Innovation and value: What payer-led managed-care models may look like

Innovation and value: What payer-led managed-care models may look like

While traditional levers (for example, utilization management or provider networking and contracting) can support these goals, a more direct role in care delivery can allow payers to unlock better health outcomes, experience, and affordability for members. M&A, strategic partnerships, and affiliations between payers, providers, and technology companies have continued as payers seek to expand their role in reimaging care models. In these models, payers take a substantially more active role in the health and healthcare of their members through one of three approaches: provider enablement via a management-services organization (MSO) or other services organization, a platform-based ecosystem convener, or direct ownership of care-delivery assets.


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