As payment reform takes shape, the accountable care market is rapidly evolving. For commercial payers, that means grabbing a bigger piece of the pie, according to new research from KLAS. The report found that although Medicare has led the charge, payers are now very much in the mix, grabbing more than half of accountable care agreements.
Cigna has the largest footprint with 66, followed by Aetna (27), UnitedHealth (15), and Humana (5), with each payer taking a different approach to customer care. According to KLAS, Cigna provides the most hand-holding by retaining analytics and guiding local care coordinators with tactical reports, while Aetna and UnitedHealth offer tools and consulting geared to make providers self-sufficient. Humana falls in the middle, expanding cooperation in longtime relationships but headed down the transformation path.
“Payers and providers have come at this from different angles, but with some effort, they are deepening their relationships and building partnerships that may be the guidepost for others to follow,” said report author Mark Allphin.
To improve their products, a number of payers have acquired HIT vendors with solutions helpful for population health management, KLAS found, with Aetna and UnitedHealth combining their acquisitions into separate technology-related business units (Healthagen and Optum, respectively).
The report also offers recommendations from providers, such as approaching negotiations with well-defined objectives and putting expectations in writing.
For more information, visit www.KLASresearch.com/reports.