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Sustainable Financing for Complex Care Management Is Critical to a Value-Driven Health Care System
Article by David Lansky & Jeff Micklos
Care management should be payer-agnostic at its core.
Health insurance companies and a healthcare provider may greatly benefit from systems integration. Healthcare payer and provider organizations have different goals but need to work together to generate efficiencies. How can we bridge the gap between the two parties?
Care management should be payer-agnostic at its core.
Just throwing things together doesn’t make for integrated care. If we spent more time looking at what is good about each other’s health care systems rather than what we hate, that would help move forward a seamless care experience for patients.
Four points on improving value in health care via vertical integration and aggressive experimentation.
Examples of a public health and health system partnership, payer and provider partnership, and multi-hospital partnership that led to improved health care outcomes.
A state-run center of excellence uses benefit design to improve outcomes while controlling cost.
The deliberate nurturing of specific types of leadership personas seems to be a critical factor in the success of value-based care organizations.
UPMC’s payer-provider partnership integrates real-time data to support improved clinical decision-making and optimizes clinical and financial performance.
The companies most capable of leading transformation in health care coverage are the ones that least need to.
Will Amazon–Berkshire Hathaway–JP Morgan and CVS-Aetna change the health care game? To one health care employer purchaser, these announcements feel a lot like Groundhog Day.
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