Survey Points to Payer, Provider Differences In Health Data Strategies, But Also Much Common Ground

Results from a new healthcare industry survey suggest that while payers and providers are somewhat at odds when it comes to data management, their strategies still have much in common.

The survey in question was sponsored by Change Healthcare and the HealthCare Executive Group conducted by InsightDynamo. It draws on responses from 445 healthcare leaders across payer, provider and third-party vendor organizations and was conducted in late 2019,

Broadly speaking, payers and provider respondents have found common ground in several areas, including the need to address Social Determinants of Health, consumerism in healthcare and the potential for AI and machine learning to transform the industry.

Both payers and providers reported that smart AI technologies are improving operations and health system efficiency (payers 38%, providers 56%) and reducing costs (payers 28%, providers 42%). Both sides also agreed that AI and machine learning are having an impact on consumer engagement, with roughly a third of both groups (payers 36%, providers 39%) saying that seeing tangible results working with these technologies.

While neither providers nor payers reported having implemented a “full consumer-centric strategy,” they seem to be at similar stages in cultivating such a strategy. While just 24% of payers and 18% of providers reported having rolled out consumer-centric programs, both seem to be preparing to launch such efforts, with 100% of payers having already created such a strategy or working on one.

Thirty-four percent of providers and 43% of payers called their consumer-related strategies “nascent,” while 33% of payers and 36% of providers characterized their efforts as being at an “intermediate” stage.

On the other hand, payers and providers seem to have different views as to what will foster healthcare interoperability. For example, while roughly one-fifth of providers said that consumer demand is driving interoperability, just 11% of payers agreed. Meanwhile, 36% of payer respondents said regulatory change will fuel interoperability compared with 20% of providers. Only scant numbers (payers 2%, providers 18%) think that physician-driven initiatives will make interoperability happen.

Meanwhile, not too surprisingly payers are much further down the path toward value-based care than providers. While 62% of payers said their organizations were using alternative payment models, and 9% full capitation, 43% of providers were involved in alternative payment schemes and 2% working under full capitation contracts.

Also, contrary to what one might assume given their deep pockets, 25% of payers reported that IT infrastructure was an important barrier to implementing value-based care, as opposed to 8% of providers. This is consistent with the results of a study released in mid-2019 which found that health plans need to build out their technical and administrative infrastructure to succeed in the Medicare space.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.