Cooperating for better care.

News & Views

5 notable provider-payer collaborations

Share this:


This FierceHealthcare article looks at five particularly interesting provider-payer collaborations in 2016.

In some cases, “a driving force behind these partnerships is the quest to expand access to data that holds the key to lower costs,” Fierce wrote.

The collaborations are:

  • Geisinger Health Systems and St. Luke’s University Health Network, both in Pennsylvania, announced a new partnershipto cut insurance premiums.  Six hospitals and 270 medical offices within the St. Luke’s system partnered with the Geisinger Health Plan.
  • partnershipbetween Moffitt Cancer Center, in Florida, and UnitedHealthcare established a new bundled payment program to cut the cost of cancer care. For a three-year pilot project, the two organizations developed surgery and radiation therapy bundles focusing on early-stage lung cancer. The goal is to reduce costs by incentivizing providers to reduce variation through evidence-based best practices.
  • Anthem joinedwith Aurora Health Care in Wisconsin to create the Wisconsin Collaborative Insurance Co. The partnership offers a commercial health plan called Well Priority to move patients to high-quality providers within the state. ‘’The new 50-50 venture was born out of a 2012 partnership in which Anthem offered incentives and penalties for Aurora physicians based on specific quality measures,’’ says Fierce.
  • Aetna and Inova Health System, in Northern Virginia, solidified their partnership back in 2012through creating Innovation Health Plans, a jointly owned plan that offered financial incentives for low-cost, high-quality care. Four years later, executives have cited such tangible benefits as a reduction in medical-waste costs.
  • After Humana and UnitedHealth exited Colorado’s Affordable Care Act exchange earlier this year, insurance startup Bright Health saw an opportunity to fill the gaps left behind. The company is set to offer plans on the state’s marketplace starting in 2017. Using its existing partnership with Centura Health System, Bright Health co-founder and President Kyle Rolfing told FierceHealthPayer that the insurer, in Fierce’s words, “plans to leveragethat partnership to maintain cost efficiency and high-quality care and invest in technology that allows the two organizations to share data.’’

To read the whole article, please hit this link



Contact Info

(617) 230-4965

Wellesley, Mass