1. John Bulger, DO, CMO of Geisinger Health Plan, on the future of the payer-provider relationship: “That relationship has to be as close as it can be. We try not to have an adversarial relationship where providers are saying to health plans, ‘Mother may I?’ but be proactive and say, ‘Hey, let’s come up with guidelines of when we should do things and when we should not do things upfront.’ … Kaiser is maybe the poster child example, but they’re almost fully integrated. I think you’re going to see more and more of that. How do providers and payers work closely together, realizing all of us aren’t going to become Kaiser?”
2. Andrea Gelzer, MD, senior vice president of medical affairs for the AmeriHealth Caritas Family of Companies, on the payer-provider relationship: “There has been a lot of consolidation in the industry, and I’m sure we’ll have some more of that. To succeed, providers need data in a timely manner. We provide online resources and every month update those resources so that providers are able to manage the contracts with them. I see us continuing our partnership and collaboration and becoming ever closer.”
3. James Napoli, MD, CMO of Blue Cross Blue Shield of Arizona, on what excites him about his role: “I am most excited about how my team and I will be working to transform care delivery in our marketplace by continuously improving the consumer experience, achieving even higher standards in patient outcomes, and enhancing the value of the product and services Blue Cross Blue Shield of Arizona offers. In this role, I’ll also have the ability to be more connected to our provider community to gather provider feedback and ensure that we are truly aligned with providers and are collectively working together to improve healthcare for all Arizonans.” [Read the full interview here.]
4. Douglas Nemecek, MD, CMO of behavioral health at Cigna, on working with providers: “We take that partnership with the physician very seriously. We think that’s the key to truly helping our customers get the optimal health outcomes, as well as making healthcare as affordable as it needs to be for everybody. We’re really working hard to build those relationships and identify how we can best support our physician partners in all our communities.”
5. William Shrank, MD, CMO of Humana, on the insurer’s physician strategy: “The large payers — at least the three of us focused heavily on Medicare Advantage — are blurring the lines between payer and provider. We’re thinking more holistically about how we manage a population rather than figuring out how to pay claims. We are all taking a little bit of a different tactic. Ours is focused on the home, on meeting patients where they are. United is going to buy more and more primary care docs, and CVS is doing more in the retail space. We think the future of healthcare is going to be in the home.” [View the full interview here.]
More articles on payers:
UnitedHealth records $3.3B profit in Q2
New York insurer opens office in hospital
BCBS of Minnesota defends restrictive policies that hospitals call unlawful
