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White Paper - Increasing Importance of Payer-Provider Collaboration

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SPH Population Care ™ Question 9 What are your greatest OPPORTUNITIES related to Payer-Provider Collaboration? Respondents were asked which of the following programs and initiatives represent the greatest opportunities to collaborate across the aisle: Aligning Goals; Care Coordination; Communication; Cost Savings; Disease Management; Market Expansion; Network Iimprovement; Organization Structure; Outcomes/Quality Improvement; Quality Incentives/ Value Payments; Technology; Increased Revenue; Cost Transparency. The leading initiatives were as follows: The Top 4 Opportunities for Payers 1. Technology – 28% 2. Communication – 24% 3. Outcomes / Quality Improvement – 13% 4. Quality Incentives / Value Payments – 8% The Top 4 Opportunities for Providers 1. Technology – 38% 2. Quality Incentives / Value Payments – 14% 3. Outcomes / Quality Improvement – 10% 4. Communication – 10% Both payers and providers selected "Technology" as the top initiative to help with closer collaboration. Interestingly, both organization types chose the same four initiatives out of a choice of thirteen as their highest priority opportunities for improvement. Question 10 What are your greatest CHALLENGES related to Payer-Provider Collaboration? With regard to the greatest challenges related to payer- provider collaboration, respondents were asked to select their top challenges from among the following: Aligning Goals; Communication; Limited Resources/Finances; Technology; Value-Based Contracts; Willingness to Collaborate; Competition; Security. The top challenges were: The Top 3 Challenges for Payers 1. Willingness to Collaborate – 35% 2. Technology – 33% 3. Limited Resources / Finances – 14% The Top 3 Challenges for Providers 1. Technology – 33% 2. Willingness to Collaborate – 24% 3. Value-based Payments / Contracts – 19% "Willingness to Collaborate" and "Technology" share the top two spots for both payers and providers. It's somewhat ironic that such a high percentage find "Willingness to Collaborate" to be a big challenge, when overall 94% of respondents stated that payer-provider collaboration was important or very important to their organizations. Perhaps this reflects a misalignment between corporate vision and tactical execution. Conclusion Overall, the survey results indicate significant movement towards closer payer-provider collaboration. More than 70 percent of payers and providers surveyed already participate in payer-provider collaborative partnerships, and nearly all survey respondents recognize that that collaboration is the key to success in a value-based healthcare environment. However, it's important to note that the journey to achieve collaborative partnerships is still early for both healthcare stakeholders – and 20 percent of organizations still aren't collaborating via data sharing at all. Significant opportunities exist to further develop payer-provider collaboration in the areas of Technology, Communication, Outcomes/Quality Improvement, and Quality Incentives/Value Payments. The good news is that these types of activities are more likely to be prioritized with increased financial incentives from the shift to value-based care. 11605 Haynes Bridge Road, Suite 400 Alpharetta, GA 30009 866-460-5681 info@SPHAnalytics.com SPHAnalytics.com © 2019 Symphony Performance Health, Inc. All Rights Reserved. 19.5.2

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