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Temos Alliance: payer – provider relationship

Temos Alliance: payer – provider relationship

Temos Alliance: payer – provider relationship

Comment by Ms Laila AlJassmi, Founder & CEO of Health Beyond Borders, Temos Regional Director UAE.

Payers and providers in the past have faced a lot of challenges due to competition, unsustainable financial losses and risk management. Therefore, to build a successful relationship we need to transition the operational and care delivery from volume-based to value-based payment models; by taking on risk for clinical outcomes, building population health management capabilities and moving from a “consolidated practice” to a “clinically integrated” practice. Both payers and providers need to be transparent about their data and share information. We need to enhance the payment for performance (P4P) in order to increase the quality of care given and raise the standards of health care among the care giver.

Transparency in healthcare is unique. Providers need to be able to give consumers enough information to make an educated decision of where to go for care. Payers need to be accountable for the care they provide for their consumer. However, there will always be a challenge that we will face when it comes to patient referral analysis – where patients should be referred for the best outcome? and under-/overutilization of care but we should be proactive in our approach and trust each other.

Photo: Laila AlJassmi

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