Michigan Association of Health Plans

Priority Health first insurer in Michigan to use Epic’s Payer Platform for real time provider, payer collaboration

This release is from Priority Health. Read more here

Priority Health, the nation’s third-largest provider-sponsored health plan, announced today it has partnered with Epic, the most widely used and comprehensive health record system, to implement Payer Platform with its delivery system, Spectrum Health, and other contracted providers already using Epic. The technology will allow for bidirectional real-time exchange of patient health information at the point of care between Priority Health and providers. Through Epic’s Payer Platform, Priority Health aims to reduce administrative burden for providers, lower the cost of care for members and improve quality of care.

Priority Health, who is the first insurer in Michigan to implement Epic’s Payer Platform, noted that the investment is a major component of its long-term strategy to accelerate value-based care. 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. “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.”

Priority Health shared that their team focused on the Quadruple Aim strategy when moving this project forward. The Triple Aim strategy in health care focuses on enhancing patient experiences, improving population health and reducing costs, where the Quadruple Aim adds the important fourth element of improving the work life of health care providers, including clinicians and staff.

“Our ability to seamlessly connect our health plan with care delivery systems is a game changer, resulting in better care, a better experience, and a lower overall cost for our members and patients,” said Jason Joseph, chief digital and information officer at Spectrum Health.

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, MD, senior vice president and chief medical officer of ambulatory and population health at Spectrum Health. “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. In coming years, the insurer’s use of Payer Platform is poised to benefit more than one million Priority Health members who are served by providers already using Epic for their electronic medical records.

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