Hospitals & Health Systems

Release Exchange

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Audit Manager
Institutional Audit Manager

Professional Audit Manager

Ambulatory and Physicians

Release Exchange

Audit Manager

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Clinical Forms Exchange

Accountable Care Organizations (ACO) Capabilities

Medical Specialty Societies & Registry Capabilities

Health Plan Capabilities

How a payer-provider collaboration around quality reporting can reduce costs and improve patient outcomes

October 30, 2023

Too often today, relations between provider and payer organizations can become contentious around issues related to payment and quality of care. Yet such conflict does not serve patients well, because it deflects these organizations’ attention from their underlying shared purpose: To work together to deliver well-coordinated, cost-effective healthcare to patients.

With this purpose in mind, LifeBridge Health, a health system with 1,200+ beds and 120 physicians, and CareFirst BlueCross BlueShield (CareFirst), a payer organization with about 3.5 million members, are collaborating on an initiative to innovate the quality-measures reporting process. The two Baltimore, Maryland-based organizations have developed new processes, procedures and workflows to fine-tune information sharing that supports a more automated quality measures reporting process. The arrangement has proved beneficial to both organizations in helping them improve patient outcomes while meeting regulatory requirements. It offers a viable example of how other payer and provider organizations can begin to collaborate meaningfully.