As IDC Health Insights predicted in August 2017 (Digital Transformation and New Economics Highlight Payer Disintermediation), we anticipated more deals and vertical integration. CVS announced its intention to buy Aetna. In December, and this week Amazon, Berkshire Hathaway, and JPMorgan Chase announced a partnership to cut health-care costs and improve services for their U.S. employees, with the aim of improving employee satisfaction and reducing costs.
The day-to-day management of fee-for-value (FFV) transactions is virtually 100% manual, with critical calculation of value-based payments performed by spreadsheet or custom programming in SAS or SQL. As the number and breadth of value-based relationships grow, the industry’s administrative burden worsens. Important FFV calculations and financial settlements are months delayed, lacking transparency and accuracy. The ability of payers to launch new value-centric benefit products is hobbled by inflexible contract and payment platforms.