Health Data Exchange on AWS to Improve Member Experience

Outcomes

PBM claims adjudication platform enablement
Reduced data pipeline development time by 50%
Rationalized 90+ obsolete tables/entities

Rightway

Healthcare Data Exchange on AWS to Improve Member Experience through PBM Cloud Operations

Rightway and Inspire11 have partnered with AWS to launch a member-centric Health Data Exchange. This partnership builds on each business’s innovative and collaborative nature to leverage modern AWS technology to solve complex problems while delivering value to consumers. 

Rightway has experienced high growth as a next-generation pharmacy benefit manager. They are on a mission to tackle healthcare’s most significant challenges by transparently delivering lower costs, helping members find the best care, and simplifying the experience so members can spend more time living their lives and less time navigating the complexities of the healthcare industry.  

Rightway knew that in order to continue their growth trajectory while delivering on their member promises, they needed to lead the way in transforming the healthcare industry through innovation and agility enabled by AWS. Together with Inspire11 and AWS, Rightway redesigned their architecture to be Cloud native. The Healthcare Data exchange was built as the way to deliver exceptional experiences to both clients and members. It allows healthcare information to be sent and received on a moment’s notice, so that prescriptions can be filled quickly and members can find the best service at the lowest cost. 

Health Data Exchange 

Rightway and Inspire11 built and deployed the Healthcare Data Exchange by connecting core AWS technologies such as Redshift, RDS, Lambda, Glue, S3, among others. By integrating into the Healthcare Data Exchange, clients and TPAs (Third Party Administrators) can now securely send and receive, in near-real-time, member eligibility information and other data file transfers needed for claims processing and adjudication.   

The Healthcare Data Exchange is built to be scalable and secure, HIPPA compliant, and can incrementally pull in claims every 10 minutes for operational processing at speeds far above healthcare industry standards. With the help of Inspire11 and AWS cloud technologies, Rightway was able to streamline its operational pharmacy benefit processes and automate IT builds and deployments with cloud-forward infrastructure as code, resulting in an 88% reduction in API response times.   

 

“Inspire11 was an amazing partner in our journey to find a PBM infrastructure partner, architect our solution, and build a next generation PBM platform. Collaborating with Inspire11 made our team stronger and gave us a technical foundation we can build on for many years to come.” 

– Ion Feldman, Chief Technology Officer, Rightway

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Enhanced Experience, Lower Costs

For years, Rightway has been leading the healthcare industry in terms of member experience and cost savings. Rightway’s partnership with Inspire11 and AWS gives them the agility they need to continue leading the way with a scalable, cloud-native infrastructure that benefits members and employer groups alike. The numbers speak for themselves: in an independent study by Aon, it was found that employers who use Rightway’s care navigation have 15% lower healthcare costs compared to the market average for employer groups. Even more compelling was the healthcare spend decreases for Rightway members managing a chronic condition. Those members saw a 26% lower healthcare spending than the market average. Rightway’s engaging, easy-to-use services now have a super-charged cloud infrastructure that set them apart on their mission to simplify the healthcare experience.   

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