Payers and Providers: Developing At-Risk Programs cover imageThe 2016 HealthLeaders Media Payer-Provider Survey makes a clear case for the central role of analytics and information sharing in the success of value-based payment models. When asked about top payer activities that provide healthcare organizations with the most benefit, respondents cited access to risk-adjusted patient data as the top response (31%), as well as access to aggregate claims data (29%), and support for risk-related analytics activities (19%).

What strategy is best for addressing the necessity of analytics? Clearly, approaching information sharing and analytics on a case-by-case basis will not be effective in an environment where health information—particularly that of the highest-risk, most costly plan members—is dispersed among different providers, provider locations, and health plans. If you don’t already have a strategy in place, where can you begin?

Start by placing plan members at the center of all technology and business decisions. Rather than payers and providers sitting across the table to negotiate rates and contracts—creating a you-versus-them scenario—having a patient-centric perspective places health plans and providers on the same side. You can cooperate, with the member as part of the process to improve health outcomes, reduce costs, and share the savings.

Next, choose a secure health informatics platform that provide analytics and comprehensive claims-based and clinical information for better clinical and business decision-making. Accurate, timely, and clear information presented to the plan members will help them better understand and manage their own health.

Information exchange through the health informatics platform enables enhanced care management, risk mitigation, and optimized engagement. Ultimately, healthcare systems that invest in a health informatics platform are able to deliver the right information in the right amount, to the right person at the right time, to drive the right actions for everyone involved.

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Payers and Providers: Developing At-Risk Programs