Nearly two years after announcing a collaboration to enable more data visibility across the care continuum and reduce administrative burden, Epic and Humana say they’ve “completed the first stage” of their work together and are now eyeing new innovations to streamline prior authorization and claims processing.
WHY IT MATTERS
Back in June 2019, when Humana became the first insurer to work with Epic toward enabling value-based care advancements, one of the major first steps was integrating Humana’s benefits check tool, IntelligentRx, into Epic’s e-prescribing workflows.
Since then, more than 50,000 providers have used IntelligentRx, with clinical data for more than a 500,000 of Humana’s members shared for real-time prescription information across Epic’s customer base, the companies said.
Next up, the companies plan to add support for automated prior authorizations and other member insights at the point of care, they said – helping speed access to care for patients as providers are more quickly able to assess procedures’ coverage status.
Such decision support will offer Humana data – preventative services that are past due, history of medication adherence, care coordination insights for chronic disease management – in the Epic workflows.
First up is New Orleans-based Ochsner Health, which will roll out the electronic prior auth tools to improve clinician experience – obviating the need to switch screens when ordering up new procedures – and enabling more timely care decisions.
“Having a comprehensive view of our patients’ medical history and health insights allows our clinicians to dedicate more time to addressing health concerns and setting a course for treatment,” said Dr. Philip Oravetz, chief population health officer at Ochsner Health.
Epic and Humana said they plan on other new tools in the year ahead, including decision support for specialist referrals – helping to lower costs by enabling easier selection of in-network providers when possible.
THE LARGER TREND
This isn’t the only bit of news this week involving an electronic health record giant and a health plan. Just yesterday, Epic’s rival Cerner signaled a move toward the life insurance business with its new collaboration with New York Life.
With an eye toward accelerating underwriting decisions and simplifying the application process, Cerner will work with the insurer to help with access hospitals’ EHRs – with patient consent – in near-real time.
ON THE RECORD
“The past year has shown us how important it is to share data so that we can understand the health of patients and members, communicate with their providers to address chronic conditions, understand gaps in care, and reduce barriers to getting that care,” said Alan Hutchison, VP of population health at Epic, in a statement. “Throughout our partnership, we’ve witnessed Humana’s dedication to innovation and the health of their members. The success of this first phase shows there is tremendous opportunity for the future.”
“Humana is taking a proactive approach to improving the experiences of patients and physicians with partners like Epic,” added Alan Wheatley, president of Humana’s retail segment, in a statement. “By increasing the efficiency of health plan interactions and delivering valuable health insights at the point of care, we increase physicians’ ability to provide efficient, quality care.”