Better Communication Tools Needed to Support Payer-Provider Collaboration, Survey Finds | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Better Communication Tools Needed to Support Payer-Provider Collaboration, Survey Finds

June 29, 2017
by Heather Landi
| Reprints

Online and multi-payer portals are viewed as promising solutions to improve communications between payers and providers while also mitigating costs, yet these tools are underutilized. While 60 percent of payers prefer the use of online portals as the primary means of communication with providers, it seems providers are less enthusiastic, as only 39 percent of practice-based providers and 40 percent of facility-based providers strongly support online portals as a primary source, according to a survey by Availity.

The survey conducted by Availity, a healthcare information technology company, found that while payers and providers want to collaborate more closely on value-based care initiatives, such partnerships remain vulnerable to poor data transparency, competing business goals, and significant administrative burdens.

The survey, which included responses from 40 health plans and more than 400 practice- and facility-based providers, indicates that a majority of all groups believes that improved collaboration will lead to greater profitability. However, many of the same data-sharing and administrative issues endemic to fee-based healthcare are present in value-based initiatives.

With regard to communication, almost all providers consider the phone to be the primary communication vehicle with payers, while a smaller percentage of payers agree. multi-plan portal was preferred by 35 percent of practice-based providers and 42 percent of facilities-based providers.

All respondents agree that any proposed solution must be easy to use, a good value, and reduce staff time.

A solid majority across all groups (an average of 76 percent) viewed administrative waste as a significant contributor to ongoing communication problems. Among the top issues for providers were redundant information requests, denied claims, and inconsistent rules. 

“Providers communicate, on average, with 17 to 20 payers a week, so the problems associated with administrative waste can have an amplifying effect,” Brian Kagel, Availity’s director of market research, said in a statement. “Often, representatives from multiple payer units will unknowingly contact a provider seeking the same information, leading to provider abrasion. Until providers and payers can address this challenge, it may be difficult to accurately measure value-based outcomes.”

As for collaborative opportunities, patient/member satisfaction was viewed as a significant priority for a majority of payers and providers. There was consensus among all surveyed groups that in the age of high-deductible health plans patients need to better understand their benefit information and financial obligations. Fifty-one percent of practice-based providers and 61% of facility-based providers consider patient communication—specifically in regard to understanding benefits and financial responsibilities—to be a challenge.

“Trust is essential to building a successful payer-provider relationship. When both parties come to the table with an open mind, and a common platform, they can focus on creating alignment in several key areas,” said Jeff Chester, Senior Vice President and Chief Revenue Officer of Availity. “Establishing a transparent and collaborative relationship between payers and providers will ease costly and inefficient burdens for both stakeholders and foster the rich, actionable information to ensure that value is achieved throughout the continuum of care.”


Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More



Dignity Health, UCSF Health Partner to Improve the Digital Patient Experience

Dignity Health and UCSF Health are collaborating to develop a digital engagement platform that officials believe will provide information and access to patients when and where they need it as they navigate primary and preventive care, as well as more acute or specialty care.

Report: Digital Health VC Funding Surges to Record $4.9 Billion in 2018

Global venture capital funding for digital health companies in the first half of 2018 was 22 percent higher year-over-year (YoY) with a record $4.9 billion raised in 383 deals compared to the $4 billion in 359 deals in the same time period last year, according to Mercom Capital Group’s latest report.

ONC Roundup: Senior Leadership Changes Spark Questions

The Office of the National Coordinator for Health IT (ONC) has continued to experience changes within its upper leadership, leading some folks to again ponder what the health IT agency’s role will be moving forward.

Media Report: Walmart Hires Former Humana Executive to Run Health Unit

Reigniting speculation that Walmart and insurer Humana are exploring ways to forge a closer partnership, Walmart Inc. has hired a Humana veteran to run its health care business, according to a report from Bloomberg.

Value-Based Care Shift Has Halted, Study Finds

A new study of 451 physicians and health plan executives suggests that progress toward value-based care has stalled. In fact, it may have even taken a step backward over the past year, the research revealed.

Study: EHRs Tied with Lower Hospital Mortality, But Only After Systems Have Matured

Over the past decade, there has been significant national investment in electronic health record (EHR) systems at U.S. hospitals, which was expected to result in improved quality and efficiency of care. However, evidence linking EHR adoption to better care is mixed, according to medical researchers.