Case Study: Oscar Insurance Corp. achieves timely, coordinated, patient‑centric care with InterSystems HealthShare

Clinical Event Notifications Promote Well Coordinated, Patient-Centric Care for New York Health Plan Members

Oscar Insurance partnered with Healthix, the largest regional health information exchange in New York, to solve a core challenge: how to track and coordinate care for members across hundreds of hospitals, clinics and providers so emergency visits, admissions and discharges trigger timely, patient-centered interventions. Oscar needed real‑time visibility and consented alerts to ensure members—especially those with complex or chronic conditions—received coordinated, cost‑effective follow‑up and navigation through the health system.

Using Healthix’s real‑time Clinical Event Notifications, powered by the InterSystems HealthShare platform, Oscar’s care team receives alerts about ED visits and hospital discharges and then intervenes with education, referrals and care coordination. These interventions—ranging from arranging home nursing instruction to securing in‑network specialist appointments—reduced subsequent ED use, lowered out‑of‑pocket costs, increased member satisfaction, and provided richer data for population‑health analytics and proactive care management.

Oscar