Pittsburgh-based Highmark Well being says it’s collaborating with Epic and Google Cloud to higher help coordination throughout payers and suppliers.
Epic’s Payer Platform is designed to ease collaboration between insurers and healthcare suppliers. Highmark mentioned that by connecting to Google Cloud, the insights shared with payers and suppliers can be utilized to tell customers of the following greatest 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 mentioned it anticipates closing roughly 2.5 care gaps routinely, with upwards of 300 % 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 scientific care and affected person expertise.
Highmark mentioned the from a clinician’s perspective, payer-derived insights delivered to present 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 help, and care administration.
“Epic’s Payer Platform is a strong useful resource that permits payers and suppliers to work extra successfully collectively. Pairing that useful resource with Google Cloud’s expertise offers Highmark Well being the power to vary the paradigm,” mentioned Tony Farah, M.D., govt vp, chief medical and scientific 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 bettering well being outcomes and reducing price of care.”
Google Cloud information analytics applied sciences, similar to BigQuery and Healthcare Knowledge Engine, will facilitate insights shared with supplier companion organizations that use Epic, Highmark well being plan employees, and Highmark members via 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 precious analytics and insights to healthcare employees, sufferers, and members,” mentioned 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 expertise is delivering real-time worth and simplifying communications; it is redefining the supplier and client expertise.”
Highmark added that automated data sharing can set off actions to enhance well being outcomes, similar to making a case for authorization, prompting acute care concurrent evaluation, or initiating transitional care. As well as, well being techniques 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, similar 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 expertise similar to Epic’s Payer Platform, well being techniques directors usually interact in time-consuming factors of connection, like making cellphone calls or sending faxes.
“Leveraging automation for accountable information sharing is a game-changer, particularly with regards to decreasing the executive burden of relaying scientific data in varied instructions—to payers, suppliers and clients,” mentioned 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 handbook again‐and‐forth, all inside the confines of Highmark’s safe Google Cloud infrastructure.”
Along with Epic’s Payer Platform, Highmark Well being mentioned it’s deploying a collection of instruments to enhance digital enablement of supplier companions, together with a brand new supplier useful resource middle and supplier portal powered by Availity.
