Epic’s MyChart takes aim at medical sticker shock

When it comes to providing affordable medical insurance for employees, dealing with rising health-care costs is a top priority for most business operators. Employers who control their workers’ health-care “spend” through wellness, plan design, and other means have a number of competitive advantages, and they also have an increasingly valuable ally in Epic’s MyChart portal.

Among the new MyChart features highlighted at the recent Epic Users Group Meeting is one that could remove the sticker shock from medical billing. It’s the ability for patients to generate their own price estimates on various medical procedures before undergoing them.

“What this means is that prior to having a particular procedure done, a patient can now go in and see what that particular procedure is going to cost them based on their real-time benefits information and based on the historical cost of that procedure in other similar scenarios,” explains Sean Bina, vice president of access and patient experience for Epic. “It provides a level of price transparency that hasn’t been available in the past.”

Overcoming opaqueness

Sean Bina

The MyChart web portal, which is offered by most health-care organizations that use Epic’s electronic medical records software, provides patients with controlled access to the same Epic medical records the patient’s doctors use, and it provides self-service functions that are designed to reduce cost and increase patient satisfaction.

When patients go to MyChart, they see pieces of their medical record that are allowed by their health-care providers, and patients have comprehensive access to their clinical information, including lab results, appointment information, current medications, and immunization history. They also now can access MyChart, including medical images, on mobile devices.

The growing trend of price transparency among health-care providers is one of the ideas being advanced to control care costs and related monthly insurance premiums, and the timing of patient price estimates in MyChart comes amid real bipartisan momentum for price transparency. While special-interest groups are still defending opaque pricing structures, leaders in both political parties have called for a more transparent approach to pricing and quality information so that patients can make fully informed decisions about their health care. Earlier this year, President Trump issued an executive order directing the Department of Health and Human Services to require hospitals, doctors, insurers, and other providers to disclose negotiated rates for medical services, as well as provide patients with out-of-pocket costs before undergoing their procedures.

Enter MyChart and its new patient price estimate. To use it, patients log into MyChart, select the procedure they need, and enter their insurance information. An estimate based on the median cost for that procedure over the past six months is then produced; patients are shown what they should expect to pay with their insurance coverage factored in.

There are no limitations for what this feature can be used for. Consumers can use it for comparison shopping on medical imaging procedures such as mammograms, computerized tomography or CT scans, and magnetic resonance imaging tests, commonly known as MRIs. They also can use it for certain health-maintenance procedures such as colonoscopies and core surgical procedures such as hip or knee replacements.

Epic is working on a feature that would enable patients to shop for price estimates across three health-care providers at once. At the moment, they have to go into each individual customer website to do a price search.

Charting a free course

MyChart has become a tool to help employers maximize their investments in worker wellness and well-being. Most Epic user groups — again, the aforementioned health-care entities that buy Epic medical records software — share with patients their health summaries (current health issues, allergies, and medications), test results (including lab and radiology), after-visit summaries, education, and visit histories. Some groups also share notes, pathology results, radiology images, genetic profiles, information about medical history (medical, surgical, and family history), and condition-specific summaries.

For example, Group Health Cooperative of South Central Wisconsin offers the following through MyChart: health summaries (current health issues, allergies, medications); lab results (lab and radiology), after-visit summaries; shared notes; medical history (family, social, surgical, and medical); medical bill payment; insurance bill payment; insurance details (claims, referrals, ID cards, and benefit information); messaging (medical care teams and customer service); and fitness tracking (connect to Fitbit, Google Fit, Apple Health, and/or Withings devices).

(Continued)

 

Employers can also gain from encouraging their employees to use the MyChart portal. Tracking return on investment from wellness has proven to be an impossible task, especially given the many factors that impact medical costs, but many employers encourage their workers to use MyChart because it helps them become more savvy health-care consumers, and it can help save money. Everything a patient does within MyChart provides potential savings, notes Bina, because instead of having to place a phone call, patients can self-schedule and self-arrive into the system. At one Epic customer site, almost one-quarter of all of appointments — clinic appointments, procedures, etc. — are now scheduled through MyChart.

According to an article in Modern Healthcare, Epic user groups have reported cost savings from using MyChart, including Scripps ($2.5 million overall), and Ohio State University. Each patient who uses MyScripps, the Scripps system’s Epic patient portal, saves the organization about $25 per year in fewer phone calls, better routing of messages, and paperless billing. Meanwhile, researchers at Ohio State University found that MyChart saves health systems $89.73 per patient over a three-year period, or $171,473 for just over 2,000 patients.

Those savings can help lower the cost of health insurance.

Patients also can settle their co-pays and any outstanding balances, and many have, Bina says. “About $36 million has been collected through MyChart in just the last three months from our community members in Madison.”

What else is new?

Other new MyChart features include a new set of tools called MyChart Care Companion. Care Companion allows patients to have daily or weekly reminders, track whether they are taking their meds, and provide targeted patient education. Bina cites pregnancy to explain how it works. “You don’t want to give somebody everything that they need to know about pregnancy on the first day they find out they are pregnant,” he states. “What you want to do is space it out over time. During the first trimester, they get certain information, and they get more education the second trimester, and so forth. What MyChart Care Companion allows you to do is provide patients with that information to help them manage their clinical episodes.”

Another new feature is Happy Together, which allows patients to combine their records across multiple organizations in a single view. Patients don’t have to navigate to two different records; instead, they see interwoven lists of test results from multiple sites that use Epic records. Bina offers a personal example of how Happy Together can be used. “My wife has records from when we had our children at both Group Health Cooperative and at St. Mary’s, and she now can see information from both sites in a single view. She can see all of her general PCP information, as well as information about her pregnancy in one spot.”

Access to MyChart is mostly free. Bina is not aware of organizations that are charging for MyChart, at least not for a basic level of access. Historically, there were a couple of groups that offered and charged for concierge-level service, but the vast majority of Epic’s user groups offer MyChart free to their patients.

In Greater Madison, Epic customers have heavily adopted MyChart. “They range from having over one-third of their patients on MyChart all the way up to roughly three-fourths of their patients,” Bina notes. “In one group, more than 80 percent of patients are active MyChart users.”

Click here to sign up for the free IB ezine — your twice-weekly resource for local business news, analysis, voices, and the names you need to know. If you are not already a subscriber to In Business magazine, be sure to sign up for our monthly print edition here.