Health systems face growing pressure to improve performance in value-based contracts while managing increasingly complex payor quality programs. Yet in many organizations, payor requirements are fragmented across contracting, analytics, population health, and clinical operations—creating attribution errors, duplicative outreach, inconsistent data interpretation, and missed performance opportunities. Sanford Health addressed these challenges by embedding payor strategy within enterprise quality through the creation of the Payor Quality Strategist role. This session highlights how this model strengthened attribution integrity, standardized payor data/reporting, and improved the usability of quality information for operations. Attendees will learn how shared campaign governance reduced waste and conflicting outreach, identifying that 56% of payor generated lists were clinically inappropriate.

The session also demonstrates how measure prevalence analysis across payors elevated medication adherence measures as systemwide priorities, informing workflow redesign to leverage 100-day benefit refills and support more consistent medication use. Within four months, 20,008 prescriptions were converted to 100-day fills, and standardized documentation created visibility into more than 15,000 adherence interventions. Leaders seeking practical, scalable strategies to strengthen payor partnerships, improve data trust, and drive reliable performance in value-based care will gain a clear set of structures, tools, and methods they can adapt within their organizations.

Key Takeaways:

• A practical governance model for unifying payor strategy within quality. Attendees will understand how a centralized Payor Quality Strategist role strengthens attribution integrity, reduces operational fragmentation, and creates an accountable structure for value-based performance.
• Repeatable methods to eliminate waste and improve data reliability. Participants will gain clear approaches—such as attribution review processes and shared campaign governance—to reduce clinically inappropriate outreach, strengthen data trust, and streamline workflows that support payor quality program requirements.
• Adaptable tools and workflows that drive measurable improvement. Attendees will leave with actionable tools including measure prevalence analysis, cross payor data resources, and benefit aware prescribing workflows that support stronger medication adherence and more consistent performance across value-based contracts.