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Payer-Provider Integration

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?

Robert Gavin head shot

New Marketplace

Amazon and CVS: Short-Lived Unicorns in Health Care, or Healers of the “Tapeworm”?

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.

Gary Kaplan Head Shot

Patient Engagement

Improving Patient Involvement in Care

The CEO of Virginia Mason on facilitating and enhancing patient participation in care.

Simplified Chain of Production for Primary Care Services Generating Retail Prescriptions. Solid arrows indicate contractual relationships or ownership, and the dashed arrow indicates referral for prescription.

New Marketplace

Does CVS–Aetna Spell the End of Business as Usual?

What might one of the largest mergers in history mean for the health care delivery system?

Lack of Incentive Is Top Barrier to Implementing Value-Based Payment

New Marketplace

Survey Snapshot: Payer-Provider Alignment Is Difficult Even for Integrated Organizations

NEJM Catalyst Insights Council members say stronger incentives and better use of analytics could improve alignment.

How Aligned Are Payers and Providers in Working Together to Achieve Value-Based Care

New Marketplace

New Marketplace Survey: Payers and Providers Remain Far Apart

Health care stakeholders are not aligned in important goals and in large part are not working together to achieve value-based care, according to the NEJM Catalyst Insights Council. They are waiting on government regulators to change the payment model — including, possibly, single-payer health care.

Health Plans of the Future Are Win-Win-Win Lynn Garbee Cigna Panel Clip Still

New Marketplace

Health Plans of the Future Are Win-Win-Win

How health plans can take advantage of their position in the ecosystem to connect motivated consumers with their perfectly matching high-performing provider.

Resolving the Payer-Employer Disconnect with Health Plans Panel Clip Still

New Marketplace

Resolving the Payer-Employer Disconnect

Payers need to break out of their insular way of thinking.

Care Redesign

Healthcare Big Data and the Promise of Value-Based Care

Big Data is essential to every significant healthcare undertaking. Read about the challenges, applications, and potential brilliant future for healthcare big data.

Value-Based Payment Models Payer-Provider Contracts Value-Based Arrangements

New Marketplace

Economic Investment and the Journey to Health Care Value — Part II: Health Care Payers

Payers’ broad scale of investment in value-based arrangements makes a compelling case for the importance of sustained efforts to identify effective value-based payment models.

New Marketplace

The Big Tent of Value-Based Care Has Room for Big Pharma

Drug companies must join providers, payers, and patients in seeing themselves as stakeholders.

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