Health Care Service Corp. has signed a contract with Epic for a data platform that links its health plans with provider organizations, the health insurance giant said Wednesday.
With the new platform, HCSC's health plans will be able to share and receive health data from provider organizations that use Epic Systems Corp.'s electronic health record software and treat their members.
Epic's payer platform allows for two-way data exchange, which means providers will be able to access patient information from other organizations in the network at the point of care and within the Epic EHR's clinical decision-support tools.
Allowing providers to review previous medical records, lab results and claims data for shared patients will help to identify gaps in care and inform care management strategies, according to Krishna Ramachandran, HCSC's vice president of provider performance. Ideally, access to the payer platform will cut down on manual processes used today when sharing patient clinical data.
The platform's meant to "provide a more holistic view of the patient's healthcare," Ramachandran said.
It's also designed help providers avoid duplicative tests, determine if insurance covers a prescribed medication and make some administrative processes—such as prior authorization—more efficient, according to Epic. Epic in August plans to release a feature to automate sending prior authorization requests, notoriously a headache for providers, through the platform.
"That has a lot of excitement … from the provider community," said Ryan Bohochik, Epic's director of value-based care.
HCSC and Epic plan to begin linking providers in HCSC's network to the payer platform this year. It's free for providers to opt into using it.
Only providers already using Epic's software will be able to participate.
About two-thirds of providers use Epic's EHR software across the U.S., which is consistent with what Ramachandran said he's seen in HCSC's network. HCSC, a Chicago-based health insurance giant, owns Blue Cross Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas.
HCSC will continue exploring ways to streamline sharing data with providers in its network, he said.
"Certainly, our providers come in all shapes and sizes," Ramachandran said. "This won't be our first or our last conversation with vendors."
The deal with HCSC marks one of Epic's largest payer platform agreements to date.
Epic rolled out availability of the payer platform about a year and a half ago. Since then, two health insurers—Humana and Blue Cross and Blue Shield of Minnesota—have gone live on it. Johns Hopkins HealthCare, the health insurance division of Johns Hopkins Medicine in Baltimore, has started an implementation.
Ramachandran declined to share financial details of the agreement with Epic.
Bohochik said Epic charges health insurers using a per-member-per-year framework. The cost includes applications, such as care management tools, that can be used with the payer platform.
