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It’s a new day in healthcare as payers and providers work together to create shared value

July 16, 2024
Newsletter

It’s no secret that the relationship between payers and providers has been strained over the years. Much of the friction has been driven by a lack of transparency and trust. Without trust each party tends to focus on protecting their own interests and creating workarounds that support their own agendas.

For years, standalone health tech solutions have flourished that help payers and providers create those workarounds—even as they express the desire to work together on the patient’s behalf. I often hear, “If we could only work collaboratively, we wouldn’t need all these workarounds.” Both parties understand the problem and want a way to fix it, but until recently, the infrastructure that would enable that collaboration hasn’t existed.

That infrastructure is here today. We now have interoperability solutions—platforms and solutions—that remove barriers, align incentives, and drive value for both payers and providers. These solutions create an environment that promotes trust and transparency and eliminates the need for workarounds. With these solutions, we can look forward to a future of healthcare that is more efficient, transparent, and collaborative.

It’s refreshing to hear the excitement of not only what’s possible but also what’s already being accomplished. We’re encouraged when we meet with payers who immediately suggest the providers in their network that would benefit most from these solutions. We’re equally encouraged when providers share their relief that these solutions are allowing them to work more effectively with their payers – not at odds.

It’s all about creating shared value and aligned incentives. It’s a new day in healthcare and we at Avaneer Health are excited to be a part of the solution that is changing the business of healthcare. Together, we can create a more united and cooperative healthcare landscape.

Bryan Derrick
SVP, Sales
Avaneer Health

 

In This Issue

Industry Highlights

Digital transformation: Health systems’ investment priorities
McKinsey & Company

It is estimated that the healthcare sector could save between $200 to $360 billion by leveraging AI and its related technologies to further “digital and analytics transformation.” However, when asked about their progress in that area, three out of four health system leaders say they lack the resources or planning to support those initiatives. This insightful article delves into the vast misalignment between digital priorities and actual investments, and what healthcare leaders can do to move the needle forward.

Read more

ONC, HRSA modernize UDS reporting with HL7 FHIR
TechTarget

Nearly 1,400 U.S. health centers that deliver care for underserved communities will find Unified Data System (UDS) reporting a bit easier, thanks to the new HL7 FHIR API standards recently launched by the ONC and Health Resources and Services Administration (HRSA). This informative article provides a background on the UDS+ project and how it supports better access to more than two million patients across the country.

Read more

History and evolution of machine learning: A timeline
TechTarget

The precepts of machine learning (ML) were established more than eight decades ago. This article walks through a timeline that highlights the progression of ML from being the “first artificial neural network” to what it is today. The article also presents the five AI technologies that are already driving value for businesses in nearly all industries. If you only read one article on ML, this should be the one.

Read more

From the Avaneer Podcast

Looking for some inspiring and insightful podcasts to listen to this summer? Here’s a list of can’t-miss conversations with some of healthcare’s most forward-thinking leaders.

The Importance of Addressing Social Determinants in Healthcare. Dr. Joseph Webb, Nashville General Hospital Listen here

Healthcare’s Data Exchange Evolution. Bob Gross and Krista Matlock, Cleveland Clinic
Listen here

Digital Tools Can Improve Healthcare Access and Quality. Ryan Howells, Leavitt partners and CARIN Alliance, and Jason Sherwin, CLEAR
Listen here

Uniting Healthcare: The Approach to Innovation and Connectivity. Seth Joseph, Summit Health Advisors
Listen here

Leveraging Technology for Superior Patient Care. Michael Archuleta, Mt. San Rafael Hospital and Clinics
Listen here

Navigating Healthcare’s Innovation Landscape. Jeremy Bikman, Reaction Data
Listen here

Enhancing Patient-Centered Care: Strategies for Innovation. Dr. John Chelico, CommonSpirit Health
Listen here

From 72-Hour Waits to Real-Time Rides to Save Patients’ Lives. Sufian Chowdhury, Kinetik
Listen here

Transforming Healthcare through Habit Change. Jeffrey Ruby, Newtopia
Listen here

From the Avaneer Blog

The New Role of Platforms and Networks in Driving Shared Value and Collaboration

Healthcare has no shortage of innovators looking to make significant improvements in our industry and in the lives of patients. Many new digital solutions have been introduced to the market, promising to do just that. However, for these new solutions to reach their true potential, they must be able to drive shared value between our largest players—payers and providers. Seth Joseph, Summit Health founder and managing director, and frequent Forbes contributor, explains, “The challenge is no longer building software or apps for individuals. The opportunity now lies in connecting those individuals, and their systems, to facilitate new or more efficient interactions.” And that, according to Seth Joseph, requires platforms that align incentives and drive value for all stakeholders equally.

Read more

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