Faced with many of the same complexities as their healthcare provider counterparts—combined with the no less complex demands of the insurance space proper—payer organizations face the daunting task of managing vast amounts of patient data while ensuring accurate claims processing and staying compliant with a panoply of government regulations.
With their deep understanding of the intricacies of Epic Electronic Health Records (EHRs), the Hakkoda healthcare team has written at length about the unique synergies that become possible for healthcare providers when EHR systems are unified with other mission critical data sources in a cloud-based data strategy. Perhaps less clear, however, is how many of the same synergies can be just as beneficial to companies in the payer space.
In this blog, we will highlight some of the value payer organizations unlock when they unify health records with the rest of the data ecosystem, leading them to enhanced operational efficiency, improved standards of patient care, and better financial outcomes.
Improved Data Accuracy, Sharing, and Accessibility
The integration of Epic EHR systems with the Snowflake AI Data Cloud offers unparalleled data accuracy and accessibility for payer organizations. Access to complete and up-to-date patient health records, supplemented and cross-referenced with other data from across the patient lifecycle, ensures that all pertinent information is available for accurate claims submissions.
Real-time data sharing enhances coordination with healthcare providers, enabling efficient validation of claims and reducing the risk of processing delays. This immediate access to critical health information allows payer organizations to make informed decisions based on the most accurate and current data, minimizing errors often caused by incomplete records.
Enhanced Efficiency in Claims Processing
The integration of the Epic EHR and Snowflake brings transformative efficiency to claims processing for payer organizations. Automated and standardized workflows streamline administrative tasks, reducing manual intervention and potential errors. By leveraging these integrated systems, payers benefit from seamless coordination with billing and coding processes, ensuring precise and timely billing.
The robust data-sharing capabilities facilitate accurate capture of detailed information, such as J-code injection NDC, that may not be captured in a standard claims data mart in a data warehouse. This comprehensive data availability enhances the appeals process, allowing for quicker resolutions and improved accuracy in claims adjudication. Overall, the integration accelerates reimbursement cycles and optimizes operational performance.
Effective Cost Management
Effective cost management is pivotal for payer organizations, and integrating Epic EHR data with Snowflake provides the tools needed to manage expenses efficiently. One major benefit is the ability to reduce duplicate testing by having comprehensive patient records readily accessible, preventing redundant procedures that contribute to unnecessary healthcare spending.
Additionally, this integration enhances utilization management by allowing payers to closely monitor and manage service usage. The insights gleaned from Epic EHR data enable payers to identify patterns in care delivery and encourage more cost-effective treatments. This ensures that patients receive necessary care without inflating costs.
Enhanced Quality of Care & Care Coordination
Integrating Epic EHR data with Snowflake substantially improves the quality of care by enabling a more data-driven approach to patient management. Utilizing advanced tools for population health management, payer organizations can accurately identify high-risk patients and tailor proactive care strategies to mitigate potential health issues. This focused approach not only helps in reducing complications but also enhances overall patient outcomes.
The integration also revolutionizes care coordination among healthcare providers. By centralizing patient information, healthcare teams can seamlessly share data, leading to more coherent and comprehensive care plans. This coordination is particularly crucial in managing chronic conditions, where multiple specialists need to collaborate. Real-time data sharing ensures that all providers are on the same page, reducing the likelihood of redundant or conflicting treatments.
Moreover, this integrated system supports timely interventions by providing actionable insights derived from comprehensive health records. Payer organizations can facilitate smoother transitions of care, such as from hospital to home healthcare, by ensuring that all relevant information is readily accessible to the necessary parties. Enhanced communication among providers leads to more effective monitoring and follow-up, which are critical for preventing hospital readmissions and improving long-term patient satisfaction.
Ultimately, the integration of Epic EHR data with Snowflake empowers healthcare providers to deliver high-quality, coordinated care that is both efficient and effective. This collaboration fosters a healthcare ecosystem where patient needs are met more accurately, resulting in better health outcomes and optimized resource utilization.
Compliance and Advanced Reporting
Unifying Epic EHR data with other sources in Snowflake equips payer organizations with comprehensive tools to navigate the intricate landscape of healthcare regulations. Through meticulous documentation and sophisticated reporting features, payers can seamlessly adhere to various compliance requirements set forth by regulatory authorities. This integration ensures that all necessary data is captured and easily retrievable, facilitating audits and inspections with minimal disruption.
Snowflake’s advanced analytics capabilities further enhance compliance efforts by enabling payer organizations to produce detailed reports on healthcare trends, patient outcomes, and financial metrics. These in-depth reports are invaluable for identifying patterns and anomalies that could indicate compliance issues, allowing for timely corrective actions. Additionally, the ability to analyze real-time data helps payers stay abreast of regulatory changes and adapt their practices accordingly.
Moreover, the integration supports proactive compliance management by offering insights into operational performance and potential risk areas. Payer organizations can leverage these insights to implement best practices and continuously improve their compliance strategies. By maintaining a comprehensive and up-to-date view of their operations, payers can mitigate risks and ensure that they meet the stringent standards required in the healthcare industry.
Improved Patient Engagement and Security
Epic data integration takes patient engagement to the next level by providing user-friendly patient portals. These portals empower patients to take an active role in their healthcare by offering easy access to their personal health records, enabling them to view lab results, medication lists, and health history in real-time. Patients can also conveniently schedule appointments and communicate directly with their healthcare providers, fostering a collaborative environment that enhances the overall patient experience.
In addition to improved engagement, this integration ensures the highest standards of data security and privacy. Utilizing Snowflake’s cutting-edge security features, alongside Epic’s comprehensive privacy compliance tools, payer organizations can effectively protect sensitive patient information from unauthorized access and breaches. Robust encryption, multi-factor authentication, and continuous monitoring are just a few of the measures that ensure patient data remains secure.
This dual focus on engagement and security not only enhances patient satisfaction and trust but also encourages better adherence to treatment plans and follow-up care. As patients feel more connected and informed, they are more likely to participate actively in their health management, leading to improved health outcomes and a reduction in the need for costly, last-ditch medical interventions.
Unlocking Epic Synergies for Payer Organizations with Hakkōda
For both provider and payer organizations alike, the EHR plays a critical role in keeping operations efficient while optimizing outcomes for patients and plan members. But, critically useful as they may be, EHRs only tell part of the healthcare system’s story. For the rest of that story, organizations across the industry also need a vast array of financial, claim, care management, drug adherence, supply chain, quality and other data to understand the context surrounding a patient, their history, and their options for care.
Fortunately, with the power of a centralized data platform like the Snowflake AI Data Cloud, these disparate and often siloed data sources can then be aggregated in a number of ways to ensure compliance, best practices, and provider efficiency, at the individual provider, campus or system level.
The flipside to this solution is that it can be egregiously difficult to design and implement a modern data stack capable of synergizing all those data sources in one place—especially with regards to the tight grip Epic Systems keeps on its proprietary EHR data.
For healthcare payers looking to make the leap to the cloud, there’s no reason they have to go it alone. In fact, 79% of healthcare industry companies reported last year that they will need a “moderate” or“large” amount of external help in modernizing their data stack.
And Hakkoda’s healthcare team has the experience to guide you on that journey. We built our practice with leadership sourced from some of the biggest payer and provider companies in the industry and data talent certified across the modern data landscape. We’ve helped over a dozen providers and payviders ingest and integrate Epic data with their other key data sources to drive value, which has helped us make a name for ourselves in the Snowflake ecosystem while helping organizations like yours unlock 360-degree patient and member views in Snowflake.
Ready to unlock the synergies Epic and Snowflake have in store for payers and their customers? Let’s talk today.
