Pittsburgh-based Highmark Well being says it’s collaborating with Epic and Google Cloud to higher assist coordination throughout payers and suppliers.
Epic’s Payer Platform is designed to ease collaboration between insurers and healthcare suppliers. Highmark stated that by connecting to Google Cloud, the insights shared with payers and suppliers can be utilized to tell customers of the subsequent finest actions of their care journeys.
Greater than half of Highmark’s 7 million insurance coverage plan members are at present attributed to an Epic supplier. For each attributed member, Highmark stated it anticipates closing roughly 2.5 care gaps mechanically, with upwards of 300 p.c potential improve in care gaps closed.
Highmark Well being’s 14-hospital supplier system, Allegheny Well being Community, estimates this shared claims information will quantity to $2.7 million in annual financial savings, which might be reinvested into high quality medical care and affected person expertise.
Highmark stated the from a clinician’s perspective, payer-derived insights delivered to current supplier workflows in Epic give a extra full view of a affected person’s well being. These insights can embrace a affected person’s circumstances, historical past of in- and out-of-network visits, well being plan advantages and applications out there, insurance coverage claims, alerts for acute occasions, choice assist, and care administration.
“Epic’s Payer Platform is a robust useful resource that permits payers and suppliers to work extra successfully collectively. Pairing that useful resource with Google Cloud’s know-how offers Highmark Well being the flexibility to alter the paradigm,” stated Tony Farah, M.D., govt vp, chief medical and medical transformation officer for Highmark Well being, in a press release. “It is one other step ahead in attaining higher experiences for each customers and clinicians, whereas enhancing well being outcomes and decreasing price of care.”
Google Cloud information analytics applied sciences, akin to BigQuery and Healthcare Knowledge Engine, will facilitate insights shared with supplier associate organizations that use Epic, Highmark well being plan employees, and Highmark members by different built-in digital channels such because the affected person portal.
“Highmark Well being’s use of Google Cloud will allow the group to create an intelligence system geared up with AI to ship invaluable analytics and insights to healthcare employees, sufferers, and members,” stated Amy Waldron, director of healthcare and life sciences technique and options for Google Cloud, in a press release. “Highmark Well being’s funding in cloud know-how is delivering real-time worth and simplifying communications; it is redefining the supplier and shopper expertise.”
Highmark added that automated data sharing can set off actions to enhance well being outcomes, akin to making a case for authorization, prompting acute care concurrent overview, or initiating transitional care. As well as, well being programs working with Highmark can leverage well being plan-calculated care hole statuses to provoke actions that obtain hole closure, to keep away from pointless outreach, and to grasp high quality efficiency outcomes from the well being plan’s perspective.
Utilizing Epic’s Payer Platform, notification can happen when a affected person has an occasion, akin to an arrival to the emergency division, an admission, a affected person class change, or a discharge. Well being plans usually request to be notified when a member has been admitted to or discharged from a hospital. With out know-how akin to Epic’s Payer Platform, well being programs directors sometimes have interaction in time-consuming factors of connection, like making cellphone calls or sending faxes.
“Leveraging automation for accountable information sharing is a game-changer, particularly in relation to decreasing the executive burden of relaying medical data in varied instructions—to payers, suppliers and prospects,” stated Richard Clarke, Ph.D., senior vp and chief analytics officer for Highmark Well being, in a press release. “It facilitates knowledgeable choices with out the necessity for guide again‐and‐forth, all inside the confines of Highmark’s safe Google Cloud infrastructure.”
Along with Epic’s Payer Platform, Highmark Well being stated it’s deploying a set of instruments to enhance digital enablement of supplier companions, together with a brand new supplier useful resource heart and supplier portal powered by Availity.
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