Although industry progress in the transformation journey from volume-based reimbursement (fee-for-service) to value or outcomes-based reimbursement (value-based care) has been mixed, industry leaders believe this strategy holds promise for a better system that lowers costs while improving health outcomes and patient satisfaction.
Many payers have established deeper relationships with primary care organizations as a way to accelerate progress. Relationship models include ownership, joint-ventures and strategic contracts.
Payers pursuing provider alliance strategies have generally reached certain conclusions.
Establishing provider alliances is only the first step for payers to accelerate value-based care progress.
Establishing effective and differentiated payer-provider alliances can be a major strategic advantage for payers and beneficial for forward-looking providers. This strategy is quite different than other provider network strategies and can be somewhat disruptive in the local marketplace. At the same time, disruption is probably a prerequisite for transformation.