The Power of Seamless Data Exchange in Healthcare

Discover how Arkansas Blue Cross Blue Shield transformed its risk adjustment and care coordination efforts using Datavant’s Clinical Data Platform for real-time, structured clinical data acquisition.

Challenges:
Arkansas Blue Cross faced significant hurdles in accessing complete and timely clinical data across its provider network, which impacted its ACA Risk Adjustment operations. Traditional procurement methods resulted in delays and data gaps, impeding the efficiency of care coordination and risk management processes.

Solution:
Arkansas Blue Cross leveraged Datavant’s platform to achieve a streamlined, fully automated record retrieval system. By tapping into Datavant’s digital network, Arkansas Blue Cross gained near real-time access to structured data, dramatically improving its operational workflows.

Key Results:

• 50% of charts required for RADV audit were already in-house due to Datavant’s member-centric approach, reducing the need for additional manual data procurement.
• 30% of the membership had clinical data retrieved consistently each month.
• 1-4 days to retrieve the majority of clinical charts from request.
• 48% of newly identified HCCs for ACA supplemental submissions were derived from Datavant’s data.

How It Works:

• Automated Data Retrieval: Monthly refreshes of clinical data with member demographics—no provider information needed.
• Reduced Provider Abrasion: Fewer faxes and calls due to Datavant’s digital-first approach.
• Structured Data Capture: Extracted NPIs, Dates of Service, and diagnoses, matched to the correct claims for accurate reporting.