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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?

Shah05_ integrated systems innovation pullquote

Care Redesign

Build vs. Buy: What Should Health Systems Do?

The consolidation craze continues, but vertical integration has yet to demonstrate real progress toward the Triple Aim. Health care leaders would do well to consider innovative approaches that are working in other industries, including the tech-enabled full stack model.

Diagram Illustrating the COPD Care Pathway at Allegheny General Hospital

Care Redesign

End-to-End Care for COPD Patients that Improves Outcomes and Lowers Costs

Allegheny General Hospital created a comprehensive solution for patients with chronic obstructive pulmonary disease (COPD) that led to improved clinical outcomes, reduced hospital admissions and readmissions, and a resultant decrease in the total cost of care.

Sands01_pullquote clinical research partnership for learning health care

Leadership

Real-World Advice for Generating Real-World Evidence

If envisioned and implemented properly, a partnership between clinical delivery systems and clinical research programs can get us closer to the goal of achieving learning within the care continuum and discovering evidence that is available when it is needed.

Murali01_pullquote Home Recovery Care patient satisfaction

Care Redesign

No Place Like Home: Bringing Inpatient Care to the Patient

Providing home-based acute care improves patient satisfaction and care quality while reducing costs.

Payer-Provider Partnerships Produce Better Quality Outcomes 3 - community health plan - physician partnership

New Marketplace

New Research Shows How Payer-Provider Partnerships Can Accelerate Adoption of Evidence-Based Care

Five best practices that are replicable and scalable are facilitating improved clinical and financial outcomes today.

Elements of a Sustainable Complex Care Management Contract

New Marketplace

Sustainable Financing for Complex Care Management Is Critical to a Value-Driven Health Care System

Care management should be payer-agnostic at its core.

Integrated Care Lessons from Across the Pond - Nick Seddon talk still

New Marketplace

Integrated Care Lessons from Across the Pond

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.

Vertical Integration and Bold Experimentation - Peter Orszag Talk Still

New Marketplace

Vertical Integration and Bold Experimentation

Four points on improving value in health care via vertical integration and aggressive experimentation.

Khaldun02_panel.clip still Health Care Partnerships Rise All Ships

Leadership

Health Care Partnerships Rise All Ships

Examples of a public health and health system partnership, payer and provider partnership, and multi-hospital partnership that led to improved health care outcomes.

Washington State Health Care Authority Center of Excellence joint replacement elements and outcomes of program produces strong patient experience scores

New Marketplace

Improving Care by Redesigning Payment

A state-run center of excellence uses benefit design to improve outcomes while controlling cost.

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