The Importance of Scalable Payer-Provider Partnerships to the Future of Care for our MVPs

July 9, 2019

Hank Schlissberg

AHIP Institute and Expo 2019 

At the AHIP Institute & Expo in Nashville June 19-20, Becker's Hospital Review asked 17 executives from health plans and providers one question: What is the future of the payer-provider relationship?

There were a lot of great themes mentioned in these interviews:

  • “… every large provider will have or be a strategically aligned payer” – Stephen Klasko, MD, Jefferson Health
  • “While value aligns incentives, we also have to be cognizant of the fact that we have to align payment methodologies” – Dan LaVallee, UPMC Health Plan
  • “We should think about payers as a function done well [when people] look at populations, figuring out which people are the sickest, figuring out how best to account for risk, figuring best intervention strategies and how to segment and target conditions and populations.” – Andy Slavitt, Bipartisan Policy Center
  • “We should think of a provider function as how to deal with the whole person, and I think increasingly that means both clinically and socially.” – Slavitt

Most of us in health care know the right answers for patients and the broader system.  We’ve actually seen them play out in amazing ways in smaller pockets.  But the most important challenge we must address is how can those who finance the care (government, employers, and commercial payers) drive these solutions at scale?  The answer must begin with a strategic payer and provider partnership.

As Slavitt appropriately summarizes, “[The payer and provider functions] can get done by the same person, by the same entity, or by different parties, but what's fundamental to it is there's a place for a patient to have a relationship in a community that's holistic and comprehensive and where they can have a regular source of care, and then those functions blend together based on expertise and how different markets look.”

Expertise in highly specialized populations, like ESRD and polychronic, means tailored care models and corresponding payment models. I had the pleasure of presenting about innovations in chronic condition management, both within the kidney care industry and beyond. I touched upon the importance of strategic partnerships between payers and providers that bring scale to markets while addressing the comprehensive needs of our nation’s Most Vulnerable Patient populations. If you’d like a copy of my presentation, The Avengers of Value-Based Care: How to Earn the Superpowers that Drive Better Outcomes, please email me at Hank@VivelyHealth.com.

 

Hank Schlissberg
President, Vively Health
Hank@VivelyHealth.com
VivelyHealth.com