Anthem has partnered with Epic to create an info change platform between its well being plans and supplier organizations, with the purpose of automating prior authorization requests, offering data-driven insights into affected person care and selling value-based funds, the insurer mentioned Wednesday.
Anthem, which operates Blue Cross and Blue Protect plans in 14 states, launched a pilot program with Epic and The MetroHealth System in Cleveland. That pilot might embody roughly 21,000 sufferers throughout the four-hospital and 40 well being middle system. Over the following few years, the Indianapolis-based insurer goals to develop the partnership throughout each hospital in its community that makes use of Epic’s payer platform. The insurer estimates it is going to be used to change the scientific info of about 14.7 million Anthem members.
Epic’s payer platform might assist lower prices for these people—by highlighting which medicines are lined below a affected person’s insurance coverage coverage and decreasing duplicative testing—and bridge gaps in care by permitting suppliers to overview earlier medical data, labs outcomes and claims information for shared sufferers, mentioned Ashok Chennuru, chief information and insights officer at Anthem.
“We additionally see this as a push in direction of value-based care as a result of one of many keys for suppliers to undertake value-based care, together with threat, is ensuring we have now the seamless information change between the payers and the suppliers,” Chennuru mentioned, including that the corporate is in value-based relationships with 100,000 suppliers nationwide.
Anthem will combine Epic’s payer platform into its Well being OS working system, or its information integration and perception engine that it shares with suppliers, mentioned Rajeev Ronanki, chief digital officer at Anthem.
Over the following three years, the corporate goals to combine further EHR suppliers into this platform, he mentioned, like Cerner, athenahealth and eClinicalWorks. The corporate began this program with Epic due to its massive footprint. Two-thirds of hospitals throughout the nation use the EHR supplier, Ronanki mentioned. Finally, Anthem goals to attach the some 2 million massive and small well being programs it companions with.
“Our purpose is that, over the following three years, all of our suppliers shall be linked into Well being OS, creating primarily what can be a digitally built-in community throughout the nation for us,” Ronanki mentioned.
He declined to share monetary particulars of Anthem’s partnership with Epic. It is not the primary insurer to make use of the EMR platform for sharing information.
Well being Care Service Corp., Humana and Blue Protect of Minnesota have all gone stay on Epic’s payer platform. In March, Humana introduced it was ramping up its partnership with the EMR big to streamline digital prior authorization requests.
The funding comes as Congress debates cracking down on how payers approve—or deny—supplier care requests for sufferers.