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Highmark works with Epic and Google to boost payer-provider data exchange

by News7

Highmark Health this week announced its collaboration with Epic, hosting the IT giant’s Payer Platform on Google Cloud to enable more coordination and cross-collaboration between payers and providers.


The aim with a cloud-based deployment is to enable easier and more timely sharing of insights from payers and providers to help educate consumers as they navigate their care journeys, the companies say, with a virtual platform offering faster decision-making or better care.

“Epic’s Payer Platform is a powerful resource that enables payers and providers to work more effectively together,” said Dr. Tony Farah, chief medical and clinical transformation officer at Highmark Health, in a statement. Working with Google Cloud, he said, makes for “another step forward in achieving better experiences for both consumers and clinicians, while improving health outcomes and lowering cost of care.”

For health systems, the goal is to help providers find the best care covered by their patients’ particular health plans, according to the announcement – enabling them to craft optimized treatment plans that can minimize out‐of‐pocket costs while expediting authorizations.

Highmark says the Google Cloud-enabled automation can help with tasks such as “creating a case for authorization, prompting acute care concurrent review, or initiating transitional care,” through Epic’s Payer Platform.

Meanwhile, health systems seeking to improve their population health management can use the platform to work with Highmark to close gaps in care, to avoid unnecessary outreach and assess quality performance outcomes – all while automating the payer notification process around admissions, discharges and transfers.


Highmark says that more than 7 million of its plan members are currently seeing at least one provider using Epic. In the new announcement, it says it anticipates closing perhaps 2.5 care gaps automatically – a potential 300 percent potential increase.

The health plan cites the example of Allegheny Health Network, which predicts $2.7 million in annual savings from shared claims data that can be reallocated to other quality-improvement and patient-experience initiatives.


“Highmark Health’s use of Google Cloud will enable the organization to create an intelligence system equipped with AI to deliver valuable analytics and insights to healthcare workers, patients, and members,” said Amy Waldron, director of healthcare and life sciences strategy and solutions, Google Cloud. “Highmark Health’s investment in cloud technology is delivering real-time value and simplifying communications; it’s redefining the provider and consumer experience.”

“Leveraging automation for responsible data sharing is a game-changer, especially when it comes to reducing the administrative burden of relaying clinical information in various directions – to payers, providers and customers,” added Richard Clarke, chief analytics officer, Highmark Health. “It facilitates informed decisions without the need for manual back‐and‐forth, all within the confines of Highmark’s secure Google Cloud infrastructure.”

Mike Miliard is executive editor of Healthcare IT News

Email the writer: [email protected]

Healthcare IT News is a HIMSS publication.

Source : Healthcare IT News

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