPM) platform that allows them to manage all of their provider profiles (referring and credentialed physicians, nurses, and mid-levels) across all of the health system hospitals’ clinical, financial and operational IT systems.

Yale New Haven‘s UPM platform allows them to unify, manage and share a single, verified, custom profile on each of their providers, regardless of where that data exists in their multiple IT systems. Provider profiles are verified through the UPM and the very latest, accurate information on all providers is synchronized in real time to Yale New Haven’s IT systems and can be shared, based on permissions, across their entire health system via a private portal and mobile apps.

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