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

June 29, 2017
by Heather Landi
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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.”

 

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