Technology is causing unprecedented disruption and changing the world of work as we know it, and the Healthcare industry is forcing much of this change.
New business models like the gig economy and cloud are leading to the disappearance of jobs, while new ones are emerging. This transformation is forcing healthcare companies to rethink the customer experience and prompting a digital transformation that includes investing in emerging technologies like AI, ML, IoT, and Blockchain to stay ahead.
Healthcare organizations are merging, acquiring, and divesting at record levels to help with their transformation and gain access to emerging technologies so they can be more of an intelligence-driven enterprise to drive business outcome.
Major “forces of change” in healthcare – driving much of the change include:
- We have an aging population coupled with an increase in chronic conditions (such as type 2 diabetes, hypertension, COPD and heart disease).
- There is an increased use of genomics in mainstream decision making to identify the most effective treatment – especially in oncology and rare diseases (i.e. precision medicine).
- There is a need to not only improve the health of a population – but to also understand the risk within a population served.
- Today nearly 1/3 of physicians are over the age of 60, and nearly 1/2 of all registered nurses will reach traditional retirement age by 2020.
- It’s not just about recruiting talent – it’s about keeping them (reducing turnover) through work-life balance and system “simplicity” and access to information they need.
- Clinician satisfaction is critical as it impacts cost, service performance, and patient experience.
- Increased spending has not equated to better outcomes – resulting in new outcome-driven reimbursement models.
- More consolidation in the industry and new locations/expansion – for better market position and leverage with payers.
- The need to reduce per capita cost – make healthcare more affordable.
4. Care Delivery & Reimbursement
- A shift away from “fee for service” towards new value-based programs.
- Service rationalization – with consolidation, systems are making decisions on what & where services are provided – based on volume, payer-mix & competition.
- Care coordination – such as patient-centered medical homes, linking to community health workers, etc. – sounds easy but remains elusive.
5. Patient Experience
- Today’s consumers have a choice – they pay attention to shared patient-experiences and hospital ratings / HCAHPS scores.
- Portability/Interoperability – As patients become more involved, this becomes more important to them and can be a differentiator. – CVS does this with their minute clinics as “backup primary care” with data sent the PCP.
6. Compliance, Healthcare Reform and Security
- HIPPA/HITECH (PHI-protected health information), GDPR (PII-personally identifiable information) and security – HITRUST & FedRAMP.
- Though reform remains a work in progress – cybersecurity continues to be a huge threat.
Part of transformation includes financial planning, costing and profitability management.
Many healthcare providers have difficulty achieving the granularity required as the information is either siloed or simply not available.
Having tools and information available to quickly drill-down to address cost-issues impacting margins for a particular service line (such as cardiology or orthopedics) is critical for today’s healthcare finance organizations.
Enterprise Performance Management (EPM) solutions help with financial planning, budgeting and forecasting; profitability and cost management; as well as faster financial close and reporting. These tools also enable other groups to plan and generate financial reports without the need for IT involvement, boosting efficiency and collaboration.
Contact Highstreet to learn more.