Payer are setting a double standard for patient care that both pushes for centralized, coordinated care and pulls patients away from receiving care in one place, according to Tim Maloney, vice president of payer relations at UC Health in Cincinnati (Ohio).
Payers have continued to emphasize value-based, coordinated care, which in many cases, allows patients to see improved outcomes by allowing them to receive all of their care in-house with one provider, Mr. Maloney said on "Becker's Payer Issues Podcast." .
But due to vertical integration — payers purchasing pharmacies and providers — payers are disrupting coordinated care by instead pushing patients to disjointed practices, including those that belong to payers in order to cut costs.
Below is an excerpt from the podcast. Listen to the full interview here.
Tim Maloney: As a referral center, we have patients who get all their care here — primary care through specialty and subspecialty — because their [care is] complex and they have a lot of things going on, and it seems like there's value in having that happen. It seems like the industry wants on the one hand to organize payment mechanisms that incentivize that coordinate of care.
But at the [same] time, there are these trends that appear to me to possibly want to segment or disconnect the way care is delivered. So that's a trend that's been on my mind.