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Epic Systems Tool to Boost EHR Data Exchange for Payer, Providers

For the first time, Epic Systems aims to navigate the difficult payer-provider relationship and facilitate EHR data between the two.

Epic Systems has announced a partnership with Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), to create an interoperable information exchange between providers, payers, and patients on the Epic and HCSC platform.

The secure Payer Platform, which is the first of its kind between the EHR vendor and a large payer, aims to improve patient care, patient interaction, and reduce administrative burden.

“Sharing data between payers and providers at the point of care is a great way to make a real difference in patient care and lower health costs,” Krishna Ramachandran, vice president of provider performance at HCSC, said in a statement.

“This agreement will help advance access to a truly integrated value-based care delivery system, while giving our providers and members actionable information to make more informed care decisions.”

This platform allows providers and HCSC customers to review patient data, streamline administrative processes, such as prior authorizations and paying claims, and facilitate a care management strategy to help patients make informed choices in an effort to reduce care costs.

“This relationship connects the provider, the payer, and the patient in a trusted network,” said Alan Hutchison, vice president of population health at Epic.

“It will enable a more robust, data-driven approach to improving patient health. It will also streamline administrative processes such as the authorization process for providers, so patients can receive more timely access to appropriate care.”

Data exchange between payers and providers often relies on extensive processes to track down clinical data, lab results, and patient health records.

“Research on the effectiveness and cost savings associated with value-based reimbursement models is mixed,” explained the recent Insights by Xtelligent Healthcare Media Value-Based Care Assessment report. “Cost savings related to these models are often not seen until several years after the initial arrangement, in part because of data lag.”

A value-based care model can be adjusted on a yearly basis as more data becomes available and negotiations continue.

“Because each contract varies in terms of program scope, performance targets, and incentives, it is nearly impossible for researchers and contract negotiators to truly understand what aspects of the model result in cost savings and better patient outcomes.”

The Payer Platform aims to strengthen the relationship between payers and providers to lower costs and reduce administrative burden by enhancing the information exchange through a system that is already in place by the providers and health systems in the HCSC network.

HCSC said it recognizes the challenges that hospitals and providers have faced throughout COVID-19 and the payer has implemented multiple temporary policies to enhance care delivery for its members at this time.

The payer also noted the partnership presents an opportunity to enhance and streamline patient care across the health system during COVID-19, and it will implement the best available practices.

The Payer Platform promotes and increases interoperability between the payer and providers. The integrated partnership aims to accelerate patient data sharing within and outside of the payer. This connection helps avoid testing duplication, streamline administrative tasks, and improve care quality.

HCSC is the country’s largest customer-owned health payer and fifth largest health payer with roughly 16 million members spanning across five states. The Payer Platform is set to launch later this year with its Epic customers.

“Our strong networks of community providers in our states is the reason we can help our members access high-quality, affordable health care,” wrote HCSC. “Our providers are on the front lines of care delivery, member health management, and member satisfaction. We are committed to helping our providers deliver quality care for our members.”

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