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Providers Grade Health Plans. Guess Who Still Stinks.

Jacqueline Fellows, for HealthLeaders Media, May 1, 2013

Historically, the relationship between health plans and the hospitals and physician practices has not been great, to put it mildly. Is communication between them at an all-time low? Probably not, but it doesn't bode well on the near-eve of health insurance exchanges, value-based care incentives, and other payment models that require providers and payers to share more information to aid in better value, care, and quality for patients.

And the survey shows hospitals moving toward more collaborative models of care with payers. Last year, only 36% reported being in a phase of ACO implementation; this year that percentage jumped to 51%.

There was also an increase in the number of hospitals reporting that they have two or more payer contracts that included established quality criteria. In 2012, 37% of hospitals said those contracts existed; this year, it rose to 47%—nearly half.

Despite the increase in hospitals and payers participating in some type of collaborative agreement this year, the lowest contracting priorities are the industry's top buzzwords: bundled payments, ACOs, and population health strategies.

The survey was conducted between February and March using a combination of phone and online portal interviews. Revive says respondents were screened to "make sure they were responsible for negotiating contracts with major health plans."

Of those responding, 17% were identified as C-suite executives, 19% were VPs of managed care, 37% were the equivalent of a director, and 27% were responsible for either contracting or revenue cycle activities.


Jacqueline Fellows is an editor for HealthLeaders Media.
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