Healthcare isn’t static—and neither are your members. They move between plans, providers, and geographies, creating complexity that often translates into higher costs and lower satisfaction. When health plans collaborate, that complexity becomes an opportunity to improve care, reduce administrative burden, and strengthen financial performance.
That’s why we’re so proud to sponsor the 2025 Inter-Plan Solutions Forum. We sat down with Directors of Healthcare and Life Sciences, Pavan Madhira and Priyal Patel, to explore why inter-plan collaboration is no longer optional for health insurers. From breaking down silos to accelerating innovation, they shared insights on how working together can transform member experience and deliver measurable outcomes.
“Healthcare has long struggled with inefficiencies and slow tech adoption—but the AI revolution is changing that. We’re at a pivotal moment, similar to the digital shift of the 1990s, where AI is poised to disrupt outdated processes and drive real transformation.” – Pavan Madhira, Director, Healthcare & Life Sciences
Why Health Insurers Need Inter-Plan Collaboration to Stay Competitive
Collaboration is a growth strategy. Every gap in data or care coordination can mean missed Stars bonuses, higher compliance risk, and member churn. Working together helps plans break those barriers.
“Inter‑plan collaboration is critical because it enables health plans to deliver seamless, high‑quality care across geographic and organizational boundaries… If plans can all work together, we can chip away at achieving the quintuple aim.” – Priyal Patel, Director, Healthcare & Life Sciences
Our award-winning Access to Care research reveals friction in the care journey that directly impacts health outcomes, loyalty, and revenue. When members seek care through direct-to-consumer solutions or outside your ecosystem, you risk losing long-term revenue, loyalty, and visibility into their health journey. That creates blind spots, unnecessary costs, and missed opportunities for proactive care coordination.
92% of individuals who use direct-to-consumer, digital-first care say the care quality matches—or even exceeds—that of traditional healthcare systems
Member-centric design, using shared insights to personalize care and outreach, offers huge potential for improving satisfaction and outcomes. That’s why we drive resilient, AI-powered transformation that empowers leaders with scalable solutions to shape industry standards.
Explore More: Access to Health Care Industry Report / Perficient
Benefits of Inter-Plan Collaboration for Health Insurers
Collaboration accelerates innovation by enabling joint R&D initiatives like predictive analytics, AI-first dashboards, and digital therapeutics. It gives insurers a stronger voice in shaping reimbursement models, policies, and access to care strategies. And perhaps most importantly, it ensures members experience consistent, high-quality care and digital engagement across plans.
When plans collaborate, the wins are tangible:
- Better Quality Scores and Revenue: Shared data and aligned gap closure strategies can help lift HEDIS and Stars measures, unlocking higher reimbursement and bonus pools.
- Lower Operating Costs: Coordinated risk adjustment and compliance help reduce redundant processes and audit risk.
- Stronger Member Loyalty and Satisfaction: Consistent digital experiences across plans reduce friction, improve satisfaction, and strengthen brand loyalty.
Our approach combines AI-first delivery, platform-agnostic technology, and member-centered strategies to drive transformative outcomes and health experiences.
You May Also Enjoy: Access to Care is Evolving: What Consumer Insights and Behavior Models Reveal
Inter-Plan Collaboration Roadmap: 5 Strategic Focus Areas
Inter-plan collaboration is more than sharing data, but rather about creating a unified approach to innovation, policy, and member experience. It unlocks opportunities that no single organization can achieve alone.
“When plans work together, they can better serve their vulnerable populations, reduce disparities, and really drive to value based care. It’s about building trust, sharing responsibility, and innovating with empathy.” – Priyal Patel, Director, Healthcare & Life Sciences
So how do you turn collaboration from concept to measurable results? It starts with focusing on the areas that drive quality, cost, and elevated experiences. Here are five strategic focus areas:
- Data Interoperability and Real-Time Exchange: Move beyond administrative data sharing to real-time clinical interoperability. This fuels accurate risk scoring, timely interventions, and better care coordination.
- Federated AI and Predictive Modeling: Collaborate on AI models that learn across distributed data sources without compromising privacy. This accelerates care gap closure, utilization management, and population health insights.
- Shared Governance and Policy Alignment: Establish frameworks for responsible AI, bias testing, and audit readiness, while aligning on policy advocacy to influence regulations that impact cost and quality.
- Innovation Labs and Joint Pilots: Create cross-plan innovation hubs to incubate next-gen solutions and reduce time-to-value for emerging technologies like digital member engagement and predictive analytics.
- Member Experience Standardization: Work together to deliver consistent digital experiences, omnichannel engagement, and personalized care journeys that drive value-based care.
Success in Action: Empowering Healthcare Consumers and Their Care Ecosystems With Interoperable Data
How Perficient Helps Health Plans Drive Collaborative Success
From insight to impact, our healthcare expertise equips leaders to modernize, personalize, and scale care. We drive resilient, AI-powered transformation to shape the experiences and engagement of healthcare consumers, streamline operations, and improve the cost, quality, and equity of care.
- Business Transformation: Activate strategy for transformative outcomes and health experiences.
- Modernization: Maximize technology to drive health innovation, efficiency, and interoperability.
- Data + Analytics: Power enterprise agility and accelerate healthcare insights.
- Consumer Experience: Connect, ease, and elevate impactful health journeys.
We have been trusted by the 10 largest health systems and the 10 largest health insurers in the U.S., and Modern Healthcare consistently ranks us as one of the largest healthcare consulting firms.
