Industry Pulse Report: Value-Based Payments, Interoperability, and Healthcare Accessibility

The healthcare sector is continually evolving. Just about everything can cause a ripple effect, no matter how big or small the change might seem right now. The tiniest shift, like a slight price increase on a specific drug, can mean deferred care for patients who then flood the healthcare system later, causing higher costs down the road.

We are in the midst of an evolution as more and more Payers and Providers adopt new technologies, try to make the transition to value-based payments, enact price transparency regulations, and try to solve the cumbersome interoperability issues plaguing healthcare.

In the 11th Annual Industry Pulse Report, HCEG (HealthCare Executive Group) and WEDI (Workgroup for Electronic Data Interchange) explored the top 10 priorities facing Payers, Providers, and healthcare industry stakeholders.

Let’s take a closer look at key points and see if there is a solution to the mixed bag of negative and positive outlooks.

A Magnifying Glass on Value-Based Care

Covid-19 impacted everything in the healthcare industry. From staff shortages to deferred care that is now causing price increases. It seems the tsunami of the pandemic has even reached as far as impacting the adoption of value-based care programs for Providers.

While Payers are enthusiastic about Provider adoption, most Providers are still working under a FFS (fee for service) model. Although the progress of value-based payments has slowed, it isn’t stagnant by any means.
Providers are lacing up their boots after the pandemic and getting back to optimizing the care continuum.

Most Providers have value-based programs already in place, so now, the only thing that needs to be done is to take action. The question is, how will the staff shortages and overall lack of resources affect the adoption of value-based payments?

Top of Mind: Healthcare Accessibility

If there’s anything that can be gathered from this section of the report, it’s that improving accessibility is a sore topic across the board. Respondents from both sides were all over the map when surveyed about improving accessibility and how to do it.

One thing that they agreed on was that insufficient resources–like budget, technology, and staff shortages – are the biggest hurdles to improving accessibility.

While this isn’t an easy problem to solve, the right technology can help. For example, a compliant RPA (robotic process automation) solution can help lessen menial administrative tasks like provider data update entry and eligibility or authorization verifications. The right remote monitoring solution can lessen in-patient visits. A great telehealth solution can make healthcare accessible to populations in rural areas. The list goes on and on. 

Interoperability: Will it Ever be Easy?

Healthcare interoperability is one of the biggest objectives for Payers and Providers because it’s crucial for providing care promptly and seamlessly, no matter where patients choose to obtain care.

Security measures, compliance, and closed EHR architectures stand in the way. Patient data concerns are top of mind for Providers and Payers alike. Technology moves at a faster rate than new regulations and loosening organizational resistance. This is another area where implementing the right technology, perhaps one purpose-built for the healthcare industry, would be vital.

There is a heavy focus on value-based payments, price transparency, patient data, and interoperability. Progress in healthcare, especially when it comes to technology, isn’t always easy but by working together, the industry is slowly getting there.

For more information on how the right technology and IT systems can help your healthcare organization, contact us today!