The K2 Collaborative Summit: Valuable Findings from 2023 - Cover

The K2 Collaborative Summit: Valuable Findings from 2023

KLAS’ K2 Collaborative ultimately aims to foster trust and collaboration between payers, providers, and their technology vendors. KLAS recognizes that everyone, including patients, wins when payers and providers can form strong partnerships and engage in open conversation. To support this vision, members of the K2 Collaborative are encouraged to attend the annual K2 summit.

Ahead of the fourth annual K2 Summit on May 14 and 15 in Salt Lake City, I’m reviewing a few of the findings and suggestions from last year’s summit, as outlined in the K2 Collaborative Summit White Paper 2023.

Building Trust

The white paper breaks down the four goals of the 2023 summit. It also shares findings gleaned from a pre-summit survey completed by attendees as well as from the discussions that happened in person at the conference. The second of the four goals was to build trust between payers and providers.

The pre-summit survey showed disparities in perceptions about trust and communication between payers and providers. Payers felt more optimistic overall, with 92% feeling that there is frequent and open communication with providers; only 13% of providers shared that opinion.

While those findings may seem daunting, the tabletop discussions at the summit were encouraging as both sides had the chance to share ideas that would help them trust each other. During those discussions, providers suggested ideas like payers creating more transparency, providing timely reporting around claims denials, and having regular joint operating councils to foster understanding. Payers suggested things like providers allowing payers to access EHR data and member medical records, embracing new technologies, and improving understanding of the payers’ regulatory landscape and constraints.   

Recognizing Successful Collaborations

Another component of the summit was presentations from payers, providers, and HIT vendors who had collaborated successfully to reduce friction and waste. The K2 Collaborative has dubbed these collaborations “Points of Light,” since they represent examples of successful strategies that other organizations can emulate. Out of the 20+ Points of the Light submissions, three are selected by attendees for the honor of a Peak Award. The 2023 Peak Award winners, their challenges, solutions, and outcomes are below:

Peak Award Winner #1:

This partnership involved Innova Primary Care, BlueCross BlueShield of Alabama, and their technology partner, Secure Exchange Solutions. The challenge they wanted to solve was a lack of visibility for primary care physicians (PCPs) into data from ED or inpatient visits, though follow-up care is critical to success for patients who have been admitted or discharged from the hospital or ED. The payer organization suggested embedding care alerts into providers’ workflows.   

The outcomes from this change were clear. It reduced the providers’ administrative burden because they had access to real-time data at the point of care. It also improved connectivity between local hospitals and PCPs. Finally, it reduced readmissions and ED visits, which also reduced the actual vs. expected ED costs.

Peak Award Winner #2:

The goal of this partnership between an anonymous healthcare provider, Humana, and Moxe (their technology provider) was to get a complete view of patient data that would enable them to accurately assess patient risk. To overcome the labor-intensive challenge of extracting data from the EHR and sending it to the payer, the collaborators were able to automate the process.

This collaboration saw increased efficiency and a reduced workload for the provider’s HIM, help desk, and technical support departments. It also produced more accurate HEDIS metrics for the payer organization, which improved financial incentives for both the payer and provider.

Peak Award Winner #3:

The third winning partnership involved an anonymous provider and payer working with their vendor partner, Rhyme. Their collaboration focused on the lack of integration between the payer and provider which caused an inefficient and manual prior authorization process. The stakeholders worked together to connect payer and provider workflows and share prior authorization information in real time.

The automated data exchange made a dramatic impact. 50-60% of prior authorizations for advanced imaging were automated, reducing manual touches. Turnaround times for prior authorizations were also drastically reduced, with most requests being completed in less than 2 hours. Finally, provider efficiency improved because the prior authorization workflow was included in the EHR and not in an outside payer portal.

Though this collaboration was presented at the summit in 2023, their case study has yet to be published. Check it out here when it goes live with the other Points of Light case studies for 2024.

Preparing for the 2024 K2 Collaborative Summit

For more details on where to start tackling payer/provider collaboration, I suggest reading the K2 Collaborative Summit 2023 White Paper  in its entirety. You will also find data on the current state of the payer/provider relationship and the market and more information on all the Points of Light presentations. 

During the upcoming 2024 K2 Collaborative Summit, I look forward to an update on the advancements of the past year and learning more about the successful Points of Light collaborations. Micky Tripathi, National Coordinator for HIT for the Department of Health and Human Services, will be giving the keynote address: Bridging the Divide: Fostering Trust in Payer/Provider Collaboration Through Interoperability. For more information, please visit the event page.

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