Provider-payer Collaboration: New Secret for Value-based Success is Out Now

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Transformations in care delivery models have propelled providers and payers to foster collaborations that will not only impact the quality of the care but also enhance their financial stability. These collaborations are majorly value-driven that partly contributes to social determinants of health and overall enhances patient health.

CATEGORY: Healthcare Services GEOGRAPHY: Global

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Provider-payer collaborations have largely impacted data sharing among various health stakeholders with increased data transparency that reduces privacy issues and ultimately augment the care affordability & outcomes.

Why Providers are Collaborating with Health Payers for Value-based Approach?

Affordability: Value based care models that aligns incentives towards patient care outcomes, helps provider facilitate quality care at affordable rates along with achieving financial objectives
Effective Care Delivery: Partnering with payers who are equipped with data-focused analytics that can identify holistic patient needs will enable providers to better utilize their capabilities and staffing for effective care delivery
Patient Experience: One of the objectives is to enhance patient experience through value-based care models. This gives payers an opportunity to act like providers and emphasize on patient’s clinical experience
Not a Zero-sum Game: Providers achieve health margins while payers decrease the risk and associated costs through value-based models. This helps both overcoming traditional barriers to care and move along the risk continuum

How Value-based Care Models will Impact Associated Stakeholders?

Financial Stability

Providers, who relied on fee-for-service model, were negatively impacted financially by the lower utilization of resources during the pandemic.
Although, value-based models gave a lifeline to some providers with payers such as BCBS of Carolina who supported practices financially

Social Determinants of

Since payers are focusing on SDoH, value-based approach benefits payers and providers both from breaking silos, collaborating and sharing across patient data
This helps them emphasize on addressing social factors along with improving clinical care outcomes

Quality over Quantity

While traditional fee for service model promoted quantity of services, value-based care proposed qualitative care for better patient care
This model not only drive down healthcare costs but also incentivize care providers for the qualitative outcomes of care delivered

5 Reasons: Why Provider-payer Collaborations are Critical for Value-based Success

Data-sharing: Once care providers start sharing data with payers, it gives complete picture of patients that enhance transparency and promote evidence-based care
Transparency: Transparency that let providers know how they are performing in compare to other providers along with benchmarks and risk-adjustments
Accountability: Providers and payers are to take their responsibilities sincerely in the value-based setting since aligned incentives are designed to reduce conflicts of interest
Care and Cost Outcomes: By sharing quality measurement expertise and partnering to deliver care efficiently, payers and providers can take care of their individual goals
Patient Engagement: While cultivating mutualism and mindset of collaboration, providers and patients can engage patient effectively leading to meaningful outcomes

1. Executive Summary
1.1 Service Overview
1.2 Global Scenario
1.3 Country Overview
1.4 Healthcare Scenario in Country
1.5 Healthcare Services Market in Country
1.6 Recent Developments in the Country

2. Market Size and Forecasting
2.1 Market Size (With Excel and Methodology)
2.2 Market Segmentation (Check all Segments in Segmentation Section)

3. Market Dynamics
3.1 Market Drivers
3.2 Market Restraints

4. Competitive Landscape
4.1 Major Market Share

4.2 Key Company Profile (Check all Companies in the Summary Section)

4.2.1 Company
4.2.1.1 Overview
4.2.1.2 Product Applications and Services
4.2.1.3 Recent Developments
4.2.1.4 Partnerships Ecosystem
4.2.1.5 Financials (Based on Availability)

5. Reimbursement Scenario
5.1 Reimbursement Regulation
5.2 Reimbursement Process for Services
5.3 Reimbursement Process for Treatment

6. Methodology and Scope

Methodology for Database Creation

Our database offers a comprehensive list of healthcare centers, meticulously curated to provide detailed information on a wide range of specialties and services. It includes top-tier hospitals, clinics, and diagnostic facilities across 30 countries and 24 specialties, ensuring users can find the healthcare services they need.

Additionally, we provide a comprehensive list of Key Opinion Leaders (KOLs) based on your requirements. Our curated list captures various crucial aspects of the KOLs, offering more than just general information. Whether you're looking to boost brand awareness, drive engagement, or launch a new product, our extensive list of KOLs ensures you have the right experts by your side. Covering 30 countries and 36 specialties, our database guarantees access to the best KOLs in the healthcare industry, supporting strategic decisions and enhancing your initiatives.

How Do We Get It?

Our database is created and maintained through a combination of secondary and primary research methodologies.

1. Secondary Research

With many years of experience in the healthcare field, we have our own rich proprietary data from various past projects. This historical data serves as the foundation for our database. Our continuous process of gathering data involves:

Analyzing historical proprietary data collected from multiple projects.
Regularly updating our existing data sets with new findings and trends.
Ensuring data consistency and accuracy through rigorous validation processes.

With extensive experience in the field, we have developed a proprietary GenAI-based technology that is uniquely tailored to our organization. This advanced technology enables us to scan a wide array of relevant information sources across the internet. Our data-gathering process includes:

Searching through academic conferences, published research, citations, and social media platforms
Collecting and compiling diverse data to build a comprehensive and detailed database
Continuously updating our database with new information to ensure its relevance and accuracy

2. Primary Research

To complement and validate our secondary data, we engage in primary research through local tie-ups and partnerships. This process involves:

Collaborating with local healthcare providers, hospitals, and clinics to gather real-time data.
Conducting surveys, interviews, and field studies to collect fresh data directly from the source.
Continuously refreshing our database to ensure that the information remains current and reliable.
Validating secondary data through cross-referencing with primary data to ensure accuracy and relevance.

Combining Secondary and Primary Research

By integrating both secondary and primary research methodologies, we ensure that our database is comprehensive, accurate, and up-to-date. The combined process involves:

Merging historical data from secondary research with real-time data from primary research.
Conducting thorough data validation and cleansing to remove inconsistencies and errors.
Organizing data into a structured format that is easily accessible and usable for various applications.
Continuously monitoring and updating the database to reflect the latest developments and trends in the healthcare field.

Through this meticulous process, we create a final database tailored to each region and domain within the healthcare industry. This approach ensures that our clients receive reliable and relevant data, empowering them to make informed decisions and drive innovation in their respective fields.