High performing value-based programs: Lessons from a successful payer-provider collaboration

March 26th, 2018 / By Erika Johnson, L. Gordon Moore, MD

One of the “truisms” of value-based programs is that these programs align the incentives of the health care delivery system and the insurer, such that better care results in better outcomes and reductions in unnecessary care delivery.  A number of health care insurers use 3M methodologies and services in support of their value-based programs and we’re always interested in examples of high performing health care delivery systems in these programs. What is it about this provider, program, relationship that led them to these outcomes? 3M had the opportunity to visit one such high performing value-based program (VBP) provider and their health plan partner to discuss what made them successful.  Below is a brief overview of what we found and a link to the case study.

The provider we visited was one of the top performing providers compared to their budget, and the best performer on the program quality metric. We felt this performance warranted a closer look.

The health plan and the provider both agreed that establishing trust between their two organizations early in the program inception was a key contributor to their success. The relationship and trust lead to collaboration and data sharing that would not have been possible otherwise. The data sharing gave the provider access to new information and analytics provided by the plan’s staff, and they acted on the information quickly and efficiently. 

The case study showcases the specific interventions that were implemented.  It is an inspiring story, not only about a successful VBP provider, but portrays a simple, yet elegant, approach to population health that can be replicated by others. The approaches and insights in this case study are actionable, and can be implemented by other providers in VBP programs hoping to achieve similar results.  

We would encourage all involved in VBP to read this story of a health plan and a provider moving to the same side of the table and truly collaborating to achieve success.

Erika Johnson, consultant with 3M Health Information Systems.

L. Gordon Moore, MD, is Senior Medical Director, Clinical Strategy and Value-based Care for 3M Health Information Systems.