Building stronger bridges between payers and providers will prove critical in addressing the biggest challenges facing healthcare: affordability and access.
It's with that backdrop that Aetna is releasing its latest provider survey, a quarterly poll that seeks to better understand providers' perspective on their insurer counterparts and where there's room to continue developing trust between the two. In the third quarter survey, provided first to Fierce Healthcare, Aetna found a trust score of 6 out of 10, on par with the 6.1 score seen in Q2.
The tally makes for a significant increase from the first quarter, where the trust score was 5.4.
Steve Nelson, president of Aetna, told Fierce that "trust is at an all-time low," so the insurer has been putting an emphasis on addressing some of the biggest pain points that erode that trust, including administrative burdens like prior authorization and increasing transparency.
"It's not just a hope and a prayer here," he said. "We're actually making progress."
The survey, conducted by Morning Consult, polled 727 individuals, including hospital executives, physicians, nurses, pharmacists and health tech leaders from across the country. It found that 50% of the surveyed providers said they believe insurers are making decisions to support patient well-being, up two percentage points from the second quarter and six from Q1's survey.
In addition, 52% said payers deliver on their promises consistently, and 56% said they provide clear and understandable data, the same results as were seen in the second quarter.
Nelson said federal officials are interested in bringing the two parties together to advance critical initiatives. For example, last year, insurers pledged to ease prior authorization and support electronic avenues for determinations. But that work can only go so far without providers at the table, too.
Efforts to address healthcare costs will be more effective, he said, if they come from a "coalition of the willing" rather than a solution imposed on the industry. That's why, in addition to the surveys, the company is hosting forums that bring in leaders from hospitals and health systems to discuss where to go next.
"These are all people who are trying to fix these issues, he said. "We all wake up in the morning trying to do the same thing. We are way more aligned than people like to believe."
The next evolution will be getting other key stakeholders — like electronic medical records companies — to unlock true interoperability that drives further change, Nelson said.
The survey found signs of progress in easing those administrative burdens, too. Sixty-seven percent of providers named administrative hurdles as their biggest challenge, a decrease of six percentage points from the second quarter's survey.
Among those who said administrative challenges were the largest burden, 27% said prior auth was the largest contributor, down from 31% in Q2.
The survey also found that 25% of providers believe interoperability can improve outcomes, increasing by seven percentage points from the second quarter.
Beyond administrative challenges, providers (94%) believe fraud is a critical challenge that the healthcare system needs to address, according to the survey results. Nearly 60% of those surveyed believe addressing fraud could significantly reduce healthcare costs.
Close to a third (30%) of those surveyed said they recommend payers lean on AI to identify potentially fraudulent claims, and nearly 90% said they believe payers can substantially reduce fraud, waste and abuse each year.
Mitigating fraud has been a major topic of interest in healthcare and a particular focus of the Trump administration in recent months.
"There is a shared mindset," Nelson said. "Providers want to get that fixed as well. They don’t want to be colored in a negative light, and health plans don’t either."