In a statement announcing the acquisition, Lumeris and the three Blue health plans--Highmark, Horizon Blue Cross Blue Shields of New Jersey (Horizon) and Independence Blue Cross (IBC)—said they will build on NaviNet's platform, which links leading health plans, industry partners, and the government to hundreds of thousands of physicians, clinicians, and other healthcare professionals. The partners plan to launch an initiative to deliver critical information and applications to drive accountable, value-based health care.
"By combining the two organizations, Lumeris and NaviNet, they are creating a pretty comprehensive platform for accountable care," Cynthia Burghard, IDC Health Insights' research director covering accountable care organizations, told InformationWeek Healthcare. "NaviNet brings very deep experience on the health payer side of the market and Lumeris has experience with health plans and more importantly with providers. The ability of ACOs to actually be successful is going to rely on being able to provide the capability and functionality to both health plans and to providers. If they are able to pull it off, they'll be able to have a platform that meets the needs of both markets."
[ Another player scrambles for a slice of the ACO pie. Siemens/MobileMD To Play In Accountable Care Arena. ]
Currently, NaviNet's technology facilitates more than 50 kinds of administrative, financial, and clinical transactions among three-quarters of America's physicians, 3,800 hospitals, and dozens of the nation's largest health insurers including Highmark, Horizon Blue Cross Blue Shields of New Jersey (Horizon), and IBC. Through the partnership, NaviNet will leverage its communication network and Lumeris' accountable care delivery platform, which is a cloud-based tool that manages clinical data and financial information and has features that support new payment models that reward improved outcomes. "This accountable care solution will enable NaviNet's customers to serve as an information partner with physicians and hospitals, helping them facilitate all the administrative, clinical, and financial tasks necessary to deliver more accountable care," Mike Long, CEO of Lumeris said in a statement.
However, although all parties involved in the deal say the new partnership will allow plans to develop next-generation accountable care delivery systems to contain costs and improve quality, IDC's Burghard said there are a whole host of challenges ahead.
"How do you go from that glass of champagne to celebrate the acquisition to actually making it work," Burghard asks. Similarly, the IDC analyst wants to know who will be running the show. "One of the challenges is clearly going to be who's on first? Is it Lumeris who is actually managing the NaviNet assets and the Blues are quiet stakeholders that are looking for their royalties once a quarter?
That would be the cleanest way to manage the assets. So part of it is who is going to actually manage the asset because three Blue plans and Lumeris….if they don't clearly define who is in charge they could be in significant difficulties," Burghard said.
She also pointed out that there are classic acquisition challenges that Lumeris, the three Blues, and NaviNet may encounter. "Are the cultures compatible? How are they going to integrate the technologies so it's not two separate types of technology that they somehow glue together with band aids? How are they going to go to the market? They have different sets of clients and how are they going to approach NaviNet's client base, which is the largest of the two, and offer the Lumeris technology? How are they going to package and price that? These are all questions that the partners will have to answer," Burghard said.
In the meantime, officials at Lumeris and the three Blue health plans said the transaction to purchase NaviNet is expected to close within 30 days, subject to customary closing conditions. Lumeris and the three Blues said they acquired NaviNet for an undisclosed price.
Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)