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Avaneer Health's interoperable network creates an 'information highway'

The tech stack digitizes the back office of the revenue cycle for faster payments, says CEO Stuart Hanson.  

Susan Morse, Executive Editor

Photo: Weiquan Lin/Getty Images

Avaneer Health, the digital network founded by Aetna, Elevance Health, the Cleveland Clinic; Health Care Service Corporation, Sentara Healthcare and others, has announced a peer-to-peer care delivery system between payers, providers and other participants. The secure, FHIR-based interoperable network creates an "information highway" that can save healthcare administration billions each year, according to Avaneer Health CEO Stuart Hanson.

 "When we founded, we embraced a bold vision of a new way to enable data fluidity in healthcare differently that began in 2017 by a group of industry leaders that were committed to re-inventing healthcare from the inside out," Hanson said by statement.

WHY THIS MATTERS

The decentralized network aims to help solve the industry's long-standing problem of interoperability. The Avaneer Network gets rid of fragmented data silos, numerous point-to-point connections, layers of technology debt, incomplete information and manual processes, the company said. 

It will soon include a real-time adjudication application, which will expedite and increase the accuracy of how healthcare claims are submitted and adjudicated. The sharing of real-time data through a common technology stack, which went live in November 2022, digitizes the back office of the revenue cycle, Hanson said.

"It's removing abrasion," Hanson said. "It will help providers get paid faster."  

Jamisson Fowler, chief digital officer, Sentara Healthcare and the former chief digital officer and CIO of Anthem said from his perspective, the reason providers and payers have not shared data has been due to security standards and the "plumbing" of the health system.

"We see a very broad set of use cases," Fowler said of the network, including ones for discharges.

"This is a $30 billion problem we're tackling," Fowler said.

The secure platform features an immutable audit trail and is decentralized, so data remains in the control of its originator, Avaneer said. Participants can subscribe to and launch their own solutions in collaboration with payers and providers. These processes also improve the patient experience, the company said.

"This advancement is a foundational step towards simplifying healthcare processes, which streamlines finding and transacting with peers on a secure, permissioned network," said Sherif Kamel, SVP Enterprise Delivery at CVS Health. 

"Joining the network and transacting differently with payers and other providers will enable healthcare organizations to improve efficiencies and automate administrative processes, resulting in an enhanced patient and clinician experience," said Sonja O'Malley, senior director of Innovation at Cleveland Clinic. "Another clear advantage to the network is that data is not aggregated – it remains with the originator."

Mark Crowe, director of IT Innovations for Sentara Healthcare said, "This is a complete dynamic shift in the way providers and payers communicate."

THE LARGER TREND

The system's tech stack infrastructure streamlines compliance and complies with the 21st Century Cures Act and FHIR standards, according to Hanson.

In February, government leaders thanked the Office of the National Coordinator for Health IT and six Qualified Health Information Networks for working to create a nationwide interoperability network under the 21st Century Cures Act. 

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org