How Working Together Elevates Health Outcomes
While contracting for outcomes with advanced value-based care models is vital to help improve health outcomes, it isn’t enough to truly improve the whole health of our communities. We need to go beyond contractual agreements with our care provider partners to make a real impact on health, together.
This means:
- Becoming exceptional business partners by advancing data connectivity, automating processes, accelerating claims processing, and reducing administrative tasks.
- Becoming exceptional clinical partners by developing leading digital programs, offering direct clinical support, sharing more actionable data, and supporting patient access to care.
Becoming Exceptional Business Partners
Contributing experts: Tich Changamire, MD, and Beth Weis
By using digital solutions to streamline interactions, from contracting to payment, we’re creating a pathway for collaborative partnerships with care providers and better health outcomes for the people we both serve.
Our Provider Success Team Partners With Care Providers for Better Quality Outcomes
Care providers, by the nature of their profession, are inherently driven to deliver the best care possible for their patients. To help achieve optimal outcomes, payers and care providers have developed collaborative partnerships, such as value-based payment models, that recognize and reward high-quality care, better outcomes, and positive patient experiences.
One way we collaborate directly with care provider teams is through our Provider Success Team.
Administrative Tasks Made Easier With Digital Support
Physicians, clinicians, and care support teams spend considerable time collecting and tracking patient health plan information, verifying benefits, and handling pre-service authorizations and payments. These tasks add significant administrative burdens, especially when they involve manual, paper-based processes or phone calls. Enhancing digital capabilities reduces these tasks, enabling care providers to concentrate more on patient needs and priorities.
How Responsible Artificial Intelligence Could Simplify Healthcare
Artificial intelligence (AI) has the potential to simplify healthcare for consumers, care providers, and payers, while streamlining evidence-based, high-quality care. This is an exciting opportunity to enhance the care experience for providers and the 112 million people we serve as an enterprise.1
Becoming Exceptional Clinical Partners
Contributing experts: Adrienne McFadden, MD, JD, and Jeff Plante
By collaborating with care providers and sharing resources and expertise, we can advance whole health together. To that end, we continue to develop strategies and programs to make us better clinical partners.
Advancing the Conversation
The goal of our work together is to provide robust wraparound services to patients and clinicians in order to support both joy of work for our clinicians and excellent health outcomes for patients.
Primary Care Physician, Associate Professor in General Internal Medicine, Associate Chief Population Health Officer, Yale School of Medicine, Connecticut
How Streamlined Data Leads to a More Seamless Healthcare Experience
Building a reliable, secure digital platform is vital to creating exceptional experiences for care providers and their patients. To enhance efficiency and streamline care provider workflows, we’re focused on sharing data, aligning care management, and offering automated solutions — from prior authorizations to roster updates and claims processing.
Health OS, our digital interoperability platform, connects care providers, payers, and consumers to reduce administrative tasks and drive improved health outcomes.
How Simplifying Prior Authorization Protects Patient Safety, Controls Costs
Prior authorizations help ensure people receive the right care safely, at the right time, and in the right setting.
Most of the prior authorization requests we receive come via phone, fax, or paper. We have invested in digital solutions that enable and encourage care providers to use real-time prior authorization submission and workflow services.
Maternal Care Outcomes Improved by Elevance Health Programs and Partnerships
Elevance Health’s affiliated health plans support 1 in 8 babies born in the U.S.2 This presents a significant opportunity to work with care providers to improve the lives of their pregnant patients.
To positively influence maternal care outcomes, reduce gaps in care, and lower costs, we've developed new programs in all lines of business and expanded partnerships with virtual care providers.
Better Health Through Active Partnerships
In collaboration with care providers, we’re dedicated to making a real impact on health. To honor their outstanding patient care, our health plan affiliates launched the Care Provider Recognition Program in fall 2024.
This annual program recognizes care providers who deliver excellence in care to their Medicare patients, our affiliates’ members — which makes it uniquely centered on patient outcomes.
Award winners represent the top 5% of care providers, based on quality measured through internal performance data for Medicare Advantage members. They’re in-network with an affiliated health plan and have contracts in good standing.
See the inaugural winners at elevancehealth.com.
Driving toward better health outcomes is a critical shared goal with our care provider partners, and results like these are worthy of the spotlight.
Supporting Care Providers
Discover how being active partners that go beyond the contract can have a real impact on health. By working closely together with our care provider partners, we can make a meaningful difference.
Committing to Whole Health
Together with care providers, we’re working to address people’s physical, behavioral, and social needs — and improve healthcare quality, outcomes, and experience.
Contracting for Outcomes
Value-based care arrangements aim to enhance preventive care, reward quality outcomes, promote evidence-based practices, and improve patient experiences within the care system.
Connecting for Health
The right tools and solutions can connect the dots between care providers, health plans, employer groups, and consumers to deliver whole health more affordably.
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1 Elevance Health, internal data, Medallia Voice of the Customer Survey Data ’23 and ’24 (2023 and 2024).
2 Elevance Health, internal data, Availity 360 (2023 and 2024).