Provider/Payer collaboration and alignment

We work with providers and payers to identify and implement successful collaboration models

Payer/Provider Convergence Models

Value-Based Care Implementation

Risk Contracting Portfolio Management

Provider Sponsored Plan Strategy and Optimization

Product Design and Launch

M&A Diligence

  • Established a Joint Venture (JV) strategy, business plan and implementation plan for a hospital system and health plan

  • Served as the primary business lead for negotiations between a health plan and large provider practice to develop alternative payment models

  • Designed, developed and supported the implementation of ACO partnerships with large health systems 

  • Developed the business plan to create a Management Services Organization (MSO) to offer to independent physicians to support physician adoption of value-based care reimbursement models, and to create a deeper relationship and greater financial alignment with physicians

Client Need

Client requested HealthScape’s assistance in developing and implementing physician collaboration strategies to improve healthcare quality and enable fee for value payment structures.

HealthScape Approach

  • Completed one-on-one interviews with key stakeholders to discuss client’s strategic objectives for collaboration with providers
  • Identified and evaluated various provider collaboration models based on examples in the marketplace and HealthScape's experience
  • Analyzed client’s member and provider landscape to customize provider collaboration strategies by geography
  • Facilitated executive session to prioritize client’s strategic objectives and evaluate potential collaboration initiatives
  • Acted as liaison between client and potential collaboration partners during outreach process

Outcome

  • Client pursued several distinct provider collaboration opportunities within its market. 

Unlocking the Potential of Carrier-Provider Partnerships

In this article, we discuss the essential elements of the Integrated Operating Model required to drive execution and long-term value in carrier-provider partnerships.

It Takes Three to Tango

In this article, we discuss a more comprehensive collaboration framework to which the healthcare industry can evolve in order to achieve economic sustainability and improved health outcomes.

Provider Integration: Not Just a Trend

In this article, we discuss the five most significant reasons for provider integration and alignment permanence – and the impact to the various parties involved.

Provider Alignment: What Will Independent Physicians Do?

In this article, we discuss some of the alternative business models that exist for independent physicians and physician groups.

Service descriptions
Representative experience
Case study
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