Provider collaboratives

Collaborative focus

Collaboratives—organized groups or entities that work together toward a particular goal—aren’t a new concept in the health care industry. But they’ve been increasing in number over the past few years. Are provider collaboratives actually meeting their goals or are they a fad that will go away? Are they helping health systems compete in today’s changing payment landscape? And what makes a provider collaborative successful?

We interviewed nine provider collaboratives to understand where they’ve seen success and challenges to adoption. Our research found that, after investing appropriate time and resources into forming a collaborative, many are starting to see progress against stated goals and are evolving to expand their scope. Collaboratives are attractive to hospitals and health systems, which are evaluating options to remain independent, yet gain scale-related benefits including cost savings and better resource utilization.

With the uncertainty facing the health care industry, we may see provider collaboratives as a growing trend that’s here to stay.

Lessons learned

Early-stage collaboratives and more established ones both recognize that the road to success can be a lengthy one—and success doesn’t happen overnight. Also, not all collaboratives result in lasting relationships. Some have attempted to align, but have failed and chosen to dissolve. From our interviews and analysis, we learned some important lessons for building a strong, sustainable provider collaborative:

• Having the right team with the right skills is critical. And CEO support and participation is necessary for collaboratives to endure.
• Success doesn’t happen overnight. Patience, persistence, flexibility, and long-term vision are essential.
• Strong collaboratives are dynamic. Many begin with one set of goals that shift over time.
• Cost savings are important, but achieving value or return on investment from a provider collaborative extends to strengthening relationships, learning best practices, gaining clinical improvements, and creating a unified voice.
• Collaborative members value the relationships they’ve built and see them as a defense strategy against future challenges in the changing health care market.

The road ahead

The collaborative leaders and members we interviewed are generally optimistic about their organizations’ futures, given their progress on existing and new initiatives.

Assuming the transition to alternative payment models continues to accelerate, we may see new collaboratives form, driven by health systems’ need to develop value-based care capabilities and build robust, high-performing provider networks. Cost-saving activities may play an important role to help fund or offset investments in data analytics and clinical integration. Our research suggests that early cost-saving wins can be a strong motivator for sustained member engagement and don’t have to detract from the main goal.

As collaboratives progress along the value continuum to the “fully committed” end of the spectrum, they may need:

• Actuarial and insurance expertise to develop insurance products
• Additional partners to cover a full continuum of care
• Continued investments in data analytics

Our view is that provider collaboratives will continue to grow and evolve—shaped by market forces, health care’s transition from volume to value, and providers’ desire to gain scale-related benefits and maintain local control. Collaboratives can provide the necessary infrastructure and capabilities that many providers need to participate in value-based care payment models. They can also lay the groundwork for identifying and capturing future clinical and cost improvements.

Download the report to learn more.

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