Transforming a payer-provider relationship from conflict to collaboration.
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.
Chavanu
Kathleen
K
Children's National Medical Center, Washington, DC, USA. Kchavanu@cnmc.org
Newman
Kurt
K
Fried
William
W
Daymont
Mary
M
Slonim
Anthony
A
Koza
Edward
E
Pastor
William
W
Robinson
Nellie C
NC
Holbrook
Peter
P
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