Humana partnered with Vim to digitize data exchange and data capture - Vim

Humana partnered with Vim to digitize data exchange and data capture

Company Profile

Humana is a leading U.S. health insurance company that provides a wide range of health and wellness services, including Medicare Advantage, Medicaid, employer-sponsored health plans, and specialty coverage. The company focuses on improving health outcomes through integrated care, preventive services, and value-based healthcare models. Humana also invests in digital health and community initiatives to address social determinants of health and expand access to care.

Company Profile

The Challenge

Healthcare organizations using niche or small EHRs struggled to receive timely, actionable payer data. Their previous workflows relied on static, inconsistently formatted diagnosis gap files and manual processes, leading to high administrative burden, duplicate documentation, and missed care gaps. These limitations made it difficult to accurately risk score patients or provide consistent quality care.

The Solution

To address this, Humana partnered with Vim to embed real-time quality and risk adjustment alerts into provider workflows regardless of EHR. Using a standardized, FHIR-based, EHR-agnostic platform, Vim delivered diagnosis and quality gap alerts derived from Humana’s rich claims data directly into clinical workflows at the point of care. A 180-day pilot was conducted with 28 healthcare organizations to test the solution’s impact.

The Results

The Results

During the pilot, providers saw improved efficiency in risk score capture and gap closure, and were enables with better care coordination across the Humana network.

8,000
Unique CMS-accepted condition alerts delivered
23%
Gap closure rate
3,500
Humana members served
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