< + > The Great Alignment: How Payers and Providers Are Finding Common Ground in Post-Acute Care

For decades, post-acute care has been viewed as a coordination failure; what if it’s actually been a visibility failure all along?

The lack of visibility into what actually happens after a patient leaves the care of a provider, has arguably been the root cause of the fragmentation in the post-acute care world separating acute providers and payers on one side and the post-acute providers on the other. Acute care teams lose visibility the moment patients transition to skilled nursing, rehab, or home health. Health plans receive claims weeks later that tell a partial, retrospective story. Meanwhile, post-acute providers operate with little insight into the upstream decisions shaping patient risk.

This chasm has shaped the industry for decades.

But new evidence suggests the gap separating these two worlds groups may be closing.

A 2025 payer–provider study commissioned by PointClickCare (PCC) reveals a turning point: acute providers and payers are beginning to align not only on strategic priorities, but on the technology, intelligence, and data infrastructure needed to finally gain visibility into the post-acute world. The catalyst? Smart-care platforms, AI-driven insight, and a growing expectation for real-time data across the continuum.

I. A Fragmented Past

Historically, acute care providers could see only what happened inside their walls; payers could see only what claims revealed afterward. Post-acute organizations existed behind a kind of “one-way mirror” caring for patients with limited upstream context, while upstream stakeholders had almost no real-time insight into their performance.

The PCC study makes this fragmentation unmistakable:

• 38% of payers and providers cite lack of integration between care settings as a top barrier to managing total cost of care.
• 36% cite insufficient real-time data as a major challenge.
• Data integration & interoperability score as the overall greatest systemic challenge (3.77 on a 5-point scale).

These numbers confirm what has been implicitly understood for years: the real issue was not unwillingness to collaborate but the inability to collaborate without shared visibility. The acute and payer sides simply could not manage what they could not see.

II. Shared Priorities and a Shared Pressure

The PCC study reveals something new: both payers and acute providers now recognize that they cannot achieve high-quality outcomes without stronger collaboration with post-acute partners.

Consider the following:

• Reducing readmissions is the top strategic priority for both payers and providers (4.03 on a 5-point scale).
• Improving care coordination ranks nearly as high (3.97).
• 70.5% say collaboration with post-acute providers is the single most important driver of better coordination.

This alignment stems from a shared realization: post-acute care is now the biggest area of opportunity for avoiding cost, preventing delays in care, and reducing readmission risk.

What happens after discharge is no longer “downstream”. It is central to the full episode of care. The pressure is on both acute providers and payers to improve this part of the continuum. How they respond will define the future of episode-based care management.

III. A New Understanding of Untapped Opportunity

 1. Acute Providers

Acute care organizations have, for the most part, been ahead of payers in prioritizing post-acute care driven largely by the emergence of value-based care initiatives such as the Medicare Shared Savings Program and now, the 2026 implementation of TEAM (Transforming Episode Accountability Model). Yet many acute providers fail to fully realize how much impact they could have on preventing readmissions, accelerating recovery timelines, and improving patient flow. With better visibility into SNF-level clinical data, therapy progress, and risk indicators, acute providers can:

• Identify rising-risk patients earlier
• Ensure cleaner discharge handoffs
• Monitor whether post-acute settings match patient needs
• Proactively coordinate transitions before deterioration

The opportunity is far larger than most acute teams recognize. Fortunately, the data suggests they are beginning to embrace it.

 2. Payers

Health plans, by contrast, never had the option to engage in true post-acute care management. Not because they did not want to, but because they did not have real-time data. Claims arrive too late to influence outcomes, and phone calls reveal only fragments of what is happening. But the emergence of real-time SNF and post-acute data fundamentally changes what payers can do.

For the first time, health plans can:

• Shift from passive oversight to active episode management
• Intervene before deterioration occurs
• Identify quality variation across post-acute partners
• Prevent readmissions and unnecessary ED visits
• Support members dynamically throughout recovery

The only question now is: How quickly will payers seize this opportunity?

IV. The Bridge Neither Side Could Build Alone

Digitization alone though, will not be able solve this information fragmentation challenge. What’s driving alignment now is intelligent integration. Smart-care platforms that unify workflows, analytics, and communication.

The PCC study shows clear momentum toward a smarter ecosystem:

• 65.6% plan to implement predictive analytics in 2026.
• 65.6% plan major improvements in real-time data exchange.
• 47.5% expect AI to improve predictive analytics for post-acute coordination.

True alignment becomes possible only when all parties operate on the same digital substrate. One that combines interoperability, AI-driven risk stratification, and shared performance dashboards. Smart-care technology is becoming the neutral foundation where both sides operate from the same data and the same truth. This includes:

• Real-time patient transition dashboards
• AI-driven readmission risk scoring
• Automated referral and intake workflows
• Shared preferred-network analytics
• Standardized EHR-to-payer data pipelines

These tools don’t simply automate tasks. They align perspectives.

V. A Shared Strategy

Perhaps the strongest signal of alignment is the rapid rise of preferred post-acute networks. According to the PCC study:

• 64% of organizations are building or have already built a preferred post-acute network.
• 39.3% are actively refining them right now.

And when selecting partners, organizations expect network peers to support:

• Real-time transition data (5%)
• Performance benchmarks (1%)

These findings reflect a shift in network activity from negotiation to collaboration. Preferred networks are becoming performance ecosystems enhanced by smart-care platforms enabling transparent performance metrics that both sides trust.

VI. A New Operating Model Emerges

Taken together, the data paints a picture of a payer–provider ecosystem ready to operate as a unified performance system, not a set of transactional silos. Three elements seem to be defining this future:

1. Shared Visibility
Teams move from fragmented documentation to real-time shared dashboards, enabling clinicians and population managers to work from the same truth.

2. Predictive Foresight
Predictive analytics are no longer a “nice-to-have.” They are becoming the backbone of discharge planning, episode oversight, and network design.

3. Performance Accountability
Unified metrics and preferred networks ensure incentives and outcomes align.

VII. Why This Moment Matters for Healthcare IT Leaders

We began by asking whether post-acute care was ever truly a coordination failure, or whether it was a visibility failure all along.

The PCC study strongly suggests the latter.

Acute providers and payers never lacked motivation. They lacked line of sight into the part of the continuum where the greatest risk, and the greatest opportunity, exists.

Now that real-time, intelligent post-acute visibility is finally possible, alignment is no longer theoretical. It is becoming the operating model of the future; one shared insight, one coordinated transition, and one full episode of care at a time.