KLAS Insights Episode 8 – Round Table Discussion, Gaps Between Healthcare Providers and Payer Organizations
KLAS Insights18 Touko 2022

KLAS Insights Episode 8 – Round Table Discussion, Gaps Between Healthcare Providers and Payer Organizations

Boyd Stewart, Joe Van De Graaff and Ryan Pretnik speak with Justin on the current standing of the gaps that exist between healthcare providers and payer organizations, and obstacles to overcome. Boyd addresses some of the friction in the past, this includes lack of communication, trust, and technology. However, he mentions that there has been progress and touches on the Points of Light report that came out in April, the report is comprised of several case studies and summarizes the types of challenges tackled and outcomes achieved. Joe speaks on the core payer admin platform and how technology in that space has been termed as old and stagnant, but this is starting to change. He explains how the core systems enroll members, pay claims, and help manage benefits. Ryan brings up how risk adjustment is heavy not only in the payer space now but also starting to move to the provider end. He explains how value-based care contracts are fueling providers to keep an eye on their patients, making sure they are healthy because in the end that will help with the quality of care for those patients.

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