By now, most health systems are familiar with the term payvider, and many are weighing the pros and cons of initiating their own payvider solution. The critical tipping point to act may well be here today, as health systems feel increased pressure to make greater financial and strategic impact for their organizations even as conditions make such growth tenuous. Fortunately, technology, regulations, and market dynamics have turned a corner and are now favoring those health systems looking to address their goals by becoming both payor and provider (“payvider”).
This white paper looks at why a health system should be motivated to become a payvider at this pivotal time. The paper examines the factors important to health systems, including financial viability and stability, the potential to capture market share, and improving the payor mix, adding diversified revenue, and driving care transformation. While economics and healthcare market forces have stimulated the need for innovations such as the payvider solution, the article reveals how the emergence of advanced data and analytics has now made it viable. With health systems facing relentless pressures and a more imminent need for change—combined with favorable forces of evolving technology, regulations, and market dynamics—the stars are aligning for the payvider solution, and the timing is now optimal for health systems to get on board (and waiting too long could be detrimental). The paper also introduces how and where a health system can best start its own payvider solution.
This white paper presents the critical factors that impact a health system’s choice to launch their own payvider solution and introduces ways they might:
Capitalize on optimal timing to carve out their role as both payor and provider
Leverage advanced data and analytics to make better-informed provider- and payor-side decisions
Establish greater control of their health system’s destiny
Build strong bonds with self-funded employer groups
Capture market share and improve their payor mix
Add diversified revenue
Drive significant cost savings for their own employee health plan
