Health First’s Carr Weaves Tapestry for Integrated Payer-Provider Platform

Health First’s 10,000 employees and 600 providers now run on a unified technology backbone that spans hospitals, clinics, and a 100,000-member health plan, and the annual cost is lower than what the organization paid before. The Brevard County, Florida-based integrated delivery network completed two major Epic rollouts in rapid succession: its provider division went live […]

Source: Health First’s Carr Weaves Tapestry for Integrated Payer-Provider Platform on healthsystemcio.com - healthsystemCIO.com is the sole online-only publication dedicated to exclusively and comprehensively serving the information needs of healthcare CIOs.

Michael Carr, VP and CIO, Health First

Health First’s 10,000 employees and 600 providers now run on a unified technology backbone that spans hospitals, clinics, and a 100,000‑member health plan, and the annual cost is lower than what the organization paid before. The Brevard County, Florida‑based integrated delivery network completed two major Epic rollouts in rapid succession: its provider division went live in June 2025, followed by Epic Tapestry for the health plan on Jan. 1. Michael Carr, VP and CIO at Health First, led the IT side of both programs and says the results validate a straightforward principle: buy the full suite, follow the vendor’s methodology, and let operations drive the decisions.

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The push for Tapestry grew out of a painful reality on the health plan side. After Health First unwound a partnership with Oscar Health roughly four years ago and brought the plan back in‑house, staff found themselves toggling between as many as nine separate systems to do their jobs. Claims lived in one application, member data in another, and CRM functions in yet another. The inefficiency hampered the workforce and degraded the member experience. When a member called the contact center, the representative had to log into one system to pull up the account and a second to check claims status, a workflow that split attention away from the person on the phone.

Selecting Epic for the provider division was the first domino. Once that decision was made, the interoperability argument for Tapestry became difficult to ignore. Health First evaluated competing payer platforms but concluded that the data‑sharing advantages of staying within the Epic ecosystem were too significant to pass up. Digital ID cards, for example, flow seamlessly between the health plan and provider environments, so a Tapestry member who shows up as a patient does not need to present an insurance card; the system already has it. Even organizations that do not use Epic for claims processing have adopted the payer platform module for its data exchange capabilities, a trend that reinforced Health First’s confidence in the choice.

Health First opted for two separate Epic instances — one for the provider division, one for the health plan — a decision rooted in geography and flexibility. The provider network operates within Brevard County, but the health plan serves members in surrounding counties. A single instance would have risked letting provider‑side configuration decisions constrain health plan operations in those outlying markets. Epic’s payer platform module still connects the two instances for data sharing, so the organization captured the integration benefits without sacrificing independence on either side.

Following the Vendor’s Lead

Epic’s go‑live readiness assessment process earned high marks from the Health First team. The methodology follows a deliberate handoff sequence: Epic leads the first assessment, coaches through the second, IT leads the third, and operational leaders own the final round. By the end, the question of readiness belongs to the business, with leaders attesting that their teams are trained, workflows are understood, and the organization is prepared. That standard goes well beyond IT confirming the software works. Health First signed its provider contract in January 2024 and went live 17 months later, pulling the original September target forward to June by adhering closely to Epic’s recommended approach. On the Tapestry side, enrollment launched Oct. 1, 2025, with full claims processing following on Jan. 1.

Governance followed what Carr calls an “Epic first” principle. “We started with the assumption that Epic meets our needs,” he said. “And if it doesn’t, the operational owner needs to prove that it doesn’t.” The organization purchased the full suite and wanted to deploy everything it bought. In a few cases, Epic itself acknowledged that a specific module was not mature enough for Health First’s requirements, a level of candor Carr says few vendors exhibit. Those gaps led to targeted third‑party selections, with the understanding that Health First would revisit each one as Epic’s capabilities evolved.

That candor points to a broader conviction about how technology vendors should engage with their customers. Carr draws a hard line between companies that tell health systems what they want to hear and those willing to deliver uncomfortable truths. “That transparency and honesty is what separates a vendor from a partner,” he said. “Vendors don’t want to offend you. Partners are willing to tell you the hard things that you need to hear.” He points to instances where Epic pushed back on Health First’s preferences, connecting the team with other customers who had succeeded with the recommended approach. The willingness to say no, Carr believes, protects both parties from costly missteps.

Letting Operations Drive

Both implementations broke from a pattern Carr had seen throughout his career: IT driving enterprise technology programs. At Health First, Cheyana Fisher, the chief nurse executive, served as executive sponsor for the provider rollout, and Jamie Forrest, COO of the health plan, led the Tapestry program. Carr’s IT organization facilitated, guided, and managed technical risk, but business leaders owned the key decisions. That structure forced accountability into the right hands and kept IT from becoming the bottleneck on operational trade‑offs. Carr sees the dynamic as a dyad — the CIO blocks and clears barriers so the executive sponsor can operate at the strategic level without getting pulled into technical weeds.

The emphasis on operational ownership extends well beyond go‑live. Carr frames both platform decisions as generational commitments, and he warns against sacrificing relationships for speed. “I look at this as a generational decision,” he said. “I’m going to be on this platform for the next 20 years.” Burning bridges with operational partners during implementation — through premature rollouts, poor change management, or half‑baked pilots — destroys the trust an IT leader needs for decades of optimization work ahead. Health First preserved its governance structure through the transition from implementation to steady‑state operations, and Carr continues to push decisions back to the business side.

Take it Away

• Quantify the cost of fragmentation before selecting a platform. Health First’s health plan staff logged into up to nine systems; documenting that inefficiency built the business case for consolidation.

• Adopt an “Epic first” or “suite first” governance model, but build in an escape valve. Require operational owners to prove the platform falls short before approving a third‑party tool, and revisit those exceptions as the vendor’s capabilities mature.

• Separate instances can preserve flexibility for organizations whose payer and provider footprints cover different geographies. Evaluate whether a single instance would constrain either side before defaulting to one.

• Follow the vendor’s implementation methodology. Health First pulled its provider go‑live forward by three months by adhering to Epic’s recommended approach, including its progressive handoff of readiness assessments from vendor to IT to operations.

• Assign executive sponsors from the business side who will actively lead, and keep IT in a facilitation role. Operational leaders should own the hard business decisions throughout implementation and into steady‑state optimization.

• Protect operational relationships as a long‑term asset. A botched rollout or poorly managed pilot erodes the trust a CIO needs for 20 years of platform optimization.

• Challenge cost assumptions. Health First’s annual post‑go‑live expenses for both Epic and Tapestry are lower than the platforms they replaced.

For CIOs weighing the commitment, Carr adds, “You can definitely do it cheaper, but you’ll pay for it twice.”