While a small item among a mountain of other announcements (see HISTalk's long list from UGM's "Executive Address and Cool Stuff Ahead" here), Epic's mention of Savvy caught many people by surprise. Speculation has long swirled about what - if anything - Epic would ever do within its own MyChart software to support patient payments. However, nothing has ever surfaced - until now.
Savvy is described by those at UGM as natively built into MyChart (no need for a third-party payment gateway) that offers patients easy payment options including pay by bank, and helps healthcare providers lower acceptance costs for patient payments. One of the features of Savvy is apparently an easy pay by ACH choice, which could potentially include other payment methods down the road (e.g., real time payments).
This development is significant for the players currently offering payment gateway integrations to Epic's MyChart patient portal. Until this news, Epic has steadfastly maintained a gateway-agnostic position for patient payments. Healthcare providers could work with any acquirer and processor they wished - as long as the gateway integrated with Epic (see list of current integrations here).
Now, the rumor (confirmed according to our sources, but not publicly disclosed) is that Epic has selected Fiserv as its payments partner for Savvy. What is not clear, again because so little information has been released by Epic, is what Fiserv's role will encompass. Fiserv's Commerce Hub is likely the orchestration layer for Savvy's native payments capability, which would include multiple forms of payment (credit/ debit card, digital wallets, pay by bank, BNPL), fraud mitigation, transaction monitoring, global currencies, and many other features.
Given the apparent emphasis on pay by bank as a capability, Fiserv makes sense as Epic's payments partner given First Data's long history of going to market via bank relationships (Fiserv acquired First Data in 2019). Other leading processors evolved with different go to market approaches that make them less well suited for a comprehensive bank connection strategy: Global Payments (ISOs), Vantiv/ Worldpay/ Mercury Payments (ISVs/ middleware), Chase Paymentech (eCommerce), and Elavon (strong in corporate travel, airline, hospitality verticals).
The key questions for incumbents currently serving as the MyChart payments gateway are:
In addition to pay by bank, what other payment options will be offered natively within MyChart to current Epic customers via the Fiserv platform?
How flexible will Epic be in allowing providers to bring their own merchant relationship?
It's hard to know how to assess this development without more information, and which players will be affected relatively more or less by Savvy (though we do have some ideas). Stay tuned as we learn more about this potentially tectonic shift in the patient payments ecosystem!