Healthcare is facing rapid changes. Here’s what you need to know to stay ahead in 2019 and beyond.
The healthcare industry is facing many changes that pose new challenges to healthcare organizations big and small. In particular, the fast-evolving government regulations, technological innovations, and patient expectations create a new environment in which running a medical practice isn’t just about treating patients anymore.
Looking into 2019 and beyond, here are five major challenges faced by the healthcare industry and how to stay ahead:
Due to the highly sensitive patient information collected by healthcare organizations, the industry has become a prime target for cybercriminals. In 2017, the US medical and healthcare sector experienced over 350 data breaches, exposing 4.93 million patient records.This trend will continue as many healthcare providers are still slow in responding to threats while the decentralized systems make them more vulnerable to attacks. When a breach occurs, not only are you compromising confidential patient information, but you also face a hefty penalty if you’re found to have violated the many compliant standards regulating the industry. Besides improving cybersecurity, healthcare providers can also outsource their processes involving sensitive patient information such as invoicing and billing to a HITRUST-certified third-party provider which has dedicated resources to ensure that its system is properly protected against cyber criminals.
- Invoicing and Payment Processing
Collecting payment has become more challenging as patients are becoming responsible for a larger portion of their medical bills. If you want to increase the speed and amount of your collections, you shouldn’t make your patients jump through hoops. To meet patient expectations and improve the user experience, make sure your billing statements are patient-friendly. You should offer paperless statements and a variety of payment options (e.g., eCheck, credit card, etc.) via an online patient portal and utilize the latest payment technologies, such as mobile and text-to-pay. However, it’s often challenging for medical practices to set up such invoicing and payment processing systems in-house. Not only do they have to negotiate terms with each payment processor and build the infrastructure (e.g., patient portal, secure payment processing) but they also must absorb the ongoing administrative cost of maintaining such technologies. Additionally, healthcare providers are required to follow strict guidelines to protect patient information. You need to ensure that your payment portal and processing system are fully compliant, or you risk incurring a hefty penalty.
- Patient Experience
The medical insurance landscape has experienced some significant changes in recent years. As more patients are responsible for a larger portion of their healthcare bill, they naturally demand better services from their providers. Healthcare organizations will face tougher competition in attracting and retaining patients who demand an experience that matches the level of customer service they expect from other consumer brands. They demand a streamlined patient experience so they can “self-service” to resolve most questions, issues, or concerns (e.g., downloading an immunization record, booking an appointment, paying their bills, or checking their account/insurance status) whenever, wherever, and however is most convenient for them. For healthcare organizations offering a variety of services in different locations, it’s also important for every employee to have access to the most up-to-date patient information from one centralized location. Not only will it deliver a better patient experience (who wants to tell their story from the beginning every single time?) but also help avoid fatal mishaps such as drug interactions. To create an outstanding and streamlined user experience, you need to create a patient portal that keeps all the patient interactions in one place. It also allows all your employees to access each patient’s history — which is updated in real-time — from one centralized record to avoid costly mistakes.
- Effective payment model
In order to reduce cost and increase service quality, there’s now a trend toward determining financial incentives based on patient outcome rather than service quantity. Payers and patients are demanding new payment models — such as bundled payments, disbursement to patient-oriented care providers, global payments, and shared savings — that encourage care providers to coordinate services and promote preventive care. However, there are many challenges in implementing these new models and monitoring the processes within the existing systems. For example, new metrics need to be defined to measure performance and ROI. Healthcare providers should pay close attention to the development of this trend. Look to early adopters and large organizations (e.g., Medicaid) who are testing and fine-tuning these new payment models to understand how best to reduce cost and improve patient outcomes while staying profitable.
- Big data
Although more and more healthcare data is being generated, it’s scattered across multiple parties and systems including payers, providers, and patients. There’s no single “source of truth” that providers can use to optimize patient experience. For instance, when patients switch insurance plan or healthcare provider, most medical practices rely on patients’ self-reporting to reconstruct their records. As a result, not all the information is transferred properly and it’s very challenging to harness the power of data and generate accurate insights. In addition, healthcare data comes from many sources in a variety of formats. Currently, there’s no single system or technology infrastructure to retrieve, store, and analyze data from various sources at scale. For healthcare organizations to successfully harness the power of big data, leadership needs to embrace data-driven decision-making. The use of analytics should be woven into the organization culture to develop a trust in data so the insights can be used to support decision-making at the executive level. In order to fully leverage all the patient data from a variety of sources, healthcare organizations need to implement non-relational information technology so data from various sources can be utilized even if the datasets come in different formats. To lower your administrative cost, minimize costly errors, and improve patient experience, you can use a HITRUST-certified third-party provider to handle patient statement design, invoicing, and payment processing.
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