Payer-Provider Connectivity: How Far Have We Come, And Where Are We Going?

Payer-provider connectivity remains quite fragmented in the US. As the feds gear up for the inaugural trial of a nascent Nationwide Health Information Network (NHIN) in late 2008, many payers and providers still slog though basic transactional processes on '90s technology. All the while, growing enrollment in high-deductible health plans (HDHPs) is driving provider demand for more detailed patient information. On the clinical side of data exchange, standards remain elusive, and regional health information organizations (RHIOs) are showing mixed results at best. However, multipayer portals — secure B2B Web sites that connect multiple competing insurers to shared provider networks — are capitalizing on the commoditization of administrative transactions and breathing new life into this ecosystem. This report examines the past, present, and future of payer-provider connectivity and provides Forrester's recommended next steps for eBusiness and channel strategy professionals in the healthcare industry.