Enabling Payer-Provider Collaboration: Smart, Point-of-Care Decision Support

Presented by McKesson 

Payers and providers are trying to solve the same problem: reducing costs while ensuring appropriate decision making and high quality care.

Now with payment and delivery reform, payer and provider roles are blurring, while pressure to reduce excessive costs has increased. To address these challenges, the market needs a new approach to bridge the provider-payer gap by leveraging shared content and technology to effectively align payers and providers, alleviate cost and efficiency burdens, and maximize impact on medical costs while improving care quality. True payer-provider partnership would reduce the overall cost burden on the entire system and open up new possibilities for effective medical and network management. 

The foundation of this new approach is to make all clinical and coverage rules transparent to providers, in real-time, so that medical management staff need only to review the minority of cases that truly require their expertise. A common clinical language and common technology platform will enable transparent, evidence-based, real-time collaboration to foster optimal care and coverage decisions while building payer/provider trust and collaborative relationships. The ways to enable payer-provider collaboration will be discussed including:

• Support consistent, evidence-based care decisions before services are performed
• Reduce administrative costs and increase efficiencies through automated, evidence-based decision support tools
• Align payers and providers with an intelligent, common technology and language
• Collaborate as payers and providers to objectively measure and manage based on quality care performance

 

List of Speakers: 

Matthew Zubiller, VP, Decision Management, McKesson

Matthew Zubiller is vice president for McKesson’s Decision Management business. He leads the company’s evidence-based decision support and personalized medicine initiatives, areas that promise to change the paradigm for healthcare practice and delivery. Responsible for McKesson’s flagship InterQual® product line and its Clear Coverage™ SaaS based decision support platform, he drives operations, strategy, and product development for the business. He is a frequent speaker and author on topics such as next generation exception-based utilization management, decision support, and public policy for molecular and genetic testing. 

Previously, he created and ran McKesson’s Advanced Diagnostics Management business and was part of the corporate strategy team. His background includes diagnostics, healthcare, enterprise software, global strategy consulting and M&A.

Recognized for his innovation, Mr. Zubiller was voted to Healthspottr’s “The Future of Health 100” list (ranked #49). Mr. Zubiller is a leading voice and thinker helping to usher in a new collaborative era of healthcare where stakeholders work together to develop and deploy connected decision management solutions that benefit all stakeholders by optimizing decision-making at all points of care

Mr. Zubiller’s academic credentials include a Bachelor of Science in Economics (BSE) from the Wharton School, University of Pennsylvania, an MBA from the London Business School, and a certificate in Management of Technology jointly from the University of California, Berkeley’s HAAS School of Business and the College of Engineering. He enjoys spending his free time with his wife, Love, and two young children, Texas and India.

 

The content presented in this webinar is solely attributable to the speaker and does not represent an endorsement by America's Health Insurance Plans (AHIP) of the accuracy of the information presented in the audio conference or any opinion expressed by the speaker.