Successful payer-provider collaborations: 4 characteristics


Physicians want to do what they went into medicine to do: Take care of patients through building and fostering strong relationships with them. In the fee-for-service world, however, many independent physicians believe that calling cannot be realized. That’s because in order to stay in business, they need to see as many patients as they can during the day—and that translates into seeing each patient for only about 10 or 15 minutes, says Jeff Butler, chairman and chief executive officer of Arlington, Virginia-based Privia Health, a national medical group. Value-based reimbursement, he says, can change that.

“The opportunity for these providers is to come alongside and be the strategic partners of health plans … and really get aligned on managing a population and getting rewarded, not for doing more stuff, not for seeing more patients, but getting rewarded for keeping people healthy and keeping them out of the acute care setting,” says Butler.

While value-based reimbursement presents opportunities for payers and providers, succeeding in such a reimbursement model can be challenging. Here are four things to strive for that could increase the likelihood of success in a value-based reimbursement model.


Josh Sandberg

Josh Sandberg is the President and CEO of Ortho Spine Partners and sits on several company and industry related Boards. He also is the Creator and Editor of OrthoSpineNews.

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