Providers are crucial to achieving the admired “triple aim” objectives of improving care, improving the health of populations and reducing the per capita costs of health care. Health plans, acting as a coordinating hub between providers and patients, can advance the progress of better population health management by ensuring that accurate, timely and actionable health data is made available to providers.

Payers can increase provider population health management effectiveness by using these best practices:

Fostering Data Integration: This is a fundamental step of evidence-based cost-effective care. Leading health plans have an enterprise-wide digital transformation strategy centered on comprehensive provider and patient data. By making curated and enriched EHR, claims data and patient-reported information accessible, in real time, to hospitals and other providers, health insurance companies can streamline the care delivery process.

Facilitating Care Coordination: Coordinating care among multiple providers is often challenging, particularly with patients with multiple comorbidities. Health plans, through data-driven care management informatics, can strengthen collaboration among healthcare providers by providing accessible, on-demand patient outcome and clinical quality reporting.

Patient Engagement: Helping members navigate their health plan benefits and patient care journey is essential. A recent 2023 Harris Poll on the patient experience indicates that managing and coordinating care can be challenging for many members. By providing members with digital, mobile and other patient-facing tools, health plans can better inform and empower patients.