Ingenix inks deal to acquire Executive Health Resources

By Mike Miliard
11:07 AM

Just two weeks after it announced its acquisition of Picis, which provides information solutions for high-acuity care, Ingenix has reached an agreement to purchase Executive Health Resources, a Newtown Square, Pa.-based provider of medical necessity compliance and physician medical management solutions for hospitals. Terms of the deal were not disclosed.

With its acquisition of Executive Health Resources, Ingenix will increase its ability to help hospitals manage medical necessity compliance requirements as hospitals and health systems serve an increasing volume of patients with government-sponsored health benefit plans.

Executive Health Resources’ Physician Advisor teams provide hospitals and health systems with the dedicated, technology-supported services needed to assist hospitals with managing compliance with CMS- and state-directed medical necessity rules and regulations. Ingenix offers consulting, information systems and services that help hospitals maintain quality of care and improve operational efficiency.

Under federal and state law, hospitals and health systems must perform compliance reviews for medical services provided to patients covered by Medicare and Medicaid programs to ensure care is medically necessary and delivered in the proper care setting. Congress expanded federal auditing oversight in 2006 to all 50 states in an effort to reduce federal payment discrepancies with hospitals.

Executive Health Resources provides evidence-based clinical intelligence and Physician Advisors highly-trained in CMS rules and regulations to support hospitals in complying with federal and state provisions related to medical necessity.

"The expertise and evidence-based clinical insights that Executive Health Resources and its outstanding team provide, combined with Ingenix’s unmatched health information and analytics capabilities, will help our clients thrive in the evolving regulatory environment for healthcare," said Andy Slavitt, CEO of Ingenix. "We look forward to working with Executive Health Resources to continue to develop the insight and innovative technologies our clients need."

Executive Health Resources serves more than 1,100 hospital and health system clients nationwide. Its clients include for-profit and not-for-profit systems, academic medical centers, community hospitals and specialty centers.

"The regulatory landscape is complex and ever-changing, and compliance has become a crucial aspect of a hospital’s operational integrity," said Robert Corrato, MD, president and CEO of Executive Health Resources. "As we continue to support our clients in this rapidly growing market with solutions that simplify the compliance process, Ingenix’s impressive data assets and sophisticated technologies will help us to more quickly deliver critical, technology-enabled intelligence for our clients."

The transaction is subject to regulatory approval and other customary closing conditions and is expected to close before the end of 2010.