Organizations working toward payer-provider alignment do not necessarily have to lead with the financial angle, Sioux Falls, S.D.-based Sanford Health’s COO, Matt Hocks, said.
Mr. Hocks recently assumed responsibility for Sanford and Security Health Plans. In a recent interview with Becker’s, he shared takeaways on achieving payer-provider alignment from his experience at an integrated health system.
“Rather than just thinking about it from a financial relationship, it’s really taking the finances off the table for now and coming in and saying, ‘How do we organize around the patient, and what are we learning from that? And then how do we share that?'” Mr. Hocks said.
A key part of Sanford’s strategy in doing so: prediction and prevention, especially for chronic conditions. Sanford’s enterprise data and analytics team previously worked on prioritizing who should access COVID vaccines. Now, the team is focused on chronic diseases, which can be expensive to mitigate.
“The prediction and prevention arm of a combined health plan and healthcare delivery system … is going to be paramount for our success, regardless of what the reimbursement models look like in the future,” Mr. Hocks said.
While an integrated health system is nothing new, vertical integration has been picking up steam more broadly across the insurance landscape. That also signals a heightened obligation.
“When you provide the full spectrum of care … you have to provide the continuum to all patients, and I think that keeps you honest in those relationships,” he said.
