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Top payor-provider trends to be on the lookout for in 2021

In late 2020, Healthcare Dive laid out a few key trends they expected to play out with insurers and providers this year. Now that we’re several weeks into 2021, we wanted to see if those trends are taking shape as predicted—specifically the two surrounding VBC and health inequity.

If we had to use one word to describe 2020, it would be “change,” and that’s particularly true in healthcare. Now that we’re several weeks into the new year (that was fast!), we thought it would be interesting to investigate how and to what degree this theme has carried over into 2021. We took our cue from Healthcare Dive, which published an article at the end of 2020 predicting the key trends to expect from insurers and providers this year. Check out the article for a close look at all four—we found the two trends related to value-based care (VBC) and health inequity most interesting and share our POV on them here.

Value-based care
Healthcare Dive predicted that there would be more partnerships between health insurers and providers in 2021, especially related to VBC. If 2020 proved anything, it’s that the various stakeholders in the healthcare industry have to work together to effect positive change. And many providers have voiced a desire to partner with health insurers on VBC and care delivery in general. The question is…do health insurers want these partnerships?

The first few weeks of 2021 make us think they don’t. After all, they would have to have working relationships with providers to be able to partner on such initiatives, right? With the number of abrupt contract terminations happening already this year, collaboration isn’t exactly the word that comes to mind in describing the tone that payors are setting. Just look at UnitedHealthcare—the biggest insurer on the block started the year by cutting two major provider groups from its network, Envision and Montefiore, making it nearly impossible for either to partner on any initiative, much less VBC (something that requires an insurer and a provider).

Health equity
Another trend identified by Healthcare Dive was the expectation that key stakeholders in the system (insurers and providers specifically) would work together to tackle health inequities. But just look at the situation with Montefiore, a critical New York safety net hospital. By forcing Montefiore out of its network, the insurer is actually contributing to health inequities in the Bronx, limiting access to care for some of the city’s most vulnerable patients—and in a global health crisis none the less.

Of course, these two trends don’t comprise the complete picture of provider-payor relations in 2021, but from where we sit, they are telling. At least on the surface, it seems like insurers are continuing to sing to their own tune this year—and not only is that not great for providers, it’s pretty terrible for patients too.

Original Article:

The COVID-19 crisis has led some providers to inquire about partnering or acquiring insurance assets as the pandemic exposed the risk of relying on fee-for-service models.

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