Payer and Provider Collaborations - Why Now?
Under pressure from competitive threats and government mandates, many providers and insurers have come to the realization that working together may be the only way forward in a healthcare industry. From products and networks to risk arrangements and financial models, several issues must be thoroughly evaluated as part of a payer strategy. Kaufman Hall assists both providers and payers in creating differentiated strategies that improve care and reduce costs.
Find the right strategic partnership for your organization
What's Contributing to the Burning Need for Vertical Integration?
Large integrated competitors are increasingly shrinking the available market
Consumer expectations of a convenient, seamless experience
Pressure to control healthcare costs from employers and consumers is mounting
Intensifying scrutiny from regulators
Trusted in Payer Provider Partnerships
Working on A Broad Array of Managed Care Strategies with Payers and Providers
"The health plan isn’t getting into the hospital business, and the health system isn’t getting into the insurance business…instead the two organizations are working together to align the entire strategy around the consumer."
— President and CEO, Large Payer Organization
We help your organization look beyond transactions between hospitals and health systems to partnerships between health plans and provider organizations. Our recent payer-provider partnership highlights include:
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Successful launch of a joint venture health plan between a payer and provider
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Establishment of a health plan’s provider partnership program to prepare providers to take on financial risk for health plan lives and support the dual growth in the face of competition from a large, integrated health care company
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Development of a plan for joint investment in new delivery system assets to provide the marketplace with a low-cost site of care alternative
We're Thought Leaders in Payer-Provider Strategy
Payer-Provider collaboration and vertical integration in healthcare is becoming increasingly important as value-based care is now one of the primary differentiators for most medical systems.
Operationalizing Value-Based Primary Care: Lessons from the Field
For more than a decade, hospitals, payers, and other healthcare stakeholders have experimented with moving healthcare payment from fee-for-service, volume-based contracts to arrangements that reward providers for the value of the care they provide.
Article
Dynamic Financial Planning Provides a Hedge Against Future Disruption
The impact of the COVID-19 pandemic has introduced new and potentially long-lasting volatility into traditional financial planning processes at hospitals and health systems. Financial planning remains as important as ever—perhaps even more so as the risk of operating dislocation continues, and new risks appear on the horizon.
Article
Winter 2020 Kaufman Hall Report: The Business Case for Payer-Provider Strategies and Partnerships
Health systems and health plans are used to warily eyeing each other from opposite sides of the negotiating table as foes to be conquered, and not potential allies. Learn why this isn't the best strategy in 2020.
Research Report
Learn more about how Kaufman Hall can help with payer-provider strategy