Annual Change Healthcare report assesses state of healthcare

Change Healthcare has released its ninth annual Industry Pulse Survey assessing the state of the industry.

Research for the report came from 185 healthcare leaders at high levels in their organizations, including providers, insurers, vendors and Change Healthcare customers, all of whom collaborate via the HealthCare Executive Group. The report is important, says Ferris Taylor, who oversees the executive group. “If traditional stakeholders aren’t able to transform healthcare, outside parties will.”

The report offers snapshots of issues such as market trends, population health, value-based care, consumer engagement, data analytics, risk sharing, social determinants and cybersecurity.

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“As if insurance market changes, value-based care, consumerization and regulatory uncertainty were not enough, this year the industry is facing a new breed of market entrants and innovators whose impact remains unknown but could be substantial,” says David Gallegos, senior vice president of consulting at Change Healthcare.

“Healthcare is navigating disruptions on multiple fronts, and consequently, payers and providers are finding themselves stretched thin as they try to address a perfect storm of change,” he adds.

Findings include:

• Outside influences are intensifying as a confluence of forces such as people, processes and technology will require stakeholders to turn to new business and market strategies. In particular, watch for non-health entrants coming in the market with consumer-centric innovations that could accelerate patient engagement, report authors note.

• A healthcare market where the majority of value-based relationships include upside and downside shared risk continues to be three to five years away. This could be an indication that both providers and payers are struggling to move value-based care and reimbursement models from pilots to production.

• Consumers want better access, cost and convenience of care, which could bring in outside competitors skilled in providing a retail consumer experience.

• Cybersecurity programs remain a lower funding priority despite escalating breaches and responding organizations remain unready. Forty percent of them cite the sophistication of attacks outpacing current prevention capabilities.

The report further gives snapshots of multiple issues, such as the need for financial incentives for data sharing.

Money makes the healthcare world go around and there remains an open question of what would motivate stakeholders to share data that helps drive clinical decisions. It’s all about financial incentives for data exchange, most healthcare leaders agreed. Value-based care includes monetary incentives tied to quality metrics and outcomes, compelling close payer-provider collaboration.

“In fact, collaboration and integration are where multiple respondents put the onus for incentivizing data sharing,” according to the report. “You can’t exchange data without integration and the prerequisite standards and interoperability. This directly ties into the recognition that payers and providers must find ways to integrate processes to share data and drive decision making.”

Cybersecurity is an area that may not be getting the attention and funds needed, but that may be in part because of a belief that the criminals are too smart to be countered. Consequently, sufficient cyber funds are an afterthought until there is a big data breach. Cybercrime is a moving target and hackers cannot be outwitted, a full 40 percent of respondents say.

Progress in the use of analytics was limited in 2018, which could have been related to issues around data sharing, the lack of standardized formats and concerns around privacy and data ownership. But overall, the industry continues to make better use of analytics to improve quality and outcomes, healthcare leaders say. For example, analytics is having its biggest impact on the effectiveness and efficiency of workflows, almost a third of respondents noted. Another 28 percent viewed analytics as effective in empowering more productive providers. However, industry leaders view analytics as being least effective in reducing healthcare costs.

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