AI Article Synopsis
- The existing dynamic between payers and providers tends to be confrontational, largely due to the rise of managed care that limits cooperation.
- A case study is presented where a payer and provider successfully turned their adversarial relationship into a collaborative effort focused on patient-centered care.
- The collaboration involved sharing historical utilization data, leading to better clinical and financial results for both parties.
Article Abstract
The current relationship between payers and providers is often adversarial. The growth of managed care has fostered very little cooperation between the payer and provider, even though both are working toward improved patient outcomes. This article describes the process by which a payer and provider were able to transform a contentious relationship into a collaborative patient-centered program. The program demonstrates that through the sharing of retrospective utilization data, improved clinical and financial outcomes can be achieved.
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| http://dx.doi.org/10.1111/j.1945-1474.2006.tb00606.x | DOI Listing |
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