It used to be that “customer is king.” In the 21st Century world of value-based healthcare, it appears that the throne has been usurped by data.
On Tuesday, Moxe Health, a company that aims to power data exchange between providers and payers announced that it has raised $5.5 million in a series A funding round led by Safeguard Scientifics.
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“As there is a convergence of responsibilities within healthcare (i.e., payers and providers experiencing an increasing and overlapping need for data transparency and better insights into the health profile of their patient populations), Moxe enables these key stakeholders to share insights and create a more comprehensive understanding of their populations,” said Gary Kurtzman, managing director of Safeguard Scientifics, in an emailed response to questions. “The Moxe platform provides functionality that we believe will power the future of the healthcare ecosystem, and is a very exciting area for us as we think about where healthcare is heading.”
The need to develop a better profile of the patient is becoming increasingly key to payers and providers because are each looking to engage patients better and develop effective population health strategies to reduce overall cost.
Moxe’s CEO Dan Wilson explained that today providers have very little insight about patients’ data outside of their electronic medical records but the bi-directional data flow between payer and provider will provide a more complete picture that will benefit patients.
“For any given patient, the addition of payer information better informs the providers on the best care pathway as well as the history of the patient’s health,” he said in an email. “At the organizational level, this functionality will play a big role in facilitating successful population health strategies.”
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The Madison, Wisconsin company was founded in 2012 with the goal of enabling data flow both ways through its tech platform, Substrate, that directly links payers and their provider networks. Through Substrate, Moxe allows providers to incorporate claims, risk and other payer data into their own analytics. Meanwhile payers receive clinical data, at a fraction of the standard market rate, the news release note.
Exactly, what kind of clinical data is not immediately clear. This raises the question of whether detailed views into how the patient is being treated may prompt payers to ration care. This is how Wilson responded to that question:
“The company has a “provider first” mentality and understands that both health systems and patients are hesitant to give unlimited data to the payers. With this in mind, we do not expect this tool to limit provider control or patient privacy in any fashion.”
Historically, the payer provider interaction has been marred by mutual antagonism, but value-based care has created a scenario of a rising tide lifts all boats. Now health information exchanges are ways that data is being shared
Other companies that, like Moxe are also looking to enable bi-directional data flow, include NaviNet.
Photo: Freedigitalphotos user Salvatore Vuono