What You Should Know:
– Edifecs, Inc., a global health information technology solutions company, today announced its Healthcare Interoperability Cloud, which enables payers to take a strategic approach to interoperability and address compliance, including with CMS-9115-F and CMS-0057-F, and non-compliance use cases.
– In a recent study of 99 payers by a leading third-party consultant, Edifecs was identified as the leading partner for both FHIR® and EDI solutions – uniquely positioning Edifecs as the preferred provider of strategic interoperability capabilities for healthcare payers. Since its inception in 1996, Edifecs has been integral in defining the standards that guide and govern interoperability.
Driving Healthcare Transformation Through Advanced Interoperability Solutions
Edifecs delivers market-leading technology to over 300 payer and health system customers, supporting nearly 300 million individuals in the U.S. healthcare market. For more than 25 years, the company has driven transformation by enhancing healthcare interoperability, data management, workflow efficiency, and operational effectiveness.
· Industry Leadership & Adoption: Edifecs’ solutions are trusted by 24 of the top 25 commercial health plans, 32 of the 51 Medicaid programs, and six of the ten largest health systems in the country.
· Comprehensive SaaS Offerings: Its healthcare SaaS solutions—available via public, private, and hybrid clouds—serve as the foundation for eliminating stakeholder friction and addressing key industry challenges, including accelerating value-based payment adoption and optimizing care funding for alternative payment models.
· AI-Powered Insights: Edifecs leverages generative AI, large language models (LLMs), natural language processing, and machine learning to provide deeper insights into patient care, population health, and business processes.
· Regulatory Compliance & Innovation: As government standards and regulations continue to evolve, Edifecs remains a trusted partner in ensuring “evergreen” compliance for its customers.
Spurred by regulatory mandates, economic pressures, and the pursuit of improved patient outcomes, healthcare organizations are prioritizing interoperability as a cornerstone of digital transformation. According to a January 2024 McKinsey report, advanced technology-based segments are experiencing rapid growth, reinforcing the critical role of interoperability in digital health strategies.
“Customers increasingly recognize interoperability as a fundamental component of their digital health initiatives, driving scalability, extensibility, and adaptability,” stated Chris Lance, Chief Product Officer at Edifecs. “By facilitating comprehensive interoperability strategies rather than isolated use cases, Edifecs extends the value of existing infrastructures while enabling enhanced data transparency, information sharing, and operational efficiency across departments and organizations. This ultimately benefits health plans, their partners, and the members who rely on them.”
The Edifecs Healthcare Interoperability Cloud provides a strategic approach to interoperability, combining a comprehensive healthcare data management platform with its industry-leading unified payer gateway. This solution enables seamless exchange of administrative and clinical data in any format, including EDI, FHIR, NCPDP, HL7v2, and proprietary formats.
· Seamless Connectivity: The platform facilitates integration across systems, processes, organizations, and stakeholders within the healthcare ecosystem.
· Enhanced Collaboration & Workflow Automation: Automated shared workflows foster collaboration while ensuring compliance with evolving market and legislative requirements.
· Optimized ROI & Actionable Insights: Designed to complement existing technologies, Edifecs’ solutions maximize return on investment by delivering faster, more meaningful insights.
Recognized for its industry-leading innovation, the Edifecs Healthcare Interoperability Cloud was featured in the 2024 Fierce Healthcare Innovation Report. By enabling next-generation interoperability, Edifecs continues to transform healthcare operations and improve patient outcomes across the industry.