Strategic Payer and Provider Partnerships Post-COVID-19

Achieving Financial Alignment With Fee-for-Value Models

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While the first wave of COVID-19 had an immediate economic impact on hospitals and health systems (and waves two and three are poised to increase those financial pressures), payers will face a further delayed, but also unavoidable financial effect. Moving forward, both entities will need to consider partnership models to financially align on sophisticated strategies to achieve success in a post-COVID-19 reality.

The sharp decrease in the utilization of services and resulting financial disruption reveals the risk of relying on FFS as an organization’s primary book of business.

Although the vaccine is optimistic for patient outcomes, it won’t resolve the reliance on FFS and the economic problems it created. With both sides needing to find stability, especially as winter poses further pandemic and therefore economic challenges, the opportunity for risk-based payer-provider partnerships is ripe.

Capitalizing on the trends that have been catalyzed by the pandemic and forming partnerships that are based on a fee-for-value (FFV), rather than a FFS model, can lead to financial integration, stability, and success.

Creating strong payer and provider partnerships is critical for future financial success.

When strategically aligned, FFV payer-provider partnerships enable both entities to weather not only major disturbances in medical utilization, but also work proactively to reduce the growing medical expenditures that continue to consume the healthcare system.

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