January 15, 2019
CAQH Develops the First Provider Data Management Solution for Delegated Groups with Support from Accenture
Cloud-based platform leverages micro-services and a highly flexible database to enable improved user experience
WASHINGTON; Jan. 15, 2019 – Accenture has helped CAQH, a non-profit healthcare alliance, launch a new technology platform that will streamline professional credentialing and data sharing between delegated health providers and health plans.
The new platform replaces today’s highly manual and redundant processes with an online module, CAQH ProView for Groups, that streamlines the roster sharing process between health plans and delegated groups. Provider groups can use the platform to submit a single roster of their delegated providers through a centralized portal, giving plans access to standardized, updated files in one convenient location. In addition to simplifying the process, the platform improves data quality by requiring that all rosters satisfy more than 120 automated quality checks.
Collectively, these capabilities will help the industry improve data quality and consistency while eliminating the highly inefficient processes widely used today. CAQH estimates that the creation of a central system for delegated provider credentialing could save the industry nearly $150 million annually if three-fourths of plans and groups automated credentialing in this way.
“Our new platform has the power to transform the market and establish a standard solution that eliminates operational friction and latency between groups, providers and health plans,” Ron Urwongse, CAQH’s Senior Product Manager. “This solution centralizes and connects the consumers of data to the providers of data — reducing staff time and saving money — while enabling the platform to change and grow as the industry’s needs evolve.”
The platform allows providers and health plan administrators to quickly update and access data from multiple health plans. Built on Microsoft Azure, the solution is powered by a cloud-based data management system that leverages microservices and a highly flexible database to unify the user experience across a highly secure, multi-tenant environment.
“CAQH is a leader in creating shared initiatives to streamline the business of healthcare, and Accenture is a proud partner in this mission,” said Mike Bowman, a managing director in Accenture’s Health practice. “Through collaboration and innovation, this new platform can accelerate the transformation of business processes to deliver value to providers, groups, health plans and ultimately patients seeking care.”
CAQH Proview for Groups is expected to be used by 500 groups, supporting 300,000 providers and nearly 300 health plans. The platform can also be accessed within CAQH Proview, a provider data platform that the majority of plans and providers currently use.
CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients and health plans. Visit us at www.caqh.org.
Accenture is a leading global professional services company, providing a broad range of services and solutions in strategy, consulting, digital, technology and operations. Combining unmatched experience and specialized skills across more than 40 industries and all business functions — underpinned by the world’s largest delivery network — Accenture works at the intersection of business and technology to help clients improve their performance and create sustainable value for their stakeholders. With 469,000 people serving clients in more than 120 countries, Accenture drives innovation to improve the way the world works and lives. Visit us at www.accenture.com.
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