Epic, Anthem Strike Deal To Support Health Information Exchange

Health plan management company Anthem has struck a deal with Epic rolling out data sharing technology to health systems and providers who use the EHR vendor’s technology.

Under the terms of the deal, participating providers will have access to Epic’s Payer Platform. The Payer Platform allows the providers to exchange various types of data with payers, including clinical data and admissions, discharge and transfer data from hospital stays.

The Epic Payer Platform will be integrated with Anthem’s Health OS, a platform designed to enable health plan-provider collaboration, the health benefits company said.

Along with making more comprehensive data sharing possible, the new Epic functionality should allow Anthem to capture consumer health information provided by clinicians, analyze the data and respond with insights the care team can use.

As part of its Health OS strategy, Anthem will also integrate its near real-time data with claims data and health information it gets from sources such as health information exchanges, lab companies and other partners.

In addition to offering analytics support, the Payer Platform is designed to offer some additional benefits, Anthem says. They include:

  • The new platform should streamline admission processes such as prior authorization. Using the Payer Platform, providers will be able to send prior authorization requests directly through Epic rather than using the phone or fax. Health plans will then be able to share their decisions electronically.
  • The Payer Platform will offer near real-time access to consumer data, offering clinicians tools for preventive care recommendations dressing gaps in care such as medication adherence problems.
  • The platform will verify clinicians when patients undergo significant events such as being discharged from the hospital.

One initial health system jumping into use of the Payer Platform is The MetroHealth System, A Cleveland system that operates four hospitals, four emergency departments, more than 20 health centers and 40 additional sites. MetroHealth’s initial focus will be on care management and improving follow-up care, Anthem reports.

OK, wait. What did I just hear? That Anthem is developing a platform that could unify health data from a multitude of sources that typically don’t communicate well with each other? And that Epic technology will be integrated into the rollout?

As deals go, I’ve got to say I admire this one. In creating this Health OS. Anthem essentially subsumes the power Epic effectively has over data exchange relationships. Pretty slick.

What interesting is that it’s not clear Anthem is adding anything unique to the mix. Although, if they can help streamline the prior auth process, that could be huge. Also, if it can find ways to help providers make better use of consumer-generated health data, that’s a good thing, but bear in mind that it hasn’t made any specific promises. And given that it’s still an open question how much doctors care about such data, I’m not sure it even matters what they can do much with it or not.

What do you think of EHR vendors connecting with payers?  Remember that Cerner recently announced sharing medical records with life insurance companies as well.

About the author

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

2 Comments

  • There are certainly benefits to these arracngements between EHR vendors and insurance companies but history tells me this is not simply for the good of the health system or provider. What data will the insurance companies get access to and how will they use that, especially when combined with claims data? How might this stregthen the insurance company’s contracting position with providers? And what about privacy and consent? Who is asking patients if this is OK?

  • Vince, I didn’t get into it in this article, but I share your concerns. I’m not convinced that the interests of payers, EHRs are aligned sufficiently with providers to make this a good idea for them.

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