Alignment between health plans and physician groups not only serves the patient well but can result in financial benefits and increased market share through improvement in clinical outcomes and enhanced consumer trust.
ChanIn order to enrich the patient experience, improve health outcomes and reduce the cost of care, healthcare organizations are increasingly looking for creative ways to work together as never before. In particular, alignment between health plans and physician groups not only serves the patient well but can result in financial benefits and increased market share through improvement in clinical outcomes and enhanced consumer trust.
More and more the industry is becoming acutely aware of the benefits that health plan/physician collaboration can bring. This is particularly true for Medicare Advantage (MA) plans and their provider networks, which are entrusted with caring for the nation’s most vulnerable citizens, many of whom live with multiple chronic conditions and may be confronting end-of-life care decisions.
With the appreciation of the need for health plan/physician collaboration growing, it is not an overstatement to say that 2015 has the potential to be the year when such integration becomes the new norm. Here are three reasons why:
In these and other areas, unprecedented creative collaboration between health plans and physicians is taking place. We are seeing the development of affordable programs and products that meet the needs of Medicare beneficiaries, including those that are healthy and active as well as those living with multiple chronic conditions and becoming increasingly frail. We are seeing research into best practices in geriatric care and then unselfish sharing of that information across the industry. And we are seeing an improvement in administrative efficiencies between health plans and provider partners with a particular focus on data exchange that can support better systems of care and service.
Payer/provider collaboration is the key to improving patient care. It is incumbent upon the healthcare industry to find new ways for such collaboration to happen and, by doing so, help make sure that the system works better for everyone.
Raymond Chan, M.D., is corporate medical director at SCAN Health Plan, one of the nation’s largest not-for-profit Medicare Advantage plans.