athenahealth, Humana, and Your Health Closing Critical Gaps at the Point of Care While Reducing Administrative Burden on Clinicians

Business Wire

2 days ago

BOSTON--(BUSINESS WIRE)--athenahealth, a leading provider of network-enabled software and services for healthcare practices nationwide, in collaboration with key partners Humana (NYSE: HUM) and Your Health, a South Carolina-based primary care practice, have received a 2025 Points of Light Award from KLAS. This recognition is for the case study, ' Closing Care Gaps & Reducing the Administrative Burden Through Improved Data Sharing.' This recognition highlights how integrating timely and relevant information directly into the clinical workflow can help improve health outcomes for patients.
"Facilitating collaboration between payer and provider organizations to improve care and eliminate administrative tasks is how we can deliver care experience that patients expect and deserve,' said Sam Lambson, VP of Product Management, Data and Ecosystem.
'At Your Health, our clinicians focus on delivering care that's preventative, personalized, and high-quality. This requires our staff to track patients and their health beyond the clinic and identify and address care gaps before they escalate to more serious or costly conditions,' said Will Stillinger, chief operating officer, Your Health. 'Humana and athenahealth have established an open and seamless information exchange that helps us deliver better care while eliminating administrative burden and costly interventions. We are excited by the opportunity for future care intervention pathways based on factors like Social Determinants of Health.'
To accomplish this real-time data exchange, Humana and athenahealth partnered to implement athenaPayer's Care and Diagnosis Gaps solutions to identify and surface care and diagnosis gaps among Humana's Medicare Advantage members. Utilizing athenahealth's cloud-based, single instance platform, Your Health clinicians can now see relevant patient information ahead of visits, address identified gaps during the visit, and document diagnoses and care plans directly within athenaOne. Leveraging Da Vinci APIs, athenahealth automatically sends validated data back to Humana to appropriately document and report on the quality of care they provide to members.
As the case study reports, athenahealth has uncovered an average of 4.8 additional care gaps and 4.7 additional diagnosis gaps per member among Humana's Medicare Advantage population, and Humana has been able to close 35% of its CMS Star gaps. Your Health clinicians now spend less time identifying care gaps with limited information, improving care while reducing documentation time.
'By investing in improving preventive care and management of chronic conditions, we're able to help our members stay healthier and out of the hospital. And that leads to lower costs for members themselves,' said Chris Walker, associate vice president of Enterprise Transformation and Interoperability, Humana. 'This partnership – and the positive results we've collectively achieved – is another example of how we are working together to improve patient care and deliver better health outcomes.'
athenahealth continues to expand its work with payer organizations, boosting information sharing across its network of more than 160,000 providers and facilitating new pathways to improve patient outcomes. To date, athenahealth has surfaced information on more than 25 million care and diagnosis gaps across commercial, Medicare, Medicaid, and ACA lines of business. The company has additional solutions that support provider and payer collaboration, including electronic prior authorization, transition of care, and referral management capabilities.
'We are working to create a thriving healthcare ecosystem that delivers accessible, high-quality, and sustainable care for all,' said Sam Lambson, vice president of Product Management, Data and Ecosystem Platform for athenahealth. 'Our work with Humana and Your Health is an example of exactly what that ecosystem can look like when practices are equipped with purpose-built, innovative solutions that ease clinician burden and enhance patient outcomes. Facilitating collaboration between payer and provider organizations to improve care and eliminate administrative tasks is how we can deliver care experience that patients expect and deserve.'
The KLAS Points of Light annual awards celebrate success stories achieved by payers, healthcare organizations, and healthcare IT companies who have partnered to reduce costs and inefficiencies and improve patient experience. The organizations are honored by the recognition and recently presented about their collaboration at the KLAS K2 Collaborative Summit, May 20-22 in Salt Lake City, UT.
To learn more about the challenges, outcomes, and key lessons from this collaboration, please visit: https://www.athenahealth.com/KLAS-POL-2025.
About athenahealth, Inc.
athenahealth strives to cure complexity and simplify the practice of healthcare. Our innovative technology includes electronic health records, revenue cycle management, and patient engagement solutions that help healthcare providers, administrators, and practices eliminate friction for patients while getting paid efficiently. athenahealth partners with practices with purpose-built software backed by expertise to produce the insights needed to drive better clinical and financial outcomes. We're inspired by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. Learn more at athenahealth.com.
About Humana
Humana Inc. is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell health care services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
About Your Health
Your Health is a leading healthcare organization and physician group committed to providing high-quality, patient-centered care across various specialties, including primary and specialty care for seniors in South Carolina, Georgia, and Florida. With 300 physicians, we deliver care in homes, local offices, facilities, and virtually, ensuring services are available wherever needed. Through continuous education and clinical excellence, Your Health aims to improve health outcomes and enhance community well-being. Our team collaborates closely with families and partners to provide coordinated, compassionate care that prioritizes patients. For more information, please visit www.yourhealth.org.