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’s organized and the way it functions, while coming to grips with new strategic priorities. Payers and providers are partnering in bold new ways, while physician practices are often teaming up with larger health systems. Providers will reinvent themselves as care delivery networks focus 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. 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.
McKesson 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.
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. The steps we take now will help ensure that we create a healthier future for our organizations and, most importantly, the patients who depend upon them.
About the author
Pat Blake, Executive VP of McKesson Corporation and Group President of McKesson Technology Solutions.
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