Payers

Important transformations are occurring in the healthcare payer space. While numerous, these transformations can best be summarized by the fact that a major shift has taken place in the critical role of payers in the overall healthcare system. This shift is from the payer playing predominately the role of "transaction manager" to one of becoming a true healthcare "informediary" for the purpose of partnering in care delivery to improve health outcomes. HIMSS builds on its extensive educational resources and expertise in key healthcare information technology issues to support the payer community as it works toward the goal of improving health outcomes and quality care in a cost-effective manner through leveraging health information and health IT.

An emerging focus in the payer community is on the concept of sharing risk and reward in partnership to improve patient care and outcomes as envisioned through accountable care organizations. Whether through systems such as medical homes or accountable care organizations, the private payer sector has begun to partner with providers to create various health IT-enabled ‘collaborative’ programs to deliver improved care, quality, and value.

 

HIMSS Presentations and Discussions

Patient-Centered Payer Roundtable: Medicare Shared Savings Program and ACOs: Overview of the Proposed Rule and HIMSS’ Response Process
Speaker: Shelley Price, MS, FHIMSS, Director, Payer and Life Sciences, HIMSS
Session recording
April 21, 2011

HIMSS11 Payer Networking Breakfast: Conversation — Medical homes, ACOs and Payers
This presentation provides background and a focus on the emerging topic of Accountable Care Organizations (ACOs) and the dramatic implications they may have on increasing the quality of care through a cost-conscious functionality.
Speaker: Matt Adamson, VP, Health Solutions, MEDecision
February 22, 2011

Patient-Centered Payer Roundtable: Accountable Care Organizations “Payers and Providers Working toward Success”
This presentation provides a platform for a dialogue on what providers expect verses what providers would want from payers in an ACO relationship.
Speaker: Wes Rishel, Vice President and Distinguished Analyst, Gartner
February 23, 2011

Patient-Centered Payer Roundtable: Health IT-Enabled Medical Home
Speaker: Martin Lustick, MD, Excellus BlueCross BlueShield
Session recording  
December 16, 2010

Patient-Centered Payer Roundtable: Accountable Care Organization: Overview and ACO Pilots
Speaker: Antonio P. Linares, M.D., Anthem Comprehensive Health Solutions
Session recording
November 18, 2010

Exploring How to Get More for the Healthcare Dollar: Leveraging Value-based Insurance Design AND Purchasing Strategies Using IT Tools
The event showcased how payers are leveraging health IT in Value-based Insurance Design to gain efficiencies in health care while improving quality and delivering clinical benefit to the patient.
July 14, 2010

 

Get Involved

The HIMSS Patient-Centered Payer Roundtable
With the mission of supporting the payer community as it works toward the goal of improving individual patient care, quality, and outcomes in a cost-effective manner by fostering collaboration and trust between providers, payers, and health IT vendors though the development of interoperable health IT, the HIMSS Patient-Centered Payer Roundtable is a forum that directly links important health IT stakeholders and the payer community. Alignment between health IT and payers has become a strategic necessity for both sectors. Through the Roundtable, leaders from the payer, provider and health IT sectors engage in candid cross-industry dialogue, better integrating the activities and direction of each, and driving the transformation of healthcare through IT. The Roundtable engages on relevant issues with industry experts, and shares learning experiences and case studies. Continuing activities will include efforts that incorporate the payer perspective into HIMSS’ policy recommendations and activities, and the creation of practical resources (e.g. toolkits and white papers) that will help guide industry stakeholders toward making health it investments that will improve individual patient care, outcomes, and quality.

For more information on the HIMSS Patient-Centered Payer Roundtable, contact Shelley Price, MS, FHIMSS, Director of Payer and Life Sciences, at sprice@himss.org
 


For additional news on this and other payer topics, please visit
Healthcare Payer News, which provides original news reports relevant to healthcare insurance executives and other professionals, covering the areas of IT, finance and policy surrounding the current landscape of regulated reimbursements.