Insights into ‘co-opetition’ in the health care system

There is an old saying that goes: “A rising tide lifts all boats.” The idea of co-opetition is one that seems to embody this insight.

Co-opetition combines cooperation and competition. It’s not an uncommon arrangement in many types of business. A simple example of co-opetition is when a group of restaurants on the main street of a town band together and place an advertisement in a local newspaper. Though they might be individually competing against one another, they also want to take a strategic approach to drive traffic to all of their restaurants together. 

So, how can co-opetition work in health care, which is a far more complex undertaking than promoting a group of restaurants? And what could its purpose be?

The article, “Could Health Plan Co-Opetition Boost Action on Social Determinants?” by Stuart Butler (Brookings Institution) and Len M. Nichols (Urban Institute), published in the American Journal of Public Health, points at some ways for health plans to strategically move forward working together in key areas.

“We’re all trying to articulate a mindset from, ‘competition is always the best way’ to ‘sometimes, collaboration can actually make competition more effective,” Len said.

One of these crucial areas is data and infrastructure — for example, with referral systems to care and social services. These can often have large initial costs that become easier to bear across a multitude of organizations. Moreover, if you’re part of a community-based organization or nonprofit providing direct services, Stuart notes, it could be a real pain point to have to interact with referral systems for five or six different hospitals or managed care organizations. 

What is 'co-opetition?'

A fruitful recent example of co-opetition is with the UnitedHealthcare Catalyst program underway in several metropolitan areas, in which UnitedHealthcare convenes large public housing authorities, federally qualified health centers, and other community stakeholders to study health disparities in order to implement interventions to improve community health outcomes. The findings and data from the various Catalyst projects are then shared in aggregate with other health care organizations that may or may not have met part of the initial design. This is done in an attempt to both “scale up” and sustain these proven solutions and ensure positive impact to systemic issues in housing, access to primary care and other social determinants of health.

In the same vein, to help address food insecurity and deliver medically tailored meals, organizations are working together in northern Ohio for a greater goal. Spearheaded by the United Way of Greater Cleveland, The Benjamin Rose Institute on Aging, and 11 managed care organizations like UnitedHealthcare, hospital networks, philanthropies and community-based organizations are able to seamlessly scale a meal delivery system throughout the region.

“Bringing multiple investors together means better coordination and lower costs. Everybody involved is getting what they want cheaper than otherwise than any single entity could afford,” Stuart said.

Co-opetition is one method among many to help the overall health of a community, particularly through interventions with social determinants of health and the infrastructure needed to fund these efforts. Since these systemic issues are not tied to any single health plan in an area where different organizations might otherwise be competing for business, collaboration helps ensure a population’s overall health is supported.

“It’s upstream collaboration that enhances the ability to deliver services and goods cheaper to people downstream,” Len said.

Co-opetition, Len adds, “can also be part of a larger effort to get government to move away from ‘we are paying for health care services’ to ‘we are paying for health’ — and what would be the best way to achieve that.

Once you get to that ‘aha’ moment, then you free up all the creativity of people who know how to combine social and health services to deliver maximum health with a minimum of resources.”

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