Emphasize data sharing and make it happen.
Communication is the backbone of all partner relationships, and success requires information to flow in a timely manner across the patient continuum of care. It’s in the area of communication that payers and providers say they have made the biggest improvements in their quest to collaborate more closely, according to the survey.
But while payers and providers are comfortable using information technology solutions to collect and dispatch basic data, they’re still not always comfortable using communications technology to share sensitive clinical and financial information with each another.
More than half (58 percent) of payers and providers surveyed say they don’t have shared population health technology solutions in place, although 19 percent are planning to deploy such tools this year. For partnerships to thrive, it’s crucial that all parties find common ground with technology. Decide what will be shared, how it will be shared and which data-sharing platforms will be used.
Embrace new programs.
New incentive programs are emerging to ease partnerships between providers and payers. Most notably, the National Committee for Quality Assurance (NCQA), which oversees the administration of HEDIS measures for payers based on quality improvement standards, is encouraging payers to incorporate clinical and financial data in their quality reporting, under the recently introduced Population Health Management (PHM) accreditation standards.
The growing use of HEDIS measures among payers and providers is a positive development, but still, a notable portion of care partners don’t share claims data or clinical data. According to the SPH Analytics survey, more than 20 percent of payers are not receiving any real-time clinical data from providers.
Payers and providers have come a long way toward bridging many gaps in collaboration. Still, in order to succeed in the future, they’ll need to increase their focus on communicating, sharing data and aligning goals. By putting some of these suggestions into effect, payer-provider partners will be ahead of the game and raise the bar on what truly collaborative relationships can accomplish.
Collaboration brings so many benefits to all parties including more cohesive clinical data that shows physicians where they can make improvement and supports payer iniaitiatives, such as promoting immunizations. In doing so, collaborative relationships can help physicians and payers truly elevate care while achieving cost savings and other benefits.
Amy Amick is President and CEO of SPH Analytics, an Alpharetta, Ga.-based healthcare and population health management data analytics firm.