Developing effective payer-provider partnerships is a strategic priority for many health systems. With the ACA healthcare reform rolling out, the healthcare industry is being challenged in ways far beyond the changes directly outlined in the healthcare reform bill. Fee for service will be replaced for payments based on the quality and level of service provided. Payment models and physicians fees will be transparent so consumers can actually 'comparison shop' for their providers. Patients will compare and choose physicians on a healthcare exchange and physicians need to be prepared for the impact on their practice. For the first time, payers and providers need to consider aligning their incentives around value in the hope of becoming effective partners.
In a white paper shared by BDC Advisors, and featured in hfma.org January 2014 edition, the authors Bill Eggbeer, Kevin Sears from CHE Trinity Health, and Kenneth Homer, MD from Holy Cross Hospital describe the steps necessary to build effective payer partnerships based on their work together to build Medicare Shared Savings Programs in several Trinity markets and Holy Cross Hospital’s first accountable care contract with a national payer.