Payers and Providers: Partnering for Better Results
The imperative to deliver improved outcomes at lower cost – a big piece of which is better management of a patient population – is a driving force behind the surge in joint ventures and other partnerships between health systems and insurers. Incentives for collaboration include competition from providers either contracting directly with employers or forming their own health plans, a push for payers to incorporate clinical data in their quality reporting, and an increasing awareness on the part of both camps of the financial and clinical benefits of proactively tackling the social determinants of health. Some institutions have taken things a step further and explored direct contracting with employers, avoiding a traditional insurer altogether. The expectation: that aligning goals and processes and sharing data will mean better results for all parties, including patients. Hear what payers and providers need to know to collaborate successfully.