Healthcare Finance News, US: Cognizant’s SVP & Global Practice Leader, Healthcare Consulting Discusses Health Plan Collaboration and Interoperability

"With some of the alliances that are forming, payers have to think about what the next business model is," says Trish Birch. "We see with the rise of the on-demand economy...the value proposition for health plans will go away. It will evolve into an integrated delivery system like United acquiring providers." Excerpts:

For insurers, the word right now is collaboration.

Specifically it's partnering with, and even acquiring, providers to integrate the data necessary to reduce the cost of healthcare.

The challenge of interoperability was thrown down by Centers for Medicare and Medicaid Administrator Seema Verma at HIMSS18.

Recent examples include UnitedHealth Group's Optum buying DaVita Medical Group, OptumCare's plan to buy Reliant Medical Group and BayCare Health System partnering with Lumeris on a Medicare Advantage plan in Florida. 

Provider patient records on diagnoses, procedures, labs, drugs, will flow between different healthcare touchpoints, including payers, according to Anton Berisha, MD, senior director of Clinical Analytics and Innovation, Healthcare LexisNexis Risk Solutions.

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