The "Payor" Perspective: Risk Mitigation and Financial...

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2025-12-24 11:14:40 -

The "Payor" Perspective: Risk Mitigation and Financial Sustainability

While providers use PHM to improve care, insurance companies (payors) use it as a powerful tool for risk management. In 2025, the boundary between payor and provider is blurring, with many insurers acquiring medical groups to form "Integrated Delivery Networks." These organizations use PHM to align financial incentives with patient outcomes. By analyzing claims data alongside clinical data,...

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