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From Antagonists to Allies: Payers and Providers Come Together in the Name of Value-Based Care

Sheila Talton

Talk of value-based care has run rampant in the healthcare industry for quite some time now. However, the concept – where healthcare providers are reimbursed based on the quality of care achieved not merely the quantity of services delivered – has existed more as an academic thought than a working everyday delivery model. That’s finally changing, though, as the healthcare industry is now approaching the value-based care tipping point.

The upshot?  Healthcare payers and providers need to move beyond the talk, and start walking the walk. What does that mean?  For payers and providers, it necessitates substantial change. After years of working in adversarial relationships, these healthcare organizations now need to pull together and work together toward shared goals. As a result, collaboration is the emerging mantra, according to Sheila Talton, CEO of Gray Matter Analytics, a data analytics advisory and solutions company based in Chicago

“Payers and providers need to start to work with a different mind-set,” Talton said. “In order to succeed under value-based care, you need to have both the payer and the provider committed to improving quality.”

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