Every healthcare organization you know today will be transformed by the year 2020.
Will the changes driving that transformation force our industry to retrench and cut back in order to survive or will we grow and innovate to achieve new levels of service, quality and business health? These two possible futures are largely contingent on our ability to strategically employ information technology.
Forces of Change
It’s no mystery why healthcare is under such pressure today. Regulatory and political reform is driving a level of change and adaptation unprecedented in the history of our industry. At the same time, the costs of delivering and paying for care are increasing even as reimbursements are drastically reduced. To accommodate a reduced cost base and improve quality, safety and efficiency, new payment and care delivery models are emerging that shift more financial risk from payers to providers and patients.
This is forcing our industry to reexamine the way it is organized and functions while coming to grips with new strategic priorities. Payers and providers are partnering in bold new ways, while physician practices increasingly team up with larger health systems. Providers will reinvent themselves as care delivery networks focused on populations holistically. Care will migrate to the lowest-cost setting when possible. Patients will become healthcare consumers with the knowledge and financial motivation to make informed decisions. And wellness, care management and population health will become system-wide priorities.
None of this will be possible without information technology systems that automate administrative processes, share data across systems and organizations, and deliver financial and clinical information at the point of care. Without the support of robust IT platforms and solutions, healthcare in a value-based world will be too complex to manage, too slow and labor-intensive to be cost-effective, and too fragmented to be coordinated and intelligent.
A Strategy for Better Health
Studiomaca is focused on four success factors that are critical for connecting healthcare and addressing the business challenges of evolving financial and care models.
To transform themselves for the healthcare market of 2020, organizations will need to:
- Maximize technology: In a diverse healthcare data environment, it is critical to bring disparate data together and deliver it to the stakeholders making real-time clinical and financial decisions. Such data analytics allow an organization to track clinical and administrative performance, focus on impactful improvements and cost reductions, increase care quality and predict future needs.
- Improve performance and quality: Payer and provider organizations must be managed optimally in order to lower costs, improve margins and focus resources where they are needed most. Robust health IT solutions will also make it possible to apply insights gained from data and analytics to further improve quality and performance.
- Connect and coordinate care: Fragmentation in care delivery is one of the major drivers of inefficiency, waste, high costs and inconsistent quality. Better health information exchange, data aggregation, performance analytics and clinical integration will enable us to coordinate care across all settings. To do so, data must be captured efficiently, shared automatically and analyzed intelligently.
- Navigate advanced payment models: Value-based models add many extra layers of complexity at a time when simplification, cost-reduction, speed and administrative efficiency have become imperatives. Automation, fluid data sharing and transparency around rules and logic are now critical for payers and providers to collaborate in real-time while also becoming clinically and financially integrated at the point of care.
Six Years and Counting
While new approaches and policies have made their mark over past decades, the processes by which care was delivered and paid for remained relatively unchanged. Today, we are participants in a total overhaul of those processes. 2020 is only a few short years away, and yet that healthcare system will look very different from the one we now rely on.
We are forced into that transformation by economic and political pressures that cannot be ignored. We face significant consequences if we fail to meet those challenges and yet, we can be thankful for the timing of this crisis. The information technology necessary to reinvent the way we deliver and pay for care is available. What steps can we take now to ensure that we create a healthier future for our organizations and the patients who depend upon them?