From contract to partnership: executive perspectives on payer-provider collaboration

At HLTH22 last fall, the CEO of Blue Shield of California, Paul Markovich, shared his thoughts on partnerships between payers and providers. He noted that provider contracts can’t cover everything and, “So, it’s important that you see the world similarly, that you’re in this together, and that it’s truly a partnership.”  

How can health plans uncover where they align with providers to truly partner? That is one question that led us to survey 200 health plan executives to understand their perspectives and priorities around provider collaboration. The big takeaway–collaboration is increasing. A majority of health plan executives (67%) want to expand their partnership with providers in 2023. 

Goals and outcomes for collaboration

Executives say their top three outcomes from more provider collaboration are:

• Improved experiences for members
• Business growth
• And, better population health.

Looking past the details of contracts and claims, getting members the care they need is at the core of the payer and provider relationship. And, when it comes to care access, a few key collaboration areas are top of mind for payers: provider information sharing (54%), online appointment scheduling (53%), pre-appointment communications (46%), and even pre-payment for co-pay (42%). 

Top on the wish list: data 

Improving the member experience is the top desired outcome for collaboration, so we wanted to explore more specifics. The one area of collaboration plan executives want the most in order to improve the member experience: provider data accuracy. With new mandates around provider data accuracy, and the burdens faced by providers to attest to their provider data for each health plan they contract with, greater collaboration becomes a win-win-win. Plans comply with accuracy and validation requirements, providers get the right patients, and members have an easier time finding the right provider. 

Sharing data is a two-way street, and our research uncovered other ways plans would like to improve the member experience through data sharing. To learn more about what both health plan and health system executives are thinking about, download the research here.

To learn more about how our work with payers, health systems and medical groups can support your collaboration initiatives, contact us.