From the Desk of: Dan

Industry reflections 

With TEFCA Version 2 now live, there is an increased focus across the industry on privacy-centric interoperability. TEFCA Version 2 not only more clearly defines use cases for data exchange, but also clarifies (and limits) the purposes for which data can be exchanged. The new version highlights the criticality of balancing patient privacy and data security with interoperability, something we’ve long championed.

With the publication of TEFCA Version 2, health systems are thinking about how they can effectively and efficiently implement changes to ensure compliance. They’re wondering: Are we complying with the enhanced security requirements? Are we able to facilitate appropriate patient access to their health information? They’re also strategizing about how minimum necessary release of data, existing IT investment, payer contracts, and revenue cycle all tie together. 

Health plans, on the other hand, are navigating the challenging work of moving from today’s model of “I need a chart, I request a chart, and I get a chart” to having data much more readily available. While increased access to data is a net positive, health plans know that drowning in data without the ability to extract what they need to adjudicate decisions is basically the same as not having the data at all. 

Moxe has been prepared for this moment for a long time: the moment where interoperability, the revenue cycle, and release of information (ROI) have converged. We’re well-positioned to help both providers and payers navigate this new frontier and are committed to bolstering the frictionless exchange of information while balancing considerations around what’s in the best interest of the patient and the broader ecosystem. We’re not here to dictate what ROI looks like for our customers; we’re here to help them move data outside their organization, purposefully and securely, anywhere it’s needed.

I’m thankful the industry is increasingly recognizing the importance of marrying connectivity with data and privacy concerns. As our Chief Administrative Officer Mike Arce shared on our blog a year after the first iteration of TEFCA was published: “As the demand for data continues to increase, and rules and regulations around the release of data become more and more complex, technology is going to be increasingly critical in managing the release of information.” As we all digest TEFCA Version 2, and no matter how many evolutions TEFCA goes through, I know Mike’s statement will remain true. 

Looking back: What’s Moxe been up to the past quarter? 

This past quarter, we’ve continued to build on our track record of fostering a shared understanding between payers and providers. 

I am proud that KLAS Research recognized our team for the third consecutive year with a “Points of Light” award, which celebrates payer and provider partnerships that enhance healthcare outcomes. Our 2024 Points of Light award highlights how health plan AmeriHealth Caritas and two health systems with more than 4,600 physicians, collectively, worked with Moxe to automate the chart retrieval process. You can read more about this successful collaboration and the outcomes participants have achieved here.  

With the goal of fostering improved payer-provider collaboration, we’ve been focused on where the market is going and where we need to be to continue to play a meaningful role in facilitating data exchange. Until fairly recently, the focus has been on how health systems can more efficiently and effectively share data with health plans. Now, we’re also laser focused on how providers can get high quality, meaningful insights directly from payers—prospectively and in real-time—to aid in the delivery of the best quality, highest-value care. 

To that end, we’ve been refining our Point of Care product to ensure the insights delivered to providers are high value, don’t require double documentation, and provide a consistent experience across EHRs. I have to give kudos to our entire team—from engineering to customer success—who have listened closely to our customers and partners to build a modern data platform that allows us to ingest data from a multitude of sources and efficiently transform that data into meaningful insights tailored to the clinical context. 

We know that getting insights to providers from multiple data sources can help them understand a patient’s health more completely. That only matters, of course, if they act on that better understanding. Point of Care seeks to not only provide high quality insights, but also drive action around them. Point of Care can be a stepping stone into a much broader prospective approach, and I’m excited to see how it can aid in transforming how care is delivered. 

Looking forward: What are we focusing on in the coming months? 

In the next quarter, in addition to continuing to refine and optimize our Point of Care offering, we’re increasingly providing value across a broader range of ROI needs.

As our SVP and General Manager of Release of Information, Ron Raymond, shared this spring, our ROI solution has expanded to offer best-in-class ROI experts—versed in blending both digital and traditional release services. Our ROI services help bridge the gap between customers’ IT, compliance, privacy, and billing office teams, and fill a hole in the market in the privacy-centric interoperability space. 

Closing notes

As we look ahead to the next quarter and beyond, I urge our current customers who look to us only to automate payer audits to check out what we can do to help you manage all of your record requests. 

To providers curious about what getting actionable insights directly from health plans looks like and how it helps optimize care delivery and revenue, we’d love to chat with you. 

Ultimately, we’re here to help both providers and payers effectively use clinical data to improve their business while protecting patient privacy and data security. We do this all while helping organizations comply with the latest regulations, like TEFCA. In the end, we all share the same goal: providing the highest quality care at the lowest cost. 

Here at Moxe, we continue to passionately push on in pursuit of helping our customers do just that. Thanks to our team, customers, and other partners who continue to invest and believe in our mission. 

Until next time,

Dan