This week, we continue to explore the results of our College of Healthcare Information Management Executives (CHIME) survey and the need for various data sources. Our survey asked the question: Do you have a strong grasp on how to deal with payer data today? The results show that the majority (57 percent) of provider organizations do not.
As healthcare costs continue to rise and the industry focuses on value-based care, payers and providers need to look for ways to collaborate. This relationship is critical to payers as they leverage EHR data to better understand the cost of services rendered by the providers, measured against the outcome of care. For providers, combining both claims and clinical data can reveal some extremely valuable insights that can positively influence clinical decisions and drive down costs. However, many organizations still face challenges, including a lack of appropriate tools and an influx of data that is difficult to manage. This then creates a lag in insights being delivered to the right people at the right time. Bruce Carver, associate vice president of payer services, believes optimized organizational coordination can help address some of these issues.
Here are two of his best practices for making the most out of payer-provider collaboration:
- Trust Each Other– The first step in any relationship is trust. Are your goals aligned? Do you have redundant reporting or processes to get to these shared goals? Where can things be streamlined? This relationship will take time as both parties must work together to improve collaboration and ultimately gain more insights.
- Establish Communication Processes – Communication is also key and establishing efficient processes can help ensure that organizations are on the same page when issues arise. Some of these issues include, gaps in payer data or instances when payer data is not directly aligned with provider data.
Once organizations are aligned, payer data can be leveraged to better meet industry-wide demands of becoming more patient-centric and value-driven. This collaboration can also help providers manage medication adherence and establish cohesive strategies that address this issue.
As providers continue to struggle with a lack of organizational resources and payers begin to shrink in numbers, payer and provider collaboration will be more important than ever. Additionally, creating this collaboration can help both parties ensure that they are on the right track towards value. To see more results from our CHIME survey, access recent blogs here and here. If we can help get your organization on the right track, make sure to contact us.
Get our take on industry trends
Will adopting a risk-based approach with augmented analytics support care gap closure?
A common challenge for healthcare systems is how to properly segment its patient populations based on risk profiles and co-morbidities. Doing this well ensures a high quality of care delivery and superior patient outcomes.
Read on...4 questions healthcare executives are asking about augmented analytics
At our annual Impact Summit, I had the privilege to talk about augmented analytics and address questions from healthcare executives—many…
Read on...Using data analytics to combat the maternal health crisis
With most pregnancy-related deaths being considered preventable, why is the United States facing a maternal health crisis? The country’s maternal mortality rate is the highest of any developed nation in the world and more than double the rate of peer countries.
Read on...Q&A with Dr. Lyle Berkowitz: Diving into the future of AI, analytics and precision medicine
Estimated reading time: 4 minutes After an excellent keynote session led by Dr. Lyle Berkowitz at our 2022 Impact Summit…
Read on...