Highmark Health and Epic to Improve Payer-Provider Collaboration with Insights from Google Cloud
Customer Company Size
Large Corporate
Region
- America
Country
- United States
Product
- Epic's Payer Platform
- Google Cloud
- BigQuery
- Healthcare Data Engine
Tech Stack
- Google Cloud
- BigQuery
- Healthcare Data Engine
Implementation Scale
- Enterprise-wide Deployment
Impact Metrics
- Cost Savings
- Customer Satisfaction
- Productivity Improvements
Technology Category
- Platform as a Service (PaaS) - Data Management Platforms
- Analytics & Modeling - Predictive Analytics
Applicable Industries
- Healthcare & Hospitals
Applicable Functions
- Business Operation
Use Cases
- Predictive Maintenance
- Regulatory Compliance Monitoring
- Remote Patient Monitoring
Services
- Cloud Planning, Design & Implementation Services
- System Integration
About The Customer
Highmark Health is a large healthcare enterprise based in Pittsburgh, Pennsylvania, employing over 42,000 people and serving millions of Americans. It is the parent company of Highmark Inc., Allegheny Health Network, enGen, and Helion. Highmark Inc. provides health insurance to 7 million members across Pennsylvania, West Virginia, Delaware, and New York, along with dental insurance and related health products. Allegheny Health Network is an integrated delivery network in western Pennsylvania, comprising 14 hospitals, over 2,600 affiliated physicians, ambulatory surgery centers, and various health services. enGen focuses on IT platform needs, while Helion works with payers to enhance network performance. Highmark Health aims to improve healthcare delivery and outcomes through innovative solutions and partnerships.
The Challenge
Highmark Health faced challenges in coordinating care across payers and providers, leading to administrative burdens and fragmented care. The need for improved collaboration and data sharing between health insurers and providers was critical to enhance patient care and reduce costs. The existing system required manual processes, such as phone calls and faxes, to notify health plans about patient encounters, which was time-consuming and inefficient. Additionally, there was a need to provide clinicians with a comprehensive view of a patient's health, including conditions, insurance claims, and care management, to avoid surprise out-of-pocket costs and expedite service authorizations.
The Solution
Highmark Health collaborated with Epic and Google Cloud to host Epic's Payer Platform on Google Cloud, enhancing payer-provider collaboration. This integration allows for automated information sharing and insights delivery to providers, improving decision-making and care quality. Google Cloud's data analytics technologies, such as BigQuery and Healthcare Data Engine, facilitate the sharing of insights with provider partners and Highmark members through digital channels like the My Highmark member portal. The solution provides clinicians with a comprehensive view of patient health, including conditions, insurance claims, and care management, enabling better care coordination and reducing surprise costs. Automated notifications to health plans about patient encounters streamline processes, reducing the need for manual communication. The solution also leverages analytics to improve population health performance, enabling health systems to close care gaps and understand quality performance outcomes.
Operational Impact
Quantitative Benefit
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