The relationship between payer and providers is shifting. Payers are establishing greater expectations of providers for integrated care, including care coordination and care management activities that have typically been the functional responsibility of the payer. Provider reimbursement is being tied to performance metrics such as overall health outcomes, functional life skills improvement and quality of care. These shift are fraught with challenges and risks. Collaboration and trust between payer and provider are key.
The audience will learn:
- How and why the Sandhills enter set expectations for network providers to institute and delivery integrate care services using data to drive performance
- The decision points for sharing full claims data with the provider to support this effort and the challenges/risks they mitigated to do so
- How Evans-Blount Total Access Care operationally began to more fully provide integrated care services
- The challenges of the “gift of data” experienced by Evans-Blount Total Access Care and how they are addressing them
- The outcomes goals for 2017 as a result of the collaboration.