Collaboration Is the Key for Health Plans in a Shared Risk Environment

Information Sharing Enables Health Plans to Leverage Data and Analytical Assets to Deliver Sustained Value

Executive Summary

The shared-risk payment models that are central to health reform all require tight coordination among payers, providers, and patients if they are to succeed. As payers and providers enter into more and more such agreements, they need to enhance success by communicating and collaborating more effectively with their partners and actively engaging, supporting, and empowering their members.

To foster this collaboration and engagement, payer organizations must make critical decisions about technology and solutions that will provide timely, comprehensive information at the point of care. This will enable providers to make better clinical decisions and members to better understand and manage their health.

Delivering the right actionable information for risk mitigation is challenging. Health plans and providers have extensive investments in data and analytic assets. Yet neither party in most risk-sharing agreements has the full picture, and there is often no efficient mechanism for getting the information to those involved in clinical decisions in a timely manner to optimize care delivery.

Care communities of payers, providers, and patients need the right foundation to effectively connect people, organizations, and systems. That foundation includes information sharing through a secure, comprehensive health informatics platform. Information exchange builds sustainable value through enhanced care management, risk mitigation, and optimized engagement. Ultimately, health plans that invest in information exchange are able to deliver the right information in the right amount to the right person at the right time to drive the right actions by everyone involved. They deliver better health through connected care.