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Strengthening The Payer/Provider Relationship For Value-Based Success

They call it the great shift.

And the move to value-based payment models is exactly that: a tremendous change that will transform the healthcare market—offering unparalleled opportunities for healthcare organizations to better manage costs while dramatically improving the health and well-being of patients.

But this shift is possible only if healthcare organizations can create the right roadmap, one that leverages best practices and robust supporting data streams to guide their way.

In 2015, the Deloitte Center for Health Solutions added an important subtitle to their seminal report on value-based care shifts, “The Road to Value-Based Care.” That subtitle was, “Your mileage may vary.” It’s an apt metaphor. As the authors of the Deloitte report point out, there is no one-size-fits-all transition plan to effectively move from fee-for-service to value-based care. That’s why
you see such stark contrasts in how, where, when, and why organizations are moving towards the value-based market. And those differences are more than understandable. Each and every organization needs to carefully consider what makes it unique—the financial position, core competencies, and other key capabilities within that will allow them to develop a unique and effective plan for success.

That consideration is important. As a report by the Society of Actuaries noted in 2015, the organizations that are poised to succeed at any payment reform efforts share several important qualities. One of the most important? A strong collaborative relationship between payers and provider organizations. Mike Hurley, Industry Manager for Healthcare Payers at Hyland, says their finding comes as no surprise to him. He argues that collaboration bolstered by strong, advantageous payer-provider relationships is the key to not only surviving but thriving, in a value-based care world.

“The payer-provider relationship is at the heart of a successful transition to value-based care,” says Hurley. “But it goes beyond just reimbursements and financial statements. Those strong relationships help get healthcare organizations focused on what’s really important: how to help patients live better, healthier lives while still maintaining their organization’s economic well-being. That’s what healthcare is really all about.”

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