Trinity, Anthem ink 'breakthrough' value-based Epic partnership

Livonia Mich.-based Trinity Health and several Anthem BCBS health plans have signed a new multi-year provider network contract that includes advanced collaboration on data connectivity and value-based reimbursement models through the Epic Payer Platform.

"We're excited for this new relationship we've developed and are encouraged by this breakthrough as it relates to how we are going to jointly administer the payment for healthcare," Jordan Vidor, Anthem's vice president of networks, told Becker's.

The new partnership took effect in the new year and is aimed at streamlining patient data flow between the organizations, along with improving operational efficiency, approval processes, and health outcomes for hundreds of thousands of patients.

"The old way of doing things was to extract clinical records from our systems and submit them manually to the payers we work with. This technology allows us to submit that information automatically," Stuart Kilpinen, Trinity’s senior vice president for payer strategy and product development, told Becker's. "Anthem will have the ability to capture that information automatically from our EHRs within our clinician's workflows."

Trinity and Anthem have partnered on value-based delivery and payment models in the past, but the new agreement "begins a process of changing how we reimburse for care at Trinity on a path toward shared accountability for our patient and member populations," according to Mr. Vidor.

The contract also creates several new value-based initiatives, including for preventive medicine, annual visits, and the establishment of operating guidelines to reduce administrative reviews. The Epic Payer Platform will allow the organizations to transact care gap data in real-time and reduce prior authorization burdens on clinicians.

"This started with an appreciation of each other's perspectives," Mr. Kilpinen said. "There's an appreciation by Anthem of the real issues we're facing as a health system, and likewise we have appreciation for the goals and objectives of Anthem to deliver health coverage to their members." 

Anthem health plans, owned by Elevance Health, operate in 14 states. The new contract includes Trinity's St. Agnes Medical Center in Fresno, Calif.; Hartford, Conn.-based Trinity Health of New England; Athens, Ga.-based St. Mary’s Health Care System; Mishawaka, Ind.-based St. Joseph Health System; Albany, N.Y.-based St. Peter’s Health Partners; and Columbus-based Mount Carmel Health System.

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