Breakout Session 2 Insurers And Personalized Healthcare

Personalized Healthcare
Payer Perspective

Session Leader: Cindy Gadd
Scribe: Danny Sands
ACMI Winter Symposium
February 21, 2009

Key Informatics Issues

  • Curation of data—real vs. virtual
  • Portability of health information
    • 30~40% of American’s change plans annually
    • Prisoner’s dilemma
  • Quality and completeness of health plan information
  • Payers have claims not clinical data
  • P4P requires actual results not just claims
  • Clinical care requires clinical data

Action Items for ACMI/AMIA
1. Engagement and education about value of personalized health information through summit/white paper:

  • Payers
  • Individuals
  • Providers
  • Need to involve key decision makers

2. Define care coordination models and data requirements, perhaps through #1
3. Create mechanisms to link claims and clinical data

  • All vs. prioritized data elements
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