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Highmark Health Collaborates with Epic, Google Cloud To Improve Payer/Provider Coordination – MedCity News


Highmark Health is working with Epic and Google Cloud to help advance the coordination between payers and providers, the companies announced Monday at ViVE in Los Angeles.

Pittsburgh, Pennsylvania-based Highmark Health has about 7 million members, of which more than half are attributed to an Epic provider. The company also has a 14-hospital provider system called Allegheny Health Network.

Through the partnership, Epic’s Payer Platform (which helps payers and providers collaborate) is being integrated with Highmark’s claims data on Google Cloud. Google Cloud’s data analytics technologies will be able to provide insights to provider partner organizations that use Epic, as well as Highmark health plan staff and Highmark members. This will help providers understand patients’ health better, such as their conditions, health plan benefits, insurance claims, acute events and in- and out-of-network visits. Providers will also have a better idea of what’s covered by patients’ health plans.

“We curate the data and make it personalized so that the doctors now are getting more real-time actionable information. … The provider has the clinical data. We have the claims data. We now put them both on this Google Cloud Platform. Now, the fragmented data is all in one place,” said Dr. Tony Farah, executive vice president, chief medical and clinical transformation officer at Highmark Health, in an interview.

The collaboration will also streamline administrative tasks like prior authorization, a practice used by health plans to determine if they will cover a medical service (though many providers say it creates dangerous delays in patient care). In addition, health systems will be able to automate the process for notifying a health plan about patient events, such as emergency department visits.

This collaboration between Highmark Health, Epic and Google Cloud comes at a time when healthcare data is siloed.

“We have over 700 billion data points or bits around our members and as an industry, healthcare is data rich and insight poor,” said David Holmberg, president and CEO of Highmark Health, in an interview. “This is starting to give us insights. 

“What we’re looking for are insights that increase adoption rates by patients and members for the services that are available to them. [We’re also looking for] increasing the scale of the picture and how fine the picture is in terms of clarity for the clinician so that they have a better picture of who you are and what’s going on with you.”

The new collaboration will go into effect in the third quarter of 2024. Highmark Health anticipates saving $2.7 million annually by working with Epic and Google Cloud.

Photo: LeoWolfert, Getty Images



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