Health systems are sitting on troves of data that often languish unused in silos, but this data can supercharge an organization's ability to compete with nimble new competitors.
During a featured session sponsored by Health Catalyst at Becker's Annual Health IT + RCM Virtual Event, Adam Ziegel, senior director of product management operations at Health Catalyst, discussed a strategic shift that traditional health systems need to make to stay competitive.
Five key learnings:
1. The healthcare landscape is evolving amid dynamic competition and changing goalposts. Consolidation and integration between providers and insurers are intensifying, patient volumes are decreasing and labor expenses are increasing. These trends are putting pressure on traditional healthcare delivery systems to compete on value against powerful new entrants such as Teladoc, Amazon and Boeing that are offering value in new ways and pricing it competitively. "At Health Catalyst, we think this is a permanent impact and that the goalposts of the field on which healthcare providers are playing have shifted," Mr. Ziegel said.
2. To thrive in this new world, legacy organizations must act more like the newcomers. It is time for traditional health systems to evolve their business model and embrace the important factors generating business value, along with reducing physician burnout and bureaucratic burden. If incumbents do not adapt, do not respond to the changes happening around them and continue to play "prevent defense," they will likely lose out. Mr. Ziegel diagnosed this risk as a business problem, not a technology or a healthcare delivery problem.
3. To enable these changes, the role of healthcare finance must shift. Finance leaders are sometimes seen as distant by clinicians, but can recast that perception by partnering with, supporting and empowering providers, understanding their pain points, and internalizing how the choices made by finance teams affect clinicians' day-to-day work. "It's about moving the mindset toward quarterbacking the actions of the entire healthcare team," Mr. Ziegel said.
Key skills for finance teams include:
- Understanding of clinical and business operations
- Understanding of healthcare costs and methodologies
- Developing expertise in various economic models
- Effectively using analytics, statistics and data science
- Investing in technology
4. Intelligent use of data can support the modernization of traditional business models. This means deriving insights from the data that legacy organizations have accumulated, including clinical, claims, cost, revenue, patient satisfaction, geospatial and social determinants of health data. "[Leveraging analytics] is one of the few places where legacy health systems have a true leg up on the big new entrants that are out there," Mr. Ziegel said. He gave the example of a network of U.S. hospitals collaborating with a nonprofit generic drug company to procure cheaper drugs and thus claw back some of the business opportunities that pharmaceutical companies, health insurers and retailers have begun to vertically integrate around.
5. The revenue cycle presents an excellent opportunity to begin a non-siloed approach to data. Doing so entails jointly analyzing costs and charges to identify and renegotiate services with high cost-to-charge ratios, using the Price Transparency Regulation to analyze and reduce variances between individual payer contracts and taking advantage of the No Surprises Act to identify opportunities to move services in-network.
The changing healthcare landscape calls for innovative thinking and decisive action on new models that drive value for patients and business value for health systems. Organizations that leverage revenue cycle and cost data to power those shifts will come out ahead.