Exploring Effective Payer-Provider Collaborations: Insights and Key Strategies

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In episode 417 of Relentless Health Value, Stacey Richter engages in a detailed discussion with Josh Berlin from Rule of Three consulting firm about the dynamics and strategies behind successful provider and payer collaborations in the healthcare industry. They delve into the historically adversarial relationship between these entities and explore five distinct types of collaborations, ranging from data sharing to risk-bearing partnerships. Berlin outlines five crucial 'must-haves' for these collaborations to succeed, including scalability, sustainability, flexibility, effective collaboration, and compatible risk profiles. They further examine real-world examples of both successful and failed healthcare collaborations, emphasizing the importance of mutual goals and adaptive strategies to enhance patient outcomes and improve market competitiveness. The conversation offers practical insights for healthcare executives aiming to foster stronger, more innovative partnerships in a complex and evolving industry.

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06:06 Why should payers want to collaborate with providers?

09:46 “Collaboration … is bilateral. … Both sides, plan and provider, should be equally as interactive with the individual populations they work with.”

12:37 What are the must-haves for collaboration between providers and payers?

13:10 What are the five different types of collaboration?

16:03 What are the five characteristics you want to be focused on in partnership?

21:35 EP359 with Dan O’Neill.

22:16 In order to collaborate, do you have to be collaborative?

26:11 Ochsner as a great example of collaboration.

27:46 Episodes with David Carmouche, MD, and Eric Gallagher.

28:51 A collaboration failure in Haven.