The healthcare payer landscape changes almost daily and it can be hard to see the forest through the proverbial trees. It’s easy to get focused on the day to day and miss important trends that may have significant impact down the road. As we look to the future, it’s important to keep these key trends in mind:
Consolidation
The small to mid-sized payer marketplace consolidation has become increasingly common as organizations struggle with limited resources and increased demand for low-cost high-quality care delivery. While this is not the optimal solution for many organizations, it is a viable one for others. For some, there may be a negative perception that consolidation means giving up control. Concerns like declining patient experiences and/or becoming a “production shop” are always at the top of the list when weighing this option. Finding the right organization and fit to partner with is key and a collaborative environment is critical. All egos must be checked at the door. Consolidation is not necessarily a negative outcome. By partnering with larger entities, smaller organizations can better leverage technology infrastructure support and delivery. However, deep pockets shouldn’t be the only driver to a partnership. In order to thrive in the future, it’s about aligning culture, vision, and strategic direction.
Applied Innovation
I’ve seen many organizations achieve success by effectively applying innovative technologies and new strategies to their business. Operationally, advances in technology like artificial intelligence and RPA are changing the way we do our work. By streamlining mundane and manual tasks, resources can be allocated to other areas with greater returns. Organizations that embrace a growth mindset and leverage new problem-solving techniques to re-engineer and re-define their processes realize significant improvements. For those on the patient side innovative care delivery programs such as home health teams, additional patient engagement initiatives, social workers going into patients homes and assessing their environment to gather informative social determinants data, have all showed positive results in many cases.
Market Disruption
There’s much speculation about what the impact large corporations such as Amazon, Berkshire Hathaway and JPMorgan Chase will have as they enter the healthcare space. While these innovators bring extensive experience with managing big data and making it actionable, they will face the challenge of applying this experience to that touch-point between the patient and their doctor. Healthcare is accessed, delivered, and consumed locally, and to date no big box solution has shown significant success improving outcomes on a national basis. These new players do bring a new perspective that will have an impact on the future of healthcare in our nation. During a recent webinar I heard someone posed the question “When was the last time you accidentally received preventative care?” compared to accidentally buying something via the web. Amazon has effectively changed the way we all shop, only time will tell if they revolutionize healthcare.
These trends may not all apply to your business now but at some point, we will all be impacted by these drivers in one way or another. If you’d like more information about how HCIM can help you achieve your strategic objectives, complete the contact form on the side bar. Connect with us by subscribing to our blog or follow us on LinkedIn to stay up-to-date on important industry news.
Michael Wilson
President & CEO, Co-Founder
HealthCare Information Management, Inc.