Availity says acquisition of Diameter Health makes ‘perfect sense’

Availity CEO Russ Thomas says the acquisition of Diameter Health is going to enable providers and health plans to do far more with data.

Availity, a healthcare technology firm based in Jacksonville, Fla., announced in August that it is acquiring Diameter Health, a clinical data company.

Availity handles literally billions of claims and data transactions between providers and health plans each year, but the company has historically concentrated on improving administrative workflows. Diameter has focused on making clinical data more usable.

By adding Diameter, Availity will offer a powerful clinical and claims data platform, Thomas says. So even though it’s a challenging time to complete healthcare deals, Thomas said he sees enormous potential with the acquisition of Diameter.

“It is an interesting time to try to get deals done,” Thomas says. “I think it's a good time, frankly, to try to get deals done for companies like ours who have a long term view of the world and the opportunity, and it just made perfect sense.”

Thomas and Mary Lantin, president and COO of Diameter Health, talked with Chief Healthcare Executive about the acquisition and the opportunities they see to eliminate billions in wasteful spending and improve patient care. (See excerpts of our discussion with Russ Thomas and Mary Lantin in this video. The story continues below the video.)

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Mining and refining

Availity is good at mining for data, Thomas says. But using an analogy from another industry, he says that while Availity succeeds at mining the oil, the company hasn’t refined it and turned it into fuel.

However, that’s where Diameter excels, he says.

“What we found with Diameter is that they do it uniquely,” Thomas says. “Well, their ability to bring in large volumes of disparate data, unstructured data, and turn it into a usable fuel for particularly a health plan, right, or a health system is quite unique.

“And so our thesis for this acquisition, and this merger is that by integrating this upcycling capability and being able to bring sense to that complex clinical data, that we can now automate these complex administrative workflows. We can make sure that when a claim is being submitted that if it requires a medical attachment that we have the medical attachment in the right form, so that we can submit it through with the claim.”

And Thomas adds, “If we're right about this thesis, then the opportunity is literally hundreds of billions of dollars of waste that we can start to get at very, very efficiently. So that's why we're excited about this.”

Availity’s health information network is poised to handle more than $2 trillion in claims this year. With such volume, Availity enjoys a keen perspective on the healthcare landscape, including areas that can be improved, Thomas says.

Healthcare data is everywhere, but it’s also extremely messy, Lantin says. And that makes it more difficult to capture the value in that data. Diameter has focused on what Lantin calls “upcycling the data.”

“Where we have really spent our energy and time is, how are we able to make that data usable?” Lantin says. “How do we normalize that data, enrich it, organize it, and you know, have it come out at the end, so that it can really inform these different workflows? So we couldn't be more excited in terms of our partnership, and now being a part of Availity.”

“Together we're really going to be driving an enablement platform that is informed by both clinical and claims,” Lantin adds.

Diameter is pulling data from a variety of sources to create longitudinal records. She says those complete records will “drive impact in terms of informing the right decisions, both from the administrative processes, but also at the point of care.”

“If you carry this forward, we're in a position to not only provide that data, but actually get it to the place where people can use it, and drive change and informed decisions,” Lantin says.

Patients often receive care at multiple places, so providers can do more if they have a full history.

“If you're able to look at a patient's whole record, and understand that they receive care elsewhere, that may impact different decisions that a provider is going to make,” Lantin says.

Providers and health plans both say they want to deliver the right care for patients at the right time. But lack of consistency in language can lead to what Thomas calls the “murky mess of complexity.”

One doctor might say a patient has a migraine, while another physician may say the patient has a headache. The billing codes for those are different, Thomas says.

“The ability to clean up some of this administrative mess should create transparency and consistency of outcomes in ways that drive better health care for all of us,” Thomas says. “And I just fundamentally believe, I think a lot of the problem in healthcare today is a lack of consistency and standardization of terminology.”

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Coming together

Both Thomas and Lantin say the synergy of the two companies helped drive the acquisition.

The synergy in the “mission and vision” of the companies was a driving force in the deal, Lantin says.

“The tie and potential is so strong,” she says. “It was unique and important in a particularly tough market.”

For Availity, the deal is designed to accelerate the company’s trajectory, Thomas said. In his view, Availity has a “strong growth engine as a company.”

He also noted that some of Availity’s clients have worked with Diameter, and even before the acquisition, those clients said the company would be a great fit with Availity.

“We’ve got pretty smart clients,” Thomas says. “And so when your clients are telling you, you know, it is good, then it's certainly worth digging into.”

“The culture of the companies is very, very, very similar,” he says. “You know, we all sort of believe in this mission that we're about. We work well together. I think we all value our associates and our colleagues and have a culture of collaboration and empowerment.”