A Framework For Building Trust And Collaboration Between Health Plans And Physicians

posted by Medical Advantage

on December 3, 2018

One of the best ways to maximize revenue under value-based care arrangements is for health plans and physicians to team up and work collaboratively on health care transformation. By building a strong and meaningful partnership, health plans and physicians can achieve higher quality, provider better care and improve patient satisfaction. However, sometimes this is easier said than done. There are many obstacles and barriers to collaboration that must be addressed for a successful partnership to evolve. Ultimately, it all boils down to communication and trust.

From a physician’s perspective, the health plans may be viewed in a negative light due to cumbersome prior authorization processes and other medical management policies. It is hard for physicians to partner with health plans on quality improvement if they feel that the health plans are limiting their ability to provide the member with necessary medical care and services. On the other hand, the health plans may be frustrated that physicians don’t follow the specified rules and are continually requesting exceptions or special treatment. Despite their differences, with the right level of support and infrastructure, health plans and physicians can work together to achieve their shared goals under value-based care arrangements.