New role for payers: Drive docs, patients together


The switch from volume to value-based care will thrust insurers into the role of intermediary between the physician and the patient. The new role will require insurers to offer support resources and information to strengthen the patient-provider relationship, Cigna's North Texas and Oklahoma President LaMonte Thomas said in an interview with D Healthcare Daily.

"[T]he role that we'll play is conveners: Conveners of the stakeholders as we continue to evolve and continue to grow and adjust as we learn more amid technology changes," he said.

Bloomfield, Connecticut-based Cigna will provide more coaching, management and medical management services to help employers drive workers closer to the physician. It also will provide embedded care coordinators or the funds needed to hire embedded care coordinators.

Advancements in health technology also have reinforced this new role for payers, which must provide physicians and patients with more--and better--data to enable better outcomes and lower costs.

"We had to get that information into the hands of the individuals so they could, as consumers, understand transparency, but more importantly get it into the hands of the physicians so they knew what was happening to individuals once they left their office," Thomas told D Healthcare Daily.

Payers as we know them may not exist a decade from now but they can play a role in the nexus of information and care, according to WellPoint Chief Medical Officer Samuel Nussbaum, M.D. Payers need to fill the gap in providers' ability to manage population health, have the necessary data analytics and coordinate comprehensive care, he said last week at the ACO Summit in the District of Columbia.

Blue Cross Blue Shield of Minnesota's CEO already has begun transforming its operations, with a close eye on the consumer. Minnesota Blues' staff and healthcare providers seek to remove barriers to care with pilot programs and provider partnerships.

For more:
- read the interview

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