BATON ROUGE – Blue Cross and Blue Shield of Louisiana has moved
Care Management processes and several provider services to
Epic. The insurer can now securely exchange up to three times more data with network providers.
“With Epic, Blue Cross is investing in improving health outcomes for our members across the state,” said Dr. Stephanie Mills, Blue Cross executive vice president and chief medical officer. “Epic helps us achieve a team approach to care between our providers and Blue Cross. It expands how we share information and keeps us all focused on our members’ care.”
Nearly 70% of Blue Cross members see a provider using Epic. With the Epic Tapestry and Compass Rose go-live in late April, Blue Cross has moved its clinical functions onto the same platform. These include case and disease management, utilization review, medical appeals, medication therapy management and quality of care tracking.
“Many of our clinical team members, myself included, came to Blue Cross after working in hospitals, clinics and other patient care settings. We saw the value in connecting our processes with those that providers use in treating their patients,” Dr. Mills said. “This greatly simplifies how we share information and advances how we work together to deliver better care to the people we serve.”
Blue Cross has connected through Epic’s Payer Platform with more than 500 provider locations statewide, including most of Louisiana’s major health systems. This allows secure data exchange on more than half of Blue Cross members.
Blue Cross will expand Epic connections to more locations through the end of the year. That will give more providers and the members they treat the advantage of better digital capabilities, including:
•
Giving providers a more complete picture of care their patients have outside of office visits. This could be feedback from Blue Cross clinicians based on claims data or members’ calls with a
health coach. Blue Cross can give the provider notes about any needs that make it a challenge for members to stick their care plan, like financial difficulties, lack of transportation or living alone.
•
Better data to address needs during appointments. In Epic, providers can see more details about a patient’s care history. This can include prompts about past diagnoses or recommended screenings, treatments or tests that there are no claims for. Blue Cross can let providers see this data no matter where the patient went for care or if it was within the same health system.
•
Connecting higher-risk patients with Blue Cross health coaches faster. Blue Cross’
in-house care team of nurses, dietitians, pharmacists and counselors can offer education and support or direct patients to
low and no-cost local resources to address needs.
•
Lowering the amount of outreach a member gets from Blue Cross and the provider’s office. These often address the same issues and can cause confusion.
•
Less work for providers with administrative processes like prior authorization requests and chart checks. With the shared Epic platform, Blue Cross will work toward making these processes automated to handle them faster.
Blue Cross Healthcare Economist Mike Bertaut published a
Straight Talk blog about how Epic helps members have an easier healthcare experience.
About Blue Cross and Blue Shield of Louisiana
Blue Cross and Blue Shield of Louisiana is committed to our mission to improve the health and lives of Louisianians. Founded in New Orleans in 1934, we are a tax-paying not-for-profit health insurer with offices in every major region to serve our customers. We have been recognized for the past five years as an honoree of The Civic 50, named by Points of Light as one of the 50 most community-minded companies in the United States. Blue Cross and Blue Shield of Louisiana is an independent licensee of the
Blue Cross and Blue Shield Association. We invite all Louisianians to visit our website at
www.bcbsla.com or talk to us on
social media @BCBSLA.
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