On The Issues

February 8th, 2016

As 2016 starts to unfold, the new normal holds: rapid change and innovation

A few tips on keeping pace

January launched 2016 with as much velocity as any year that I recall but as I look out to how healthcare will shift this year (and probably next), what jumps to mind is an overall comfort that almost every aspect of healthcare is undergoing rapid change (or some say evolution). This is the new normal and I see it in communities all across our country.

I also must admit that our personal thoughts and ideas are largely shaped by our circle of peers and influencers so I personally work hard to keep a foot in multiple healthcare markets to understand how the majority of our communities are shifting. Here are a few consistent themes I see emerging over the next 12-18 months:

Provider expansion of services and strategies: By this I mean, whether in the city of Atlanta, Boston or San Francisco, or the rural communities of South Carolina, Texas or Massachusetts, I see and work with health systems and physician practices that are expanding services, partnerships and expanding “consumer” access. The motivations behind these expansions are diverse, but everyone is experiencing a shift in how healthcare is being consumed, where it’s being consumed and when it’s being consumed. I am also seeing a stronger focus on efficiency, but not enough yet, in my opinion. All organizations need to strategically and wisely better align their processes and operations with their revenue drivers for today as well as their revenue drivers for tomorrow.

Focus on the patient and better respecting that the patient is a “consumer”: Physician practices, clinics and health systems of all sizes are working to make conducting business with their organization easier. In that I mean align or re-align processes, services and innovation to ensure that patients can easily access scheduling, appointments and certainly, payments. While this sounds like an “of course!” statement, most, even leading health systems, don’t properly align these aspects of their organization and operation, thus leaving millions of dollars on the table. For example, ensure your organization offers simple ways to schedule an appointment. Ensure that you are researching - or better yet deploying - “community-based” strategies that offer care where the patient/consumer wants to consume care. Sometimes the best place may be inside the four walls of your organization, but sometimes it may not be. A few proven strategies here include new care settings that are convenient for your community and even a virtual care or telehealth strategy. These can offer new revenue streams and allow practices, clinics and health systems of all sizes to deploy strategies that will allow them to evolve alongside a healthcare system that is embracing value-based medicine, bundled payments and alternative payment models.

Other consumer-focused strategies that I see growing quickly are patient navigation and wayfinding to simply and profitably enhance the patient experience (and as we know from research flooding the market, consumers are paying premiums for “experience,” and as our economy shifts, everyone needs to keep an eye on this because you can offer a terrific experience and actually save money by better embracing innovation.

The other area that I see exploding for practices, clinics and health systems is around “compassionate collections” and a strong, focused strategy on the patient revenue cycle. Many innovations are hitting this from different angles, but as patients continue to pay for more of their healthcare “tab,” efficiently and effectively managing this process is key to protecting and increasing your organization’s bottom line.

Use of innovation to navigate the future of healthcare: I see innovation being deployed at every level of service, process and technology. To start, many organizations are focusing on better managing their overall “revenue cycle”. This is best deployed through a technology-enabled service whereas a specific market expertise leverages software automation, “rules” intelligence and robust clinical, financial and administrative reporting. Not only is this important today to optimize an organization’s overall financial health, but it is going to become vital to everyone’s success and preservation as healthcare quickly shifts to new payment and care delivery models, outcomes and quality-based payments and razor thin margins on traditional payment models. This experience and expertise will be worth its weight in gold…

Interoperability is still a large focus for many. Certainly more in the urban areas than rural, but I do see the rural communities picking up interoperability steam to drive care coordination, protect or enlarge their patient base as well as to participate in new payment and care delivery models. We’ve been talking about standards and interoperability for a long time now but the conversation has shifted in many communities to actionable intelligence on how interoperability is fueling coordinated and higher quality care.

We’ll see much faster progress with “connected care” that is driving innovative care and increasing care access in every community. Advancements across the board with telehealth and virtual care as laws mature and payment & reimbursement structures are solidified.
I also see pop health & quality reporting finally begin to receive the respect that it deserves. With many progressive organizations today, it is driving their financial and strategic bottom line. Those organizations are well-positioned to successfully navigate the future of healthcare no matter what, since managing structured data, clinical quality measures (CQMs) and robust reporting will be essential to all sustainable payment structures in the very near future.

I would be remiss not to mention the importance of data security for 2016 and beyond. While it may not feel as exciting and opportunistic as implementing cool innovations popping around consumerism, mobility and population health, having a strong data and platform security strategy and implementation will be essential to protect your information, integrity, brand and bottom line…

As I wrap up these thoughts, I realize that even after 20 years in healthcare and health IT, I just love this industry and all of the opportunity it serves each of us to help create the smartest and most sustainable healthcare system in the world!

Justin is a corporate, board and policy advisor as well as host of the weekly syndicated radio show, “This Just In”.