Priority Health to Deploy Epic’s Payer Platform

Jan. 5, 2022
Michigan insurer seeks improved care coordination and reduction in administrative burden for providers, including speeding up prior authorization process

Michigan-based Priority Health, the nation’s third-largest provider-sponsored health plan, is deploying Epic’s Payer Platform with its delivery system, Spectrum Health, and other contracted providers already using Epic.

Grand Rapids-based Priority Health is the second-largest health plan in Michigan, offering a portfolio of health benefits options for employer groups and individuals. It serves more than a million members each year. Anthem and Humana are two other big payers that have launched Payer Platform.

The Epic technology is expected to allow for bidirectional real-time exchange of patient health information at the point of care between Priority Health and providers, with the goals of reducing administrative burden for providers, lowering the cost of care for members and improving quality of care.

Priority Health noted that the investment is a component of its long-term strategy to accelerate value-based care. In a press release, the company said the platform will drive higher-quality care and outcomes by:

  • Streamlining data flows, resulting in enhanced transparency and actionability
  • Equipping providers with a broader view of patients’ health, meaning providers can make more informed decisions at the point of care
  • Improving care coordination, with an enhanced focus on evidence-based medicine
  • Reducing administrative burden for providers and speeding up the prior authorization process

“We understand that data from a health plan needs to be actionable at the point of care to drive effective engagement from our provider partners,” said Praveen Thadani, president of Priority Health, in a statement. “Because Priority Health is part of an integrated delivery system, we are uniquely positioned to excel in this space, and have the needed tools and resources for successfully implementing an advanced information sharing tool.”

According to Epic, Payer Platform analyzes information surrounding patients’ medication history, overdue medical services or exams, and chronic condition management strategies, to give providers a more holistic view of a patient’s health, which is essential for value-based models of care.

“The way the industry shares information today can be complex and inefficient,” noted Alejandro Quiroga, M.D., senior vice president and chief medical officer of ambulatory and population health at Spectrum Health, in a statement. “Payer Platform allows for a more collaborative relationship between payers and providers, which is key for delivering quality care.”

Priority Health will launch Payer Platform with contracted providers already using Epic, including all Spectrum Health providers, in 2022.

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