payer-provider collaboration

Latest Headlines

Latest Headlines

Hidden fees plague consumers and insurers

Hidden fees continue to plague both consumers and insurers.  "It's probably easier to get into the FBI confidential files than to see a hospital charge master. We should know the price of a procedure before we do it,"  Shaun Green, chief operating officer of Arches Health Plan in Salt Lake City, tells  FierceHealthPayer.   

What does Anthem's Vivity collaboration mean for the healthcare industry?

The recent announcement that Anthem Blue Cross is partnering with seven major hospitals in the Southern California area to launch an integrated care program has been met with lots of publicity, including our own coverage of the venture. The collaboration, which is called Anthem Blue Cross Vivity and includes UCLA Health and Cedars-Sinai, will offer large employers less-costly coverage for members who use in-network hospitals and doctors. That in and of itself isn't particularly innovative or unique, since insurers and providers have shared savings and risks for years across different markets. But what is so special about Vivity, as a California Healthline article points out, is the way it's structuring the financial model.

Competition sparks payer-provider divorce

The Affordable Care Act is sparking competition among healthcare insurers and providers, as insurers make moves to become healthcare providers,  reports  NPR.

3 ways to enhance payer-provider collaboration

As payers and providers increase their collaboration to launch more value-based care programs, they must establish strong partnerships to ensure the relationships, reported  Health Data Management. Paul Taylor, an internal medicine physician at Mercy Health, shared three steps payers can take to enhance providers' performance in value-based programs. 

Payers: Emphasize primary care to lower costs

If insurers emphasize primary care to their members instead of specialty care, they can help lower healthcare costs, according to a panel of insurance experts speaking in Philadelphia.

Consider another perspective to improve healthcare relationships

I recently celebrated my daughter's fourth birthday; so my interest was piqued when I read a story from my colleague about how insurers should embrace their inner 4-year-old to enable...

Blue Cross CEO: Collaboration at core of integrated care

Payers and providers must lay the foundation of collaboration to create an integrated healthcare system that coordinates care, lowers costs and boosts quality, according to the chief executive of Blue Cross Blue Shield of Rhode Island.

4 steps for provider buy-in on new payment models

When insurers collaborate with providers to break down silos and create new ways of working together, they can successfully implement new payment models that boost quality and value throughout the healthcare system.

Will healthcare see more provider-payers?

To survive the industry shift to a payment system that rewards value over volumes, some hospitals are turning into provider-payers that offer health plans, according to three hospital executives at the Hospital of Tomorrow forum by U.S. News & World Report.

What insurers can learn from Kaiser's successful integrated healthcare model

Kaiser Permanente has so successfully executed its integrated healthcare model that other insurers could benefit from following its lead as health reform is pushes the industry toward further collaboration with providers.