In this episode of the Oliver Wyman Health Podcast, we discuss how providers and insurers should approach partnerships.
Patient voices, not just EHRs alone, provide valuable health information. Patients benefit when providers tune into people first, and technology second.
Transform Care
December 01, 2016
Video: How to Build a Successful Payer-Provider Partnership
Oscar CEO Mario Schlosser and Mount Sinai’s EVP Niyum Gandhi discuss what brought the two organizations together and how this payer-provider partnership is different.
A lot of health systems are talking about shifting from volume to value and the importance of population health. But many are getting stuck betwixt and between. The transformation carries major financial risk and is an organizationally complex undertaking. That’s why a recent ad in the New York Times Magazine by the Mount Sinai Health System got noticed for its simple declarative vision: “If our beds are filled, it means we’ve failed.”
Oliver Wyman’s latest ACO Update report found that almost 70 percent of Americans now have access to accountable care organizations. The next step in the evolution of the model, says report author Niyum Gandhi, are program reforms that allow the best ACOs to invest in expanding.
Healthcare providers pursuing the transformation to value face potentially high risks to financial sustainability. For many hospitals and health systems, questions are quickly arising around fluctuating volume trends and revenue projections as the market shifts to population health.
Earlier this week, the Centers for Medicare & Medicaid Services announced that it will be expanding its existing portfolio of Accountable Care Organization programs to include the “Next Generation ACO Model,” designed for providers experienced in coordinating care for patient populations. Oliver Wyman’s Craig Samitt and Niyum Gandhi draw from their work designing value-based systems around the country to highlight key updates.
Maximize Value
January 28, 2015
ACO Buzz: HHS Pushes Providers to Tipping Point on Value
Monday’s announcement by the Department of Health and Human Services that it plans to move 30 percent of Medicare payments into alternative payment models by the end of 2016 and 50 percent by the end of 2018 has put providers on notice.
This latest installment in our ACO Buzz series is contributed by Oliver Wyman Partner Niyum Gandhi, who has worked on more than 20 healthcare transformation projects. Among them, he helped a Blue Cross Blue Shield create its strategy for accountable care organizations and recently guided a large physician group in a renegotiation of its contracts to align financial incentives with patient interests before redesigning its care delivery models.
