While health plans aim to create value and provide better member experiences through improvements in the quality of care and reduced costs, providers have their own ideas and priorities for how to create value. “This is particularly evident as consolidation activity for healthcare providers has escalated over the last 10 years,” LaBine says. “Hospital consolidation has created more buying power on the provider side, therefore putting more strain on payers to implement their own member-focused programs to drive value.”
To overcome challenges associated with creating a value-based environment, health plan executives should collaborate with large health systems to foster greater change within the care continuum. LaBine says this can be accomplished through value-based contracts focused on improving patient experience, patient quality of care, and reducing costs. Health plan executives can overcome challenges by communicating their goals for improved value for their members to patients and providers.
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