The Five Principles of Provider Enablement

By Chris Bethell
read

Building a strong relationship with your provider network is the cornerstone of a successful value-based care (VBC) program, but health plans face an array of challenges when engaging with providers. From having an inadequate infrastructure to provider risk aversion to a lack of available data to communication breakdowns—there are many reasons why payers are not properly engaging with their providers in value-based care programs.

This blog post is based on our webinar “A Payer Perspective on Optimizing Provider Enablement in the Value-Based World”, which featured Rama Thummalapalli, Manager of Value-Based Care Programs at Blue Cross and Blue Shield of Nebraska, and the accompanying eBook which shares its name with this post. 

Let's explore the five key principles to enable provider success in the value-based care world:

1. Think like a provider

Provider enablement means being provider-centric—you need to think like a provider. What do they need? Are they making money? How will they use the tools we provide them? How do our enablement efforts integrate into their day-to-day workflows?

These are questions best answered before you move forward if you expect to see a real impact. Without a detailed understanding of your provider network, how can you design programs or tools for them? Before even talking to providers, put in the extra amount of care, thought, and preparation to make sure the tools and assistance you have designed for them are all appropriately provider-centric. Engage with them, understand their needs, and then show them how their needs translate into your enablement efforts.

 

2. Be Transparent

The more transparent we are with program, financial, and contract terms, the more trust we establish with our providers. From inclusion to exclusion to the details of downside risk and gain share—all of these terms have to be clear to both parties.

Many providers are still risk-averse, and being open with your providers is one of the most effective ways to quell their fears about value-based contracts. If your providers feel knowledgeable and confident, they will return higher-quality care, better outcomes, and overall better results that benefit all involved parties—payers, providers, and patients.

two-thirds infographic

 

3. Provide Actionable Analytics

When speaking to providers, one of the most common pieces of feedback has been that they are overwhelmed and lack guidance in regards to the information they are given. They have a lot of patient information but do not know how to utilize it or where it is supposed to lead them. It's a classic case of information overload.

Letting providers know what actions they can take and when they need to act on the data they are given elevates information from “just data” to actionable data, which is key to not only enabling provider adoption but also enabling them to achieve the goals and requirements outlined in their contract.

4. Provide Intuitive Dashboards

Providers are presented with a lot of data and information throughout their everyday work. In order to get the relevant data to stick with them, it needs to be presented to them in a way that's accessible, organized, and straightforward. This is where having an easy-to-digest dashboard makes a world of difference. 

If a provider finds dashboards to be difficult to use or hard to navigate, they are less likely to reference them. This can become a barrier that leads to ineffective contracts or subpar care. Data is undermined if it is presented ineffectively or if it's difficult to access.

 

5. Partner With Your Providers

Providers are your partners throughout your value-based care journey and without them, you will not succeed. You need to treat them like the partners they are and have an open dialogue through every step of that journey. Discuss their concerns, meet with them to talk about how they can improve, and take their feedback to heart. Help them feel empowered by showing them that their voice matters and implementing their suggestions when it's feasible to do so.


When they are helping to build something, they will feel like they have skin in the game and are more likely to do what it will take to succeed within the value-based care model.