The truth is that the task of transforming healthcare is complex, and there is no clear path forward. The entire healthcare ecosystem must band together to overcome significant challenges impeding access and cost of care. The question is: Where to begin?
To help you get started, we rounded up top trends to guide your Population Health strategy in 2022 and beyond.
Improving population health and controlling costs is not part of the design of the current payer financial model in U.S. healthcare. Instead, the focus is on treating illness, and, as such, providers receive payment for transactional care. But influencing population health and controlling costs takes more than appointments, tests, and procedures. Here are some of the innovations we're seeing in the payer-provider model.
During the COVID-19 pandemic, we saw a sharp spike in telehealth and other remote access solutions. This trend will continue, and many providers are expanding virtual appointments across their care lines. However, questions remain about access, pricing, and reimbursement for these alternative care settings.
It's also possible that we may see expanded home-based care options in the upcoming year. Delivering more remote services may allow organizations to reduce the number of facilities, significantly decreasing overhead costs.
Relationships between payers and providers are becoming increasingly collaborative. Evidence of this is the movement from contractual agreements with accountable care organizations to different models, including joint venture and full vertical integration mergers.
Lack of data and understanding has long been a stumbling block in achieving value-based care. But the accelerated adoption of technology can secure better outcomes for payers, providers, and TPAs.
Health systems are looking to technology to support new avenues for patient interactions. Beyond telehealth, other efforts include mobile apps that guide the patient journey in ways beyond just accessing health records. For example, with mental health patients, applications are being designed to provide auxiliary information.
Doctors spend more than half their time on paperwork and EHR-related tasks. Besides being a productivity drain, this glut of administrative tasks is detrimental to the cost of healthcare. And, since doctors are filling out forms instead of seeing patients, this can create access problems. To change this, organizations are leveraging technology such as electronic self-service solutions and EHR workflow integrations.
The goal is a comprehensive understanding of a patient — no matter how, where, and when they receive treatment. The good news is that we're getting closer. Integrated data and workflow enable the real-time exchange of information between payers, providers, and patients. In some cases, data sharing happens between health plans to allow data tracking as people move between insurance and health systems.
Now, more than ever, partnerships are pivotal to organizational health — both with other stakeholder groups and with partners who can enable better results.
In the last year, some of the most impressive results stemmed from the combined innovation of payers and providers. Alignment across groups can help with cost containment — for example, if payers and providers are aligned, it can influence pharmaceutical pricing and billing structures.
Incubation offices are another notable trend likely to improve member experience and improve cost of care. Instead of rolling out ideas across the entire patient group, payers and providers work together to create and test customer value hypotheses before widespread implementation.
While it's clear that technology is key to advancing population health initiatives, technology hasn't always been a core competency of payers, providers, and TPAs. Companies embracing these emerging trends use a company like Concord to provide flexible staffing, progressive delivery, and elastic services to support your efforts every step of the way.
To stay on top of trends in Population Health and Value-Based Care, visit https://health.concordusa.com.
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