Three strategies for health execs navigating value


Healthcare organizations are looking for new ways to engage consumers, streamline information sharing and transparency and collaborate with other industry stakeholders. As a result, healthcare stakeholders need to focus on three key strategies.

As the industry shifts toward value-based care, healthcare organizations are looking for new ways to engage consumers, streamline information sharing and transparency and collaborate with other industry stakeholders.

Incorporating these changes across providers, payers, and consumers will enable quality and cost outcomes, promote accountability, improve clinical outcomes and the patient experience, while also increasing cost efficiency.

As a result, healthcare stakeholders need to focus on three key strategies:

  • Investing in consumer-centric innovations

  • Developing a pervasive brand experience

  • Embracing disruption.

Investment in consumer-centric innovations

BridgeAs payers and providers collaborate to provide value-based care and to increase patient engagement and satisfaction, they are each assuming new roles traditionally performed by the other.

For example, providers are more accountable for population health management and financial outcomes, and payers are more engaged in patient care and clinical outcomes. The challenge of creating a truly consumer-centric care experience is the collaboration and sharing of information between payers and providers that creates the seamless navigation of healthcare systems across the continuum, from both a financial and clinical perspective.

In order to enable a consumer-centric approach, healthcare stakeholders should also look to technology investments. We’re already seeing this in the industry, where payers are investing in online, social and mobile technologies in order to connect with their members.

They are also more focused on how to acquire, engage and retain members in a highly competitive, price-driven environment due to the health insurance marketplace.

On the other hand, accountable care organizations (ACOs) are investing in patient-centric technologies-from e-prescribing services to patient portals and e-mail communication between the patient and provider-to increase meaningful engagement, drive better health outcomes and deliver the right care in the right place, at the right time.

As a result, investing in these innovations to drive engagement and collaboration is crucial to providing a holistic healthcare experience across the entire care continuum.

Next: Develop a pervasive brand experience



Develop a pervasive brand experience

The lines between payers and providers are continuing to blur, making it increasingly important for these entities to work together to provide a holistic healthcare experience.

SmithThis includes having payers and providers consider the impact of their interactions with members and patients on the overall association of their brands, which are mutually affected by the experience of both parties.

In addition, when it comes to top-of-the-line service and user experience, consumer expectations are at an all-time high. Healthcare organizations must differentiate themselves by using digital technologies that provide information tailored to the specific needs and preferences of the content user.

They also must find new ways to meaningfully interact with their members or patients on a regular basis, rather than just when they need care or help filing a claim.

Embrace organizational disruption

The healthcare industry is undergoing a disruptive change, shifting from wholesale to retail.

More Americans are now insured, but, relative to the financial risk being assumed, reimbursement per patient is dropping.

Digital technologies are becoming a core element of member and patient engagement, forcing healthcare organizations to think of new and innovative ways to engage with their customers. Financial models are also fundamentally shifting away from fee-for-service to value-based reimbursement (VBR).

The shift to VBR will also require payers and providers to embrace disruption as the healthcare industry races toward consumer-centric care. To get there, both payers and providers will require new business models that break down data silos, align incentives and develop cross-application connectivity.

However, none of this can be achieved without the support of an underlying connected healthcare network, consisting of meaningful data that orchestrates bi-directional, complex transactions and communications.

Many of these “collaboration platforms” are coming to market today, and will enable consumers, members and patients to seamlessly interact with the healthcare ecosystem to access and coordinate care.

As a result, disruptive platforms will be a key driver for any healthcare organization that is thinking about how to reengineer its business for the next generation of healthcare.

Looking ahead

Healthcare organizations are developing innovative approaches to engaging members and patients in more seamless experiences, by changing the way they conduct business and moving to a consumer-centric approach.

In addition, these healthcare stakeholders are focused on delivering experiences that span the care continuum to engage and empower consumers to make more informed decisions about the cost and quality of their health, while simultaneously looking for new ways to drive operational efficiencies in an increasingly digital world.

Larry Bridge is senior vice president, strategy and corporate development at TriZetto, a Cognizant Company.

David Smith is chief development officer, Leavitt Partners Consulting.


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