2016 Marked by Payer–Provider Collaborations

Partnerships formed to reduce health care costs, improve care, and share data

The year 2016 has seen payers and providers take steps to ameliorate years of distrust through new partnerships designed to reduce health care costs, improve care, and boost data-sharing, according to FierceHealthcare.

For example, in September, Geisinger Health Systems and St. Luke’s University Health Network announced a new partnership, with the aim of lowering premiums by allowing the two organizations to share in any costs savings. Six hospitals and 270 medical offices in the St. Luke’s system immediately added 10,000 employees to the Geisinger plan. The partnership is scheduled to launch on January 1.

In a three-year pilot project, Moffitt Cancer Center in Florida and UnitedHealthcare developed surgery and radiation-therapy bundled payments focusing on early-stage lung cancer. The goal of the partnership is to lower the costs of cancer care by incentivizing providers to reduce variation through evidence-based best practices.

Earlier this year, Anthem joined with Aurora Health Care in Wisconsin to create the Wisconsin Collaborative Insurance Co., which steers patients to high-quality providers within the state. The two companies expect to drive down health care costs by engaging with patients to improve their overall health and by using high-quality providers.

In 2012, Aetna and the Inova Health System in Virginia created Innovation Health Plans, a jointly owned plan that offered financial incentives for low-cost, high-quality care. Four years later, executives pointed to tangible benefits of the partnership, including a reduction in medical-waste costs. The balanced approach also brought in 170,000 new members.

After Humana and UnitedHealth exited Colorado’s Obamacare exchange earlier this year, insurance startup Bright Health saw an opportunity to fill the gap. The company is set to offer plans on the state’s marketplace starting in 2017. President Kyle Rolfing said that the insurer plans to leverage its partnership with the Centura Health System to maintain cost efficiency and high-quality care and to invest in technology that allows the two organizations to share data.

Source: FierceHealthcare; December 22, 2016.