Health Care Service Corp., which owns and operates Blue Cross plans in five states, has tapped Epic to develop a data exchange platform between health plans and providers.
HCSC health plans will be able to exchange medical information with health providers in its networks that use Epic's electronic health record (EHR) software.
The contract is one of the first of its kind between Epic and a large insurer, according to the companies.
Financial terms of the deal were not disclosed. The payer platform will launch later this year for select providers and health systems across HCSC’s five states that already use Epic.
The data exchange service between insurers, providers and patients is designed to improve the delivery of care to patients and improve physicians’ interactions with patients, HCSC said.
Through the payer platform, provider organizations that use Epic's EHR and HCSC health plans will be able to review patient data including medical records, emergency room visits, diagnostic evaluations, lab results and claims.
The service also will streamline administrative processes such as prior authorizations and paying claims, the companies said.
Providers and health plans will be able to facilitate a care management strategy and identify gaps in care, helping patients make smart care choices that will help reduce personal healthcare costs.
As the fifth-largest health insurer in the country, HCSC has nearly 16 million members in its health plans in Illinois, Montana, New Mexico, Oklahoma and Texas.
Epic's EHR is used by more than two-thirds of providers and patients across the country. More than 250 million individuals worldwide have a medical record with Epic.
“Sharing insights 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,” said Krishna Ramachandran, vice president of provider performance at HCSC, in a statement.
The agreement with Epic will help advance access to a "truly integrated value-based care delivery system," Ramachandran said. The service also will give providers and members actionable information to make more informed care decisions.
Hospitals, physician practices and health plans face long-standing barriers to sharing patient information in a timely way. This lack of interoperability in healthcare often results in providers and insurers not having a full picture of a patient's health.
There are different services organizations use to share and receive patient information, including local, regional and state health information exchange organizations.
Alan Hutchison, vice president of population health at Epic, said the relationship with HCSC connects the provider, the payer and the patient in a trusted network.
"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," Hutchison said.