Healthcare organizations meet at the third Annual Integrated Provider Management Symposium

More than 28 healthcare organizations were represented at the third Annual Integrated Provider Management (IPM) Symposium, hosted by Portico Systems. The focus of the event was how health plans are preparing for industry changes in terms of access, quality and payment reform. In line with this theme, leading health plan organizations demonstrated their thought and organizational leadership by presenting case study topics on Agile Network Management, Value Based Reimbursement, Lean Provider Administration, Member and Provider Transparency and Medical Home Collaboration.

The healthcare industry, and specifically health plans, is implementing strategies to deliver increased value to members, provider and employers. Value is now based on the health plan’s ability to create targeted products for its members based on provider networks that take into account provider performance and quality care.

“In today’s highly competitive environment, there is a competition for revenue and it is based on the customer segmentation, product innovation, competitive benefit structure and network design,” stated Sam Muppalla, COO, Portico Systems. “The network essentially becomes the product differentiator and a plan’s number one asset.”

In support of the symposium theme, the following trends in health plan investment behavior were identified through surveys and attendee interviews:

• 75% of the health plan attendees indicated that provider reimbursement and network access will be affected by industry reform changes
• 62% of the health plan attendees indicated further investment in provider management and care management solutions for 2010
• 60% of the health plan attendees indicated they are adopting a strategy of decoupling their provider management systems from their claims systems

“Shifts in healthcare industry trends, mounting pressures from the government and increased employer pressures are driving changes in health plans’ technology investment behavior,” stated Mike Flanagan, VP of Product Management and Marketing, Portico Systems. “We’re seeing an increased interest in the importance of modernizing provider management systems in an effort to respond to the changes that are currently within the healthcare industry and also to be better prepared for potential changes in the future. The survey evidence supports what we’ve always believed: Integrated Provider Management is a key enabler to improved access, cost and quality.”