Although the healthcare trend is shifting risk to providers, health plans have important roles to ensure both parties succeed.
Although provider risk needs include a blueprint to prepare and engage in risk-based contracts, health plans can help determine success by sharing knowledge and insight with them, said Meredith Duncan, executive director and COO of Aetna’s Texas/Oklahoma/New Mexico health plan.
Duncan’s comments came Sunday in a session titled “Building the Blueprint to Support Risk-Based Contracts,” during the HFMA 2019 Annual Conference.
Daniel Marino, managing partner for Lumina Health Partners, who co-presented the session, said providers moving into risk need to focus on the key drivers of success, including:
- Negotiating and partnering on a risk-based contract with a health plan—not just negotiating terms
- Finding ways to align all of the terms
Duncan, who has worked for providers as well, said sometimes it helps to ensure the other party understands your perspective and objectives, which can help both parties work toward a collaborative agreement. Read the article in its entirety here.
Daniel Marino is managing partner for Lumina Health Partners. This news article was originally published in the June 24, 2019 issue of HFMA’s Conference News from HFMA’s 2019 Annual Conference.