Humana and Epic are working together on a new patient engagement effort, said to be the first integration to bridge the gap between clinical care management and health plan administration.
WHY IT MATTERS
Humana is the first health plan to make its information accessible in Epic's MyChart patient portal. Having a single, centralized location to manage both their clinical care and their insurance details will simplify Humana Medicare Advantage members' care experiences, the companies say.
Previously, patients have had to navigate multiple platforms or paper documents to access their medical records and their health insurance information, often leading to difficulty in understanding how to pay for treatment plans.
When Humana Medicare Advantage members log into a healthcare system's Epic MyChart account, they will be prompted to link their Humana plan and gain single sign-on access to MyHumana. Once their accounts are linked, coverage details, benefits summaries, plan contact information and direct links to various health plan resources are then accessible in their Epic patient portal.
The integration is designed to reduce the effort required for members to find critical details about their coverage and available resources and improve transparency about covered benefits.
Humana members can view their deductible and maximum out-of-pocket progress, access a digital ID card and also find relevant phone numbers like the 24/7 Nurse Advice Line, the payer said.
The portal integration could empower members to manage their health effectively, according to George Renaudin, Humana’s president of insurance.
Accessing healthcare and understanding how it is paid for can be daunting for patients with varying deductibles and out-of-pocket costs for both in-network and out-of-network services based on health insurance plans.
Sifting through paper plan summaries or asking providers for CPT codes and then calling health plans with the codes to see if there is coverage for the care is a time-consuming, multi-step process for patients and their caregivers.
"Navigating healthcare can be complex, especially when information lives in different places," said Alan Hutchison, Epic's vice president of population health and payer strategy, in a statement.
Humana said the collaboration with Epic sets a new precedent for how payers can collaborate with technology providers to simplify patient healthcare journeys.
With a unified view, members can learn what their financial responsibilities will be and can make more informed decisions about their healthcare services.
THE LARGER TREND
In a competitive healthcare landscape, better care experiences can be decisive factors in attracting and retaining patients, David Nickelson, Randstad Digital's senior partner and consulting lead, health and life science, told Healthcare IT News at the beginning of this year.
He noted that more price transparency tools that help patients compare costs and understand their out-of-pocket expenses, along with other digital-first patient engagement tools, would appear in 2025.
"Proactive disclosure of information about costs, treatment options and potential risks can further build trust," he noted.
The MyChart integration may help Humana retain more Medicare Advantage patients despite the Centers for Medicare & Medicaid Services having downgraded the plan in 2025 Star Ratings to 3.5 stars from 4.5 the prior year. On Friday, a federal judge threw out the payer's lawsuit contesting the U.S. government's reduction star rating for its government-backed Medicare plan.
ON THE RECORD
"This collaboration aims to make things simpler by bringing care and coverage together for patients," Hutchison said.
Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.
