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Maximize Value Infographics November 23, 2015

UPDATED: Payer-Provider Partnered Products Map

Partner, Health and Life Sciences, Oliver Wyman
Principal, Oliver Wyman
Key Takeaway
Payer-provider value-based partnerships can address many of the core concerns with narrow networks #infographic

Narrow networks continue to proliferate during this open enrollment period, leading to increased regulatory scrutiny. Yet one type of narrow network has the potential to be more durable: partnered products where the payer and provider are collaborating in a value-based way. These continue to spring up across the country (see infographic).

We’re also seeing established players take the plunge with several large-scale announcements of new payer-provider partnered products before and during this year’s open enrollment season. For example, in California, St. Joseph Hoag Health is joint venturing with Cigna to launch a co-branded HMO product aimed at the commercial group market. Becker's Hospital Review reports that West Des Moines, Iowa-based UnityPoint Health and Bloomington, Minn.-based HealthPartners plan to create a new insurance company that will offer an integrated option to employers and individuals and for which both organizations will have equal ownership and governance. In Illinois Downers Grove-based Advocate Health Care has announced that it will partner with Blue Cross and Blue Shield of Illinois to launch Blue Care Direct, a new plan based around Advocate’s high-performing provider network.  

Notably, Advocate’s plan will be available on the public exchange. This is not an unusual approach – a significant portion of the activity in this dynamic space has been focused on the public exchanges, with over a third of products tracked by Oliver Wyman made available on state and federally facilitated exchanges.

The overall trends confirm our earlier research where we found that these novel responses to the shift to value-based care have the potential to address many of the core concerns with narrow networks, while delivering greater value, presenting a win-win-win for the payer-provider-consumer.

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