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Most providers and their partners have difficulties understanding how to work with payers. Physicians and other care partners want to build care models that are clinically meaningful, and they perceive that payers only want models that cut costs. Payers, on the other hand, may believe that providers are out to game them—providing unnecessary services just to get additional payment—since the fee-for-service payment methodology prioritizes volume over value. The more services one provides, the more income is earned, as payment is made regardless of the impact on individual patients’ health. Neither of these perspectives is entirely accurate. Providers and payers, together, are responsible for the management of care and the cost of care of their individual patients/members.

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