Evidence map›Paper›PMID 39497289›Full record

ArticleHealth services research2025

The impact of a payer-provider joint venture on healthcare value.

Laura F Garabedian, J Frank Wharam, Joseph P Newhouse, Matthew Lakoma, Stephanie Argetsinger, Fang Zhang, Alison A Galbraith

Abstract read
In one paragraph

Article in Health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Laura F GarabedianDepartment of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-0014-4181
J Frank WharamDepartment of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Joseph P NewhouseDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
Matthew LakomaDepartment of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Stephanie ArgetsingerDepartment of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Fang ZhangDepartment of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Alison A GalbraithDepartment of Pediatrics at Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.

Funding

The Patrick and Catherine Weldon Donaghue Medical Research Foundation
6 · The paper itself

Abstract

objectiveTo examine how a novel payer-provider joint venture (JV) between one payer and multiple competitive delivery systems in New Hampshire (NH), which included value-based payment, care management, and non-financial supports, impacted healthcare value and payer and provider group experiences. STUDY SETTING AND

designWe conducted a mixed-methods study. We used a quasi-experimental longitudinal difference-in-differences design to examine the impact of the JV (which started in January 2016 and ended in December 2020) on healthcare utilization, quality, and spending, using members in Maine (ME) as a control group. We also analyzed patient uptake of the JV's care management program using routinely collected administrative data and assessed payer and provider group leaders' perspectives about the JV via semi-structured interviews. DATA SOURCES AND ANALYTIC SAMPLE: We used administrative and claims data from 2013 to 2019 in a commercially insured population under 65 years in NH and ME. We also used administrative data on care management eligibility and uptake and conducted semi-structured interviews with payer and provider group leaders affiliated with the JV. PRINCIPAL

findingsThe JV was associated with no sustained change in medical utilization, quality, and spending throughout the study period. In the first year of the JV, there was a $142 (95% confidence interval: $41, $243) increase in pharmaceutical spending per member and a 13% (4.4%, 25%) relative increase in days covered for diabetes medications. Only 15% of eligible members engaged in care management, which was a key component of the JV's multi-pronged approach. In a disconnect from the empirical findings, payer and provider group leaders believed that the JV reduced healthcare costs and improved quality.

conclusionsOur findings provide evidence for future payer-provider JVs and demonstrate the importance of having a valid control group when evaluating JVs and value-based payment arrangements.

Indexed as

Quality of Health CareAdultFemaleHealth ExpendituresHumansLongitudinal StudiesMaineMaleMiddle AgedNew HampshirePatient Acceptance of Health Carehealth insurancepayer‐provider joint venturevalue‐based payment

Identifiers

PMID39497289
PMCPMC12120508

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.