One of the most productive steps in improving patient outcomes is for providers to actively participate in payer-provider collaborations. In fact, these partnerships are considered to be one of the most positive and productive features of the new landscape in healthcare.
Medical professionals are moving towards models that are value-based. As a result, a special emphasis must be placed on ensuring coordination with the payer sector. This will aid in outlining the best care for patients and will aid in preventing the necessity for further patient care and patient readmissions to healthcare facilities and institutions.
In this brief guide, we will expound on the topic of improving patient outcomes through payer-provider collaborations.
Throughout history, there has been a general level of mistrust between those that provide healthcare services and those that pay for such services. Recently, a survey was conducted by Numerof & Associates. According to the information obtained from that survey, just under 60% of respondents – who are also payers for healthcare services – stated that they were only “somewhat willing” to commit to agreements with healthcare providers. This is due, in part, to how payers and providers view one another.
There is an excessive amount of pressure when it comes to reimbursements. Most of the payers are not satisfied with that which they receive; however, at this point, the responsibility of this issue and similar issues is both on the providers AND the payers – not just the providers.
Both the providers in the healthcare industry and those that pay for the services of those providers must place a special emphasis on forming relationships that are considered to be genuine and will push towards transforming certain outcomes. Until now, both providers and commercial-based payers have strived to uncover methods on how to take advantage of the healthcare system.
This must come to a stop.
Instead, commercial payers and healthcare providers should work together in order to uncover a path that is considered to be mutually beneficial. We know and understand that a different payment model should be implemented. Now, both parties must agree to work together in order to successfully uncover that payment model.
By placing an emphasis on uncovering a mutually beneficial payment model, providers and payers will start to find that the quality of the healthcare provided to patients will improve and that the costs of that quality will reduce.
Yes, there will be several hurdles to overcome; however, by choosing to collaborate, everyone will – eventually – benefit.
We have seen this to be true in many instances.
One example includes the collaboration between Aetna and a Virginia-based healthcare institution, Inova Health. Today, not only is the institution able to provide highly-affordable healthcare services that are high in quality but low in cost, they have also implemented several different health care programs that have benefited their patients.
Collaborations between providers and payers are highly innovative in today’s changing healthcare landscape. In order to provide the best care at the best costs, these collaborations are necessary for improved outcomes.
Each patient that is seen deserves to have an individualized healthcare plan for their specific health needs. If we strive to collaborate on quality and value, we are all sure to find that we save on costs.
For more information on what we offer watch this video on MSO’s.
