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Points of Light 2025 Case Study 19
Using a Hub-and-Spoke Solution to Enhance Payer-to-Payer Data Exchange
Author
Boyd Stewart
Author
Aurene Wilford
In an effort to decrease fragmented patient care and reduce administrative costs, payer organizations are required by CMS to build specific payer-to-payer data-sharing capabilities by 2027. The stringent requirements in this mandate led Centene Corporation and Humana to collaborate and fund a hub-and-spoke architecture developed by Availity for payer-to-payer data exchange. Through this collaboration, stakeholders were able to standardize data exchange between themselves, potentially driving long-term cost savings.
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Key Findings:
- Executive Summary
- The Collaborators
- Points of Friction—Challenges to Be Solved
- Action Plan—How the Collaborators Worked Together to Reduce Friction
- Points of Light—Outcomes Achieved Through Collaboration
- Lessons Learned—What Best Practices Can Other Organizations Replicate?
- What's Next?—Vision for the Future
Writer
Natalie Hopkins
Designer
Jess Wallace-Simpson
Project Manager
Joel Sanchez
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2025 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.