RISE WEST REVEALS THE INCREASING DEMAND FOR PAYER-PROVIDER COLLABORATION

RISE WEST REVEALS THE INCREASING DEMAND FOR PAYER-PROVIDER COLLABORATION Note from the Director:

At our annual RISE West conference in San Diego last month, I noticed how engaged and energetic our audience was amid the conversations involving the evermore complex issues of our industry. We witness the increasing demands for more information needed to fulfill the expanding roles of the accountable organizations in our space. From providers to plans to vendors, this drive forward demands more and more every day.

Yet, in some ways, the weight of these demands seems to bear down on the office practices of physicians doing their best to provide care to their patients. Not long ago, the administrative burdens they bore involved capturing procedure codes, verifying insurance, and submitting claims. Now they are necessarily part of a larger system of care that is accountable for quality, access, and cost. And in turn, they must adapt themselves to the demands of that system for greater diagnostic information and its accuracy. Not only that, but they must also submit to scrutiny for all those dimensions of evaluation and assessment at risk for their value-based payments.

As the social determinants of health are becoming the newest point of concern, the complexity for physician practices has just dramatically expanded. How can this possibly work?

In a paper published by the United Hospital Fund, the nuts and bolts required to support referrals from physician practices to community-based resources is spelled out in compelling detail.

around making these collaborations happen successfully. It is our hope that, like RISE West, we can be the host to the creative process, the exploration and discovery of new ways to figure out how to make this work more effectively for all the stakeholders. By bringing together the providers, the plans, the community-based organizations, and the vendors, we hope to act as an accelerator and an incubator. Stay tuned for more news and ideas on this topic going forward.

It becomes obvious to me that the linkages between health plans and providers must be further expanded and deepened to supply the tools and utilities necessary to execute on these new demands. Not only that, but a thoughtful redesign must be accomplished to help protect and buffer the ways in which these new demands impinge on the doctor/ patient experience in the office practices. Collaboration is necessary to simplify, streamline, and standardize at the risk of eroding the quality of care at its very heart.

It is our hope that, like RISE West, we can be the host to the creative process.”

We view the role of the RISE organization as a facilitator and convener of audiences to have the kind of conversations and professional interactions necessary to map out strategies and to share best practices around making these collaborations happen successfully. It is our hope that, like RISE West, we can be the host to the creative process, the exploration and discovery of new ways to figure out how to make this work more effectively for all the stakeholders. By bringing together the providers, the plans, the community-based organizations, and the vendors, we hope to act as an accelerator and an incubator. Stay tuned for more news and ideas on this topic going forward.

By bringing together the providers, the plans, the community-based organizations, and the vendors, we hope to act as an accelerator and an incubator. Stay tuned for more news and ideas on this topic going forward.

Kevin Mowll Executive Director, The RISE Association