To the victor go the spoils.  And in this battle the spoils are the lifeblood of any healthcare provider or plan – the patient.  The escalating battle between Blue Shield of California and United Health regarding the business practices of UH’s Optum health services unit are but the latest example of health plans snatching up medical providers in order to lock down and increase market share.

So how does this play out? 

The lines between health plans and providers will continue to blur.  Alliances will be increasingly complicated.  It’s going to be hard to tell who is on what side at any given time.  When the dust settles the winners will be those organizations who found and exploited an advantage.

Insight as advantage

It is no secret in the business world that intelligence and strategy – not sheer force alone – consistently offer significant advantages over rivals.  In the healthcare industry Buxton is seeing significant increases in the adoption of business tools and analytic insights.  These tools and insights lead organizations to an executable strategy which accounts for patient needs and convenience, payer mix, core provider competencies and emerging specialty opportunities.

The big question to answer

So if you are a healthcare plan or provider the big question for you is, “Do you really know what your patients look like?”  If the answer is no, how do you expect to win this battle?