When deciding whether to contract directly with Epic or enter into a ‘hub-and-spoke’ arrangement, identifying goals, priorities and decision factors will set the stage for success

Epic Community Connect is a program that allows small and mid-size health care organizations — from independent physician’s offices to mid-size regional health systems — to access the Epic platform by forming a partnership with a larger hospital system that shares their patient population.

“Joining the Community Connect ‘hub-and-spoke’ model can be a great solution for small physicians’ offices who share a patient population and a strong referral pipeline but can’t purchase Epic on their own due to the size of their practice and prohibitive costs and logistics,” said Steve Hendrick, Vice President at Healthlink Advisors.

However, for mid-size healthcare organizations that can choose between contracting Epic directly or becoming Community Connect “spoke,” the considerations become much more complex.

“Selecting the right option for a regional mid-size healthcare organization requires careful analysis of the pros and cons from a patient care, patient experience, business, financial and strategic perspective,” said Hendrick. “And in order to make the best choice, organizations need to follow a thorough process that allows them to fully understand their options and identify decision factors that align with organizational priorities.”

Initial Considerations for Community Connect

One of the first questions a mid-size healthcare organization should ask when considering a Community Connect partnership is: “How many patients do we share with other healthcare organizations in our area?”

Mid-size healthcare organizations should start by looking at their data to understand where their patients are going, where natural referral patterns exist, and how patients are shared between their organization and larger area health systems that use Epic,” said Hendrick.

Hendrick said that organizations should also identify their goals for a potential Community Connect partnership, which may include:

  • Saving costs on Epic access
  • Creating a streamlined referral pipeline
  • Improving patient care and EHR access
  • Tighter alignment with the hub organization
  • Creating a pathway for a future merger

Understanding the data and keeping clear goals in mind, organizations can then identify potential Community Connect “hub” organizations in their area and engage them to learn more about costs, availability and terms.

Organizations should simultaneously explore the costs of contracting directly with Epic, if they haven’t done so already, so a comparison can be made with the Community Connect proposals from potential partner health systems.

Decision Factors: Weighing the Pros and Cons

  • Cost

There is no set pricing structure, each hub determines how to price its Community Connect proposals. Although no two pricing structures are the same, common arrangements include a flat monthly fee, per-provider fee, or a monthly fee plus an additional fee for service requests. Hub organizations may also subsidize the cost of Epic access through Community Connect, but the amount of the subsidy may vary.

“In some cases, Community Connect can cost almost as much as contracting directly with Epic, so it’s important to do a thorough analysis of all options,” said Hendrick.

  • Business terms

Spoke organizations should pay close attention to business terms, such as the length of the agreement, staffing requirements and the need for third-party software solutions.

“Spokes need to have a clear understanding of what is and is not included, as well as the requirements of partnering with the hub,” said Hendrick. “For example, spokes might need to have an IT team member who is dedicated to managing Epic, or they might be required to purchase additional software that allows the Epic system to integrate with other internal systems.”

  • Service

When evaluating proposals from hub organizations, spoke organizations need to look beyond the technology and the cost to ensure they will receive adequate service.

“Hubs are not set up to be IT service providers, so it’s important for spokes to ensure when they are entering into an agreement that clearly defines its parameters for customer relationship management, governance and troubleshooting,” said Hendrick. “For example, there should be a dedicated person on the hub’s IT team who is responsible for managing the relationship with the spoke. There should also be service level agreements that specify timeframes for responding to and resolving support tickets, and a governance structure that clarifies the spoke’s role, if any, in Epic decision-making.”

  • Strategic growth

According to Hendrick, the most effective Community Connect partnerships occur when the spoke and hub are aligned on their strategic goals.

“Whether the organizations see the Community Connect partnership as a path to future acquisition or a way to improve the patient experience through streamlined referrals, access to the EHR or enhanced services for a particular business area, it’s crucial that the hub’s vision for the future matches with the spoke’s goals and needs,” said Hendrick.

  • Community Connect accreditation

When choosing a hub, spokes may want to consider whether the hub is among Epic’s Connect Accredited Sites. Hub sites that decide to pursue accreditation must submit an application to the Connect Accredited Sites program, which scores hub organizations on their use of Epic, adherence to Community Connect best practices and satisfaction of spoke sites.

“As competition to attract spoke sites increases, more hubs are using this accreditation to demonstrate that they have a dedicated focus on their Community Connect offering and are leveraging Epic technology in a way that benefits their current spokes,” said Hendrick. “However, even if a hub is Connect Accredited, spoke organizations still need to ensure that there is a shared patient population, alignment on strategic goals, acceptable costs, as well as agreement on terms and service — otherwise a partnership may not make sense.”

When weighing whether to become a spoke or contract directly with Epic, Hendrick said organizations should remember one crucial point: It’s not just about the technology.

 “Our team can help walk organizations through the selection process, so they can identify their priorities, ask the right questions, and understand the costs, strategic considerations, terms and decision factors that will lead to the most beneficial arrangement,” said Hendrick. “Because at the end of the day, healthcare organizations need to make the decision that best fits with their priorities and enables them to deliver healthcare services to their patients.”