Accelerate Cohesive Data Access Across the Health Plan Ecosystem

Health plans operate in dynamic environments - supporting regulatory requirements, quality and cost initiatives, improved member outcomes, and efficient operations. Exchanging and operationalizing data within the application ecosystem is essential.

With a diverse collection of business systems and departmental applications - often spanning different data standards, formats, and APIs - integration calls for a thoughtful approach that is consistent and reusable. As new capabilities are added and systems evolve, the ecosystem benefits from integration patterns that scale, support governance, and help maintain trusted data across the enterprise.

InterSystems Payer Connector™ enables the operationalization of data across complex health plan environments. It provides a fast, efficient way to request, receive, transform, and route Epic Payer Platform data into health plan workflows, and send authorized health plan data back in the required formats. Using a set of prebuilt schemas and orchestrations, InterSystems Payer Connector connects Epic Payer Platform to the health plan’s internal systems, retrieves and processes data, and transforms it for downstream use across care management, utilization management, claims, and quality programs. This bidirectional approach helps health plans accelerate implementation, speed time to value and improve clinical, operational, and business performance.

• Enable new workflows faster
  Leverage prebuilt schemas and mappings for enrollment, ADT notifications, gaps-in-care, and clinical summaries. Accelerate onboarding for new data exchanges and streamline ongoing updates.
  
• Standardize connectivity
  Standardize integration patterns with a consistent interface for Epic Payer Platform connectivity. Improve reliability and simplify mapping and transformation to support efficient ongoing operations.
  
• Operationalize clinical data
  Make provider-shared clinical data available directly within care management, utilization management, and quality workflows. Support smoother transitions of care and give teams the context they need to make better decisions for members.
  
• Strengthen quality and performance programs
  Deliver clinical data that supports HEDIS reporting, risk adjustment, gaps-in-care closure, and evidence-based interventions. Streamline clinical data acquisition, improve the accuracy of quality insights and support compliance.
  
• Enhance member experiences and outcomes
  Ensure timely, complete data reaches the systems that support claims, prior authorizations, and care coordination. Improve member satisfaction and enable more personalized care.
  

• Accelerate time to value
  Streamline Epic Payer Platform adoption and realize benefits sooner with packaged, reusable connectivity.
  
• Increase business agility
  Incorporate clinical data into workflows more quickly and efficiently.
  
• Deliver meaningful ROI
  Lower development and maintenance effort with packaged, reusable connectivity.
  
• Improve data quality and compliance
  Ensure that provider data and payer responses are exchanged using standardized interfaces.
  
• Boost IT productivity
  Enable teams to focus on higher-value initiatives and strategic work.

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