Achieving value by optimizing Epic Payer Platform for payers and providers
Many health plans face challenges in implementing and operating Epic Payer Platform cost-effectively. Optum addresses these challenges by leveraging our extensive expertise in health systems and health plans to ensure the platform is set up, scaled, and optimized efficiently.
Epic Payer Platform is a powerful tool for exchanging clinical data on a large scale, enhancing health plans' ability to gather detailed clinical information and social drivers of health. By merging this data with claims information, health plans can more effectively identify gaps in care quality and risk adjustment diagnoses. The platform also supports health plans and health systems in meeting regulatory requirements like electronic prior authorization and FHIR-based data exchanges.
The Optum approach includes using Epic-certified resources for swift technical implementation, fostering organizational alignment, and developing strong relationships with provider partners to quickly connect to platform features.
What's included
Technical installation
Epic Payer Platform technical installation
The team will employ a flexible staffing approach with Epic-certified installation and technical expertise, covering both core infrastructure and specific use cases. They will bring best practices for optimization of data structure, experienced in Azure, AWS, and on-premises setups. Time to deliver is 4 months from implementation start*.
*Assumes technology, licenses and resources have been procured.
Provider connection rate
An industry-leading provider expansion rate
Epic-certified clinical consultants and provider pipeline strategists bring an industry-leading provider expansion rate, leveraging established relationships and technical expertise to secure maximum provider partner connections. Time to deliver is 100+ provider connections in 12 months across all Epic Payer Platform use cases.
Value realization
Proven track record of value enablement
Experienced professionals with a solid history of assisting clients in achieving value within the initial licensing period, collaborating with health plans and health systems to enhance data utilization and create new, innovative applications for process enhancement, value reporting, and social determinants of health integration, among other areas. Time to deliver initial feature value is within 9 months of noteworthy provider connections.
Blue Ribbon readiness
Bridge the gap between payers and providers
Strategy development, roadmap and delivery to achieve Blue Ribbon.
The Optum team came in with a high level of knowledge and expertise, partnering with providers on integration and helping drive business case and value. Their professionalism and attitude to ensure delivery was a success and exceeded our expectation. We will absolutely choose to collaborate again in the future if the opportunity arises.
National commercial payer client
Key benefits
Improved health outcomes
Interoperability enables improvements in gap closure, HEDIS®/Star Ratings and risk adjustment
HEDIS is a registered trademark of the National Committee for Quality Assurance
Enhanced care coordination and member engagement
Digitally equipping the health plan with clinical records and near real-time event notifications, care coordinators can manage utilization, scheduling, and broader engagement activities with their patient cohorts. Additionally, health plans will be able to leverage patient-facing modules like MyChart, simplifying registration and coverage activities to improve member satisfaction.
Operational efficiency
Interoperability enables more efficiencies with payment integrity appeals, claims payments and chart reduction across key operations like risk, quality, claims and medical necessity reviews.
Value-based care results
Interoperability enhances the integration of payer and provider data, offering a more comprehensive perspective of the member. This unified view facilitates a deeper understanding and assessment of risk across member populations for both parties.
Epic Payer Platform Managed Services FAQ
Optum continues to lead the way in the Epic Payer Platform community, collaborating with health plans at every step of their journey. Whether you're in the midst of implementation and not seeing the expected benefits, or you're just about to invest and want to guarantee you have the optimal strategic and technical blueprint, our team is dedicated to crafting a tailored support plan that aligns perfectly with your needs.
Optum boasts the world's largest team of Epic-certified experts outside of Epic itself, spanning numerous clinical domains. Our team comprises clinicians, application specialists, database professionals, and strategists. This diverse expertise allows us to offer health plans comprehensive support, eliminating the need for multiple vendors throughout different phases of the installation process.
Yes, Epic Payer Platform can be used alongside other Optum solutions. Optum specializes in managing large-scale clinical data for payer clients, effectively separating the data for use in downstream payer systems and other Optum assets. This enables payer clients to access the data immediately and distribute it across relevant internal or Optum systems, optimizing the value gained from the payer platform and other Optum solutions that depend on clinical data.
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Product information and resources
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Download the fact sheet
PDF
Fact sheet
Overview of Epic Payer Platform Managed Services
A fully staffed team with services in hosting, infrastructure, resourcing on-demand EHR expertise, strategic advisory, configuration and provider implementation.