NaviNet to be acquired by Lumeris, Blues

By Chris Anderson
11:46 AM

In a deal that aims to create a technology company focused on providing real-time data to doctors from both medical records and private payers, Lumeris and payers Highmark Inc., Horizon Blue Cross Blue Shield of New Jersey and Independence Blue Cross announced they will acquire NaviNet for an undisclosed price.

According to the companies involved in the acquisition, joining the strength of NaviNet’s healthcare communication network, used by more than 75 percent of the country’s physicians, with Lumeris’ suite of services, which provide real-time health and claims data, will allow the combined company to deliver critical information and applications to drive accountable, value-based healthcare.

[See also: NaviNet acquires Prematics.]

“One of the complaints about NaviNet was that doctors needed to leave their EMR or practice management system in order to do transactions on NaviNet and then cut and paste it to bring it into their system,” said Brad Waugh, NaviNet CEO.

Using the Lumeris platform, which is able to integrate data from the myriad of electronic medical records on the market today, eliminates that complaint and also moves NaviNet from the practice administrator’s desk into the doctor’s office.

According to Joel Andersen, chief marketing officer with Lumeris, the combination of NaviNet’s administrative platform that allows providers to communicate directly with health plans and the Lumeris accountable delivery platform will allow payers and providers drive broader adoption of accountable care.

“It has all been pilot focused so far and has been about increased fee-for-service pay slightly,” Andersen said. “Doctors have only had information from within their four walls either in a paper chart or an EMR, but they haven’t had information from across the continuum of care. So what we saw with NaviNet is a pervasive solution in millions of doctors offices across the country and our ability to take them to the next level by building on their administrative transaction with clinical transactions from across the continuum of care.”

[See also: NaviNet adds 1,000 providers to its N.J. health info exchange.]

For Waugh, the combination was just what the doctor ordered. He noted that NaviNet’s management and its investors had begun to see the need to broaden the company’s scope in order to serve the move of the healthcare market toward shared savings models. But there was concern about how long it would take to accomplish that.

“With Lumeris, they have spent the past five years building this capability for accountable delivery,” Waugh noted. “If we were to build this out ourselves, given the amount of time it would take, we would miss the market opportunity.”

At the heart of the combination, the companies see the ability for doctors to have for the first time real-time data that combines both medical information in the doctor’s office with claims data – all the information needed to provide for effective care coordination of the individual patients as well as broader population health management.

According to Steve Udvarhelyi, executive vice president with Philadelphia-based Independence Blue Cross, the new NaviNet solution will be based on an open platform architecture.

“This needs to be an all-payer solution,” said Udvarhelyi. “Like we saw with administrative transactions, what we want to have happen here is for physicians and hospitals to integrate this in the way they care for patients and the way they run their offices. So it is not a good idea for there to be a number of competing and proprietary solutions.

“This is more than just the sharing of data," he added. "You also need to have the technology that turns the data into actionable information and that functionality doesn’t exist today. EMRs don’t have the integration capabilities and the ability to blend the data together from multiple different sources and this solution does."