Priority Health, Epic Partner to Improve Patient Data Exchange

Priority Health has announced a partnership with Epic and plans to implement the EHR vendor’s payer platform to facilitate patient data exchange with providers, lower healthcare costs, and improve care quality for members.

Priority Health is the third-largest provider-sponsored health plan in the country, the second-largest health plan in Michigan, and the first payer in the state to adopt Epic’s payer platform. The payer said it hopes the platform will help advance its value-based care strategy by offering quality care for low costs.

The ability to exchange patient data in real-time will give providers a more comprehensive view of patients’ health and allow providers to enhance their decision-making at the point of care, according to the payer.

The platform will store information on patients’ medication history, chronic condition management, and overdue medical services.

“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,” Praveen Thadani, president of Priority Health, stated in the press release.

“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.”

Additionally, the payer platform will aim to streamline data, expedite the prior authorization process, and relieve some of the administrative burden that providers face. The platform will also improve care coordination, prioritizing evidence-based medicine in particular, the payer said.

When finalizing the partnership with Epic, Priority Health kept in mind the quadruple aim strategy, which includes focusing on enhancing patient experience, reducing costs, improving population health, and improving the work life of healthcare providers, clinicians, and staff.

The payer platform will be available to Spectrum Health providers—an integrated health system part of Priority Health’s network—and other contracted providers who currently use Epic for their EHR systems.

“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,” explained Jason Joseph, chief digital and information officer at Spectrum Health. 

Priority Health offers plans for employer groups, individuals, and families in addition to Medicare and Medicaid plans. The payer serves more than one million members every year across Michigan.

Priority Health aims to create a more holistic care experience for members by streamlining data exchange and making patient health data more easily accessible for providers.

Not only does increasing and simplifying access to patient health information equip payers and providers alike to address medical concerns, but this approach may also empower these stakeholders to address social determinants of health.  

For example, Community Health Plan Washington used population-based data and population health management tools to help them understand patient needs and inform decisions about social determinants of health initiatives. 

Additionally, the payer reinforced its commitment to cut healthcare costs for members. Priority Health has prioritized affordability concerns in the past when it announced a series of premium credits and waivers to help members who were struggling financially during the COVID-19 pandemic.

The payer waived cost-sharing for primary care services for Medicare Advantage members, and individual and group health insurance market plans received a 15 percent premium credit for members that was valid during June and July 2020.