Payer-Provider Strategies:  New Rules for Facing Risk Together

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Payer-Provider Strategies: New Rules for Facing Risk Together

Product Code: INTEL0315

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Early efforts at delivering value-based care have benefited patients and payers more than the providers who do the work. This report, Payer-Provider Strategies:  New Rules for Facing Risk Together reveals how providers are finding new ways of caring for both patients and populations based on a better understanding of risk.

With this report, you will:

  • Find out how UPMC Health Plan has saved nearly $15 million in medical costs since converting its primary care practices to its patient-centered medical home model.
  • Uncover the key discipline that payers have mastered and that providers must learn, or at least better understand.
  • Get examples of how North Shore-LIJ Health System and its CareConnect health plan subsidiary use shared data and shared clinical practice guidelines to align incentives.
  • Discover how best to demonstrate organizational strength during negotiations with commercial payers.
  • See how Crystal Run Healthcare’s care standards for diabetes patients helped to reduce office-related charges by about 9 percent and hospital admissions by about 14 percent.
  • Learn how providers can turn the subject of negotiations from reimbursement policies to value-based care and risk sharing by focusing on breadth of care service offerings and extended access to care
  • Find out how primary care physicians, specialists, and staff at Crystal Run Healthcare collaborated to implement effective care standards based on best practices.

This report, part of HealthLeaders' Intelligence Report Premium series, offers the latest merger, acquisition, and partnership strategies from industry peers, including survey results drawn from the HealthLeaders Media Council, an exclusive group of 8,000 healthcare leaders. A new segmentation tool allows you to access more specific, in-depth data by setting, number of beds and sites, net patient revenue, and region.       

This report includes:

  • Case studies from UPMC Health Plan, Crystal Run Healthcare, and LIJ-CareConnect Insurance Company, Inc.
  • Analysis and key takeaways from advisors drawn from our HealthLeaders Media Council
  • Recommendations from the HealthLeaders Media research team
  • A meeting guide to share with your organization

You can use this report to:              

  • Track the latest trends in mergers, acquisitions, and partnerships
  • Gauge your organization's performance and progress compared to peer organizations
  • Gather insights and advice from industry experts, peer leaders, and the experiences of case study organizations
  • Access discussion questions that can aid your organization in forming strategies for mergers, acquisitions, and partnerships

With healthcare moving toward collaborative care and capitation, organizations have to face the future with a wider care-delivery footprint. This report shows why your merger, acquisitions, and partnership motives must expand beyond growing market share and revenue to include gaining the skills and scale to excel at population health management while at the same time enhancing your position with payers at the negotiating table.