Consider a chronic back pain sufferer. She wants to avoid surgery and anything that feels too invasive, but she doesn\u2019t know there may be alternative treatment choices. What if her insurance plan and her doctor worked together, really collaborated, to determine the best care for her? They might suggest physical therapy, not surgery, as an initial approach. Recommending a nontraditional intervention as a competitive advantage might seem counterintuitive, but it\u2019s part of a new way of achieving better results.\nChanging Care for the Better\nThe nation\u2019s health care system is in flux \u2013 transformational care that provides better patient experiences and outcomes is becoming more and more necessary. Current health care models can be disjointed, transactional, and complex, with go-betweens and multiple vendors acting as barriers to a more seamless, effective system. Through integrated health systems, some industry leaders are exploring new ways to foster true payer\/provider collaboration that goes beyond a transactional relationship to become the kind of relationship that results in better patient experiences and outcomes.\nCreating Value for Patients\nThe \u201cvalue agenda,\u201d coined by Michael Porter and Elizabeth Teisberg in their book Redefining Health Care, is an overarching strategy that requires \u201crestructuring how health care delivery is organized, measured, and reimbursed.\u201d They present the need for providers to adopt a strategy that \u201ctranscends traditional cost reduction and responds to new payment models\u201d while improving patient outcomes and growing market share. Defining \u201cvalue\u201d is a challenge many leaders are taking on in their own organizations as well as at C-suite gatherings like the 2017 Forbes Healthcare Summit.\n\u201cThe classic definition of \u2018value\u2019 in health care is what you\u2019re paying and the outcome you\u2019re paying for. [Throughout the health care industry] what some patients are paying for may not be high value \u2013 there\u2019s a lot of overuse and misuse and a lot of services or care that\u2019s unnecessary or more expensive than it needs to be,\u201d said Diane Holder, president, UPMC Health Plan, one of the leaders at the Forbes Summit.\nThe new winning reality? What\u2019s good for the patient is ultimately good for everyone.\nAligning Incentives\nAs a large integrated delivery system, where both the payer and the provider as well as academic medical centers are taking a \u201cbench to bedside\u201d approach, UPMC is exploring how to improve value for all. This means aligning the incentives among provider, payer, and patient.\nFor example, in medical homes, which provide comprehensive medical care aimed at obtaining the best health outcome, patients\/members can see both their primary care doctors and specialists. The primary care physicians receive a wealth of data and information from UPMC Health Plan, including utilization patterns and other data that may not be available otherwise. This integration promises better coordination and collaboration and, ultimately, better care.\nIncreasing Information Sharing\nSharing data can improve quality and reduce the total cost of care, and those savings ultimately benefit patients. The physicians\u2019 and insurance companies\u2019 incentives can align, which also helps patients because they truly value the care they are receiving.\n\u201cThe ability to get care when they need it, get the right care when they need it, and get it in an affordable way are all big problems for patients,\u201d said Ms. Holder. That\u2019s why one UPMC goal is to better leverage and share data to provide the care people need, especially when more patients are paying out of pocket for it. Escalating health care costs, which are more than $3 trillion a year according to the U.S. Centers for Medicare and Medicaid Services, are contributing to patients\u2019 desire to want more for their money.\nPartnering for Change\nPatients like the chronic back pain sufferer are now able to get relief by having more information and a team of physicians, therapists, and insurance specialists who partner to create a personalized treatment plan instead of defaulting to surgery first.\nUPMC is at the forefront of this health care transformation, with a goal to deliver the right services to the right patients at the right time. In doing so, it will be among the health systems that are creating real value \u2013 improved outcomes and patient experience \u2013 and gaining a competitive advantage that\u2019s sure to deliver future growth and sustainability.