title: Transforming a payer-provider relationship from conflict to collaboration.
abstract: The current relationship between payers and providers is often adversarial. The growth of managed care has fostered very little cooperation between the payer and provider, even though both are working toward improved patient outcomes. This article describes the process by which a payer and provider were able to transform a contentious relationship into a collaborative patient-centered program. The program demonstrates that through the sharing of retrospective utilization data, improved clinical and financial outcomes can be achieved.
authors.affiliation: Children's National Medical Center, Washington, DC, USA. Kchavanu@cnmc.org
authors.forename: Kathleen
authors.initials: K
authors.lastname: Chavanu
authors.forename: Kurt
authors.initials: K
authors.lastname: Newman
authors.forename: William
authors.initials: W
authors.lastname: Fried
authors.forename: Mary
authors.initials: M
authors.lastname: Daymont
authors.forename: Anthony
authors.initials: A
authors.lastname: Slonim
authors.forename: Edward
authors.initials: E
authors.lastname: Koza
authors.forename: William
authors.initials: W
authors.lastname: Pastor
authors.forename: Nellie C
authors.initials: NC
authors.lastname: Robinson
authors.forename: Peter
authors.initials: P
authors.lastname: Holbrook
mesh_terms: D003299:Cooperative Behavior; D004219:District of Columbia; D006776:Hospitals, Pediatric; D006801:Humans; D007349:Insurance, Health, Reimbursement; D019982:Organizational Case Studies; D011787:Quality of Health Care / Q000458:organization & administration