As health care claims costs continue to rise, employers and their benefits advisors are always looking for ways to effectively lower spending and help employees adopt healthy behaviors. While value-based care (VBC) promised to address cost and quality issues, many of these models have fallen short of expectations. The question is whether new “payvider” insurance approaches can accomplish what others can’t. Under the joint-venture approach, the payer and provider share accountability for claims costs and profit or losses, which means they both have an equally vested interest in getting patients the right level of care at the right time.

Tom Grote, chief executive officer with joint venture health insurance company Banner Aetna, recently shared his perspective on joint venture health plans, the “payvider” model and where he thinks value-based care is headed overall.


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