Providers continue to face declining reimbursements and those payments increasingly will be tied to quality. At the same time they are being pressured to better coordinate treatment across the continuum of care, and if part of an accountable care organization, to assume additional financial risk.
The four health information technology acquisitions that Ingenix Inc. made over the past year are designed to help health care communities be on a path to sustainability in the changing environment, says Andrew Slavitt, CEO of the Eden Prairie, Minn.-based vendor. Success, he adds, means improving connectivity, intelligence and workflow.
On the connectivity front, Ingenix acquired Axolotl Corp., an established health data exchange platform vendor, to become a major player in linking provider organizations through state or regional HIEs or accountable care organizations. It augmented a suite of coding tools by picking up A-Life Medical, which sells computer-assisted coding software. The application uses natural language processing technology to "read" clinical documentation, decipher the meaning and context of words, identify diagnoses and procedures provided during an encounter, and recommend appropriate ICD-9 and CPT-4 codes. Slavitt forecasts a coming "revolution" among hospitals to adopt such coding systems to improve reimbursement and compliance.
The acquisition of medical necessity outsource vendor Executive Health Resources is intended to help hospitals maintain regulatory compliance and gets Ingenix into a new market. Using a proprietary library of rules to guide decisions, the firm's 600 employed physicians perform medical necessity verification checks upon request from providers and have a near 100 percent success rate in defending the decisions, Slavitt says.
Seventy percent of hospital costs and revenues come from decisions made in high acuity units, Slavitt says. By acquiring acuity information systems vendor Picis Inc., and applying connectivity capabilities from Axolotl, Ingenix intends to provide workflow improvements in emergency, surgical, perioperative, intensive care and critical care departments. "You have to make sure the surgeon has information from the primary care physician and the PCP gets alerted when a patient is admitted to the ER," he adds.
But the fact that Ingenix has entered the hospital ancillary systems market doesn't mean the company is eyeing a bigger jump into the core hospital I.T. arena, Slavitt asserts. "The intent is not to become a major hospital information systems vendor, but to better understand the workflow."
A story in the June issue of Health Data Management will dissect the busy health I.T. mergers and acquisitions environment during the past year.
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