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Guidehouse identified markets where payvider models are best positioned to disrupt incumbent hospitals, health systems, and health plans. The analysis is based on projected growth in health plan membership under capitated payment arrangements, relative to current utilization, cost, and quality performance. It details the extent to which market opportunities for payvider partnerships with upside growth potential exist.
The report also lays out strategies for building successful payvider business models, including how to strategically, financially, and operationally align scorecards to put members first, as well as the capabilities needed to initiate successful negotiations, member enrollment, and point of care transitions, payment, and coordination.
Guidehouse is a global consultancy providing advisory, digital, and managed services to the commercial and public sectors. Purpose-built to serve the national security, financial services, healthcare, energy, and infrastructure industries, the firm collaborates with leaders to outwit complexity and achieve transformational changes that meaningfully shape the future.