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Payer-Provider Collaboration in the Healthcare Value Chain: Insights from Integrated Data Analysis

Provider-related questions on the Medicare CAHPS survey are consistently in the top 5 key drivers for health plans’ performance, but these measures are difficult for health plans to impact as the patient-provider relationship is not in their direct control. However, there are clear intersections along the consumer’s healthcare journey that impact both patient experience and health plan member experience. For instance, the performance measures Access to Care and Care Coordination are driven by decisions and resources of both the payer and the provider. The ability of the provider and health plan to collaborate at these key intersections is essential to realizing better performance and improvement across the continuum of care.

Hear a unique perspective on payer-provider collaboration from these experts:

Thomas H. Lee, MD, Chief Medical Officer for Press Ganey is also a practicing primary care physician at Brigham and Women's Hospital in Boston. He is responsible for developing clinical and operational strategies to help providers measure and improve the patient experience, with the overarching goals of reducing patient suffering and improving the value of care. He serves as Chair of the Board of Geisinger Health Plan.

Jessica Dudley, MD, Chief Clinical Officer for Press Ganey, leads efforts to support organizations in increasing clinician engagement and improving patient care outcomes, particularly among physicians. Her areas of expertise include leadership development, population health, clinical care redesign through outstanding teamwork, and advancing clinician wellbeing.

Adam Higman, Partner, Strategic Consulting for Press Ganey, has consulted with health plans and health systems across the country improving consumer experience, quality outcomes and operational efficiency for more than 15 years and leads Press Ganey Strategic Consulting’s payer solutions team.

Topics include:

  • Key lessons from experience with value chains
  • Reducing friction along points of intersection between payers and providers
  • Insights from SPH member experience and Press Ganey patient experience analytics
  • Effectively engaging health system executives, practice managers, and physicians
  • Developing win-win strategies for improvement
  • Q&A Session

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