24 Jul Study: Health plans partnering with practices to improve outcomes
The Alliance of Community Health Plans (ACHP) launched a project exploring the role of health plans in influencing physician behavior and how health plans can partner with practices to adopt evidence-based practices at the point of care to improve outcomes. It was funded partially by the Patient-Centered Outcomes Research Institute (PCORI) and was conducted with its own members — 21 nonprofit, community-based health plans and provider organizations. The study was released in June 2019 and finds that closely aligned payer-provider partnerships helped hasten evidence in key chronic conditions.
The study recommends five best practices for payers and providers to partner to accelerate evidence to the point of care. They emphasize that successful efforts will use these strategies in combination, reinforcing the collaborative approach throughout the process. Here are the five best practice: (1) Build consensus and commitment to change, (2) Create a team that includes the necessary skill sets, perspectives, and staff roles (3) Customize education, tools, and access to specialized knowledge for physicians and for patients, (4) Share timely and accurate data and feedback in a culture of transparency, accountability, and healthy competition, (5) Align financial investments with clinical and patient experience goals.
While autoimmune and chronic inflammatory disease were not included diseases in the study, these best practices are important lessons learned that CrossBridge is applying to help payers and providers improve care delivery for complex chronic conditions.
Why does it matter? At $127.8 billion, the annual cost of caring for patients with chronic inflammatory diseases has surpassed the cost of treating cancer. These are lifelong chronic conditions that lead to lost productivity, disability and even death. Specialist such as rheumatologist, gastroenterologist and neurologist are in short supply and demand is increasing,
CrossBridge has set our sights on overcoming the obstacles to the treatment of chronic inflammatory diseases, including rheumatoid and psoriatic arthritis, spondylarthrosis, lupus, irritable bowel disease, crohn’s and colitis, and multiple sclerosis.
CrossBridge – spans the divide between payers and providers partnering in Value-Based Care (VBC). We connect payers and specialist physicians to deliver evidence-based care with cost efficiency while improving outcomes. Payers and providers have sought a trusted independent resource as a catalyst to lower costs and improve outcomes and patient experience. CrossBridge is independent from pharmaceutical and drug distribution companies.
For more information on the study go to the NEJM: https://catalyst.nejm.org/payer-provider-partnerships-health-plan/