Agility is an essential part of responding to a crisis like COVID-19. Without it, shifting care delivery to meet the needs of patients will be difficult to impossible. The best way for payers to achieve agility is by controlling the primary care system. With dedicated primary care, quick pivots and adjustments to care delivery become possible in a fraction of the time required in a typical health system.
Agility requires alignment
Agility is impossible without alignment. Payers, health systems, and providers typically all have competing goals. Any change in care delivery requires negotiations and compromise, with the patient often being lost in the shuffle.
If a payer controls primary care, they can easily build a care delivery model and payment structure aligned around outcomes rather than procedure reimbursement.
Once goals and incentives are aligned, quick pivots to meet emergent needs that safeguard population health are possible. No stakeholders with different priorities. No competing goals from other payers.
COVID-19 exposed systemic weakness
When case counts skyrocketed in early March, most payers had no control over the health system delivering care to their members.
But payers that had already invested in dedicated primary care delivery were able to make immediate changes on the front lines. They could do this because payers, providers, and financial models were all aligned around achieving positive health outcomes, not procedure reimbursement. They were able to pivot, meet the immediate needs of people needing treatment, and adjust their operations to continue serving the rest of their population as well — those who needed care but who weren’t a threat to spread the virus.
Shifting from a reactive to a proactive approach to population health management
Even when there isn’t a crisis, dedicated primary care helps payers tailor delivery to the needs of specific member panels using analytics and claims data. And, they can iterate the care delivery model as the needs of the population changes.