From the August 2016 issue of HealthCare Business News magazine
By August Calhoun
Health care organizations are challenged with staying financially viable while improving patient care in what has become a rapidly changing regulatory and reimbursement environment.
To accomplish this delicate task, health care providers must reshape their operations to deliver cost-competitive services that improve patient outcomes and yield sustainable growth.
Last year, the Department of Health and Human Services (HHS) announced an aggressive plan to link 30 percent of fee-for-service (FFS) Medicare payments to alternative business models — including accountable care organizations (ACOs) and bundled payment programs — by the end of 2016, with a goal of 50 percent by 2018. This HHS plan further contributes to the seismic shift from an FFS model to value-based payments within the health care sector.
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Among commercial health plans, 40 percent of payments to physicians and hospitals are designed to incent quality improvement and waste reduction. This is a rapidly growing trend from 2013, when only 11 percent of payments in the commercial sector were tied to value.
How can service organizations help customers manage these changes? Health care providers want their service providers to function as strategic partners that offer risk-sharing partnerships that can support the redesign of care processes, reduce capital expenses and navigate the shifting landscape. Historically, service providers offered product-related or point-of-care services and introduced innovations in focused areas.
The new opportunity is to offer a broader portfolio of value-added services. This portfolio can include enterprise-wide offerings such as workflow, data and analytics, consulting, managed departmental services and tools that strive to improve clinical and operational results. These services must provide clear value and deliver fast results, as well as be highly flexible to meet specific client needs.
Leveraging information is critical in this journey. Digitalization — the compilation of data to help providers make informed decisions about care delivery — can be applied at every level in a health care enterprise, from initial point of care to managing departments more effectively.