Insights

A Managed Medicaid and Medicare Advantage Plan Transforms and Strengthens Its Provider Relationships

Large, multi-state health plan engages T2C to improve collaboration with its largest provider groups.

Background:

A managed Medicaid and Medicare Advantage plan engaged T2C to transform and strengthen its provider relationships to ultimately improve the quality of care delivered to its 170,000 members. The client desired a strategy to transform relationships with the provider community and hoped to determine the operational and technology changes necessary to achieve the strategy.

Challenges:

The client and its largest provider groups wanted to facilitate stronger collaboration and communication. T2C worked with the client to facilitate forums around care quality improvement, administration and quality ratings. These “strategy summits” allowed both plan and provider to drive strategy development.

Solution:

T2C worked with the client to conduct executive interviews, cataloging initiatives across care coordination, technology and data sharing. The organized “strategy summits” between the health plan and its largest provider groups facilitated creation of a roadmap to guide provider integration initiatives. The roadmap included financial assessments for each potential initiative to help the client prioritize recommendations.

Value:

T2C successfully increased the level of collaboration and communication between the health plan and its largest provider groups – in large part due to the collaborative “strategy summits” orchestrated by T2C. In addition, these “strategy summits” helped align all of the involved stakeholders to facilitate buy-in and promote future collaborative work.