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As value-based care continues to reshape the health insurance landscape, health plans face mounting pressure to evolve by continuing to become a true partner in care delivery. The shift demands more than operational adjustment — it requires a fundamental rethinking of how plans engage with providers, share data and measure success.
To understand how health plan leaders are navigating this transformation, Becker’s spoke with 15 executives from across the industry. Takeaways from the leaders included: the need for transparent, real-time data sharing; incentive structures that reward outcomes over volume; and a recognition that value-based care will reach its potential only when plans and providers commit to genuine, sustained partnership.
Question: How must health plans change as value-based care grows?
Krista Hoglund. President of Jefferson Health Plans (Philadelphia): The growth in value-based care requires that health plans truly become partners with their providers and health systems. Health plans have to transform from simply paying claims to managing health outcomes and costs in partnership with providers. We must put more emphasis into our population health muscle rather than traditional claims payment functions. Transparency and data sharing are critical. Analytics becomes a must-have instead of a nice-to-have. We need to evolve analytics and population health management, invest in strong provider relationships and manage patient care to the best outcomes…