In a previous blog, we explored the important approaches and best practices that the payer industry needs to keep in mind to succeed amidst a climate of uncertainty. For this week’s blog post, we are exploring top provider concerns in a conversation with John Hansel, our vice president of healthcare provider solutions. During a Q&A, John shared his perspectives on the challenges that lay ahead for providers and the continued importance of investing in Enterprise Analytics (EA) strategies in today’s rapidly changing healthcare environment.
1. Major healthcare industry transformations will happen in 2017 but what will remain constant? And how can an EA strategy help organizations prepare?
Collaboration between payers and providers will be important regardless of any potential repeal and replace of the Affordable Care Act (ACA). Since the ACA passage, providers have assumed more risk which has led them to acquiring or establishing health plans to help manage and ease the financial burden. In fact, PriceWaterhouse Coopers estimates that 50 percent of health systems have applied or intend to apply for an insurance license. With healthcare organizations establishing their own health plans, they will need to continue to invest in robust analytics to properly manage insight. This collaboration creates more data as information flows in from payers, providers and patients. More data means more information to sift through, making it even more challenging to turn that information into action. The investment in analytics will thus remain a top priority as the technology can offer providers a holistic view of financial, clinical and operational data that fuel cost-saving decisions. This holistic approach to data will help providers better manage the risk they are taking on and gauge areas for improvement whether it be gaps in care or medication adherence.
2. To succeed with an EA strategy, healthcare organizations need to integrate analytics and data into everyone’s day-to-day. How is this done?
There are many challenges that arise when establishing any type of analytics strategy – from a lack of leadership, proper IT support and the associated cost. Some of this is out of our control. However, there are proactive approaches that can be taken to ensure a seamless EA strategy:
- Train and educate the clinical leadership – Healthcare organizations need to invest in their people and training. For example, clinicians often don’t have the background or bandwidth to tackle analytical insights without guidance and support. As such, clinical leaders would benefit from educational courses, workflow conversations and other prep to ensure that they can direct their clinical teams in a data-driven manner.
- Establish realistic goals – Training and education investments are doomed to fail if a provider executive doesn’t establish realistic goals. To ensure that data-driven leadership and approaches become part of a clinical staff’s day-to-day, set realistic goals and timelines. And be patient – this will be an iterative approach vs. a one and done.
- Empower self-service - Putting the tools in the hands of business decision makers can ensure real-time decisions are being made towards important organizational goals. There are various tools and interfaces that business leaders can be trained on that are geared with business end-users in mind. This ensures that insights are getting delivered and implemented throughout the healthcare organization and not in an IT-bottleneck.
3. What are the top industry trends or challenges that healthcare organizations should be wary or excited about in the coming months?
- Bundled Payments – With the blend between providers and payers, bundled payments enable the hybrid health systems to properly track and work towards the bending cost curve of fee-for-value. As organizations continue towards value, these forms of payment will bring together cost structure across the continuum of care.
- MACRA/MIPS – CMS’ quality reporting is complicated. There are numerous requirements that providers need to meet – from patient satisfaction to Electronic Health Record reporting - which can be difficult to manage. To ensure healthcare organizations are on track with these measurements, they need to have the right tools and insights in place to meet CMS’ various measures.
- Reducing Costs – Healthcare organizations need to remain focused on reducing costs, whether it’s via supply chain or labor. Understanding where revenue is going tomorrow, later this year and in the years to come is an essential piece of knowledge that will help prepare organizations for any shifts within the industry.
Regardless of the potential changes that lay ahead, one thing is clear: analytics’ role in reporting and identifying care and cost improvement opportunities will only grow in importance. Healthcare organizations need to evolve their technology structure, establish organization-wide fluency around analytics and develop user-specific data tools to ensure real-time decision-making. Through these changes, organizations will be well-equipped to pivot and tackle any industry changes that may arise.
To learn more about an EA strategy, make sure to download our Harnessing Enterprise Data Analytics for the New Healthcare Economy white paper for more insight. To better understand how our EA solution can help you, click here.