(Part 2 of 3 series)
Keeping up with the ever-changing healthcare landscape these days is daunting for provider groups. They face the non-stop challenges of expanding access to care and improving healthcare equity — all while being asked to render personalized, digitized service to each patient.
To meet these demands, many provider organizations have found it crucial to partner with an outside advisor that can deliver on the business of healthcare — the innovations, proven processes and solutions that give rise to better consumer experiences.
The disruptions that providers are grappling with include:
- Shift to value-based care models
- Increased financial pressure
- Talent shortage
- Aging patient population
- Emergence of new technologies
- Industry consolidation
- Increasing consumerism
Addressing these challenges alone can be overwhelming. A trusted advisor can provide a combination of innovation, creativity and perseverance to help provider groups meet their goals.
Drive success with data-driven solutions
Data and digital are at the heart of healthcare today. Successful organizations must collect, analyze and derive actionable insights from vast amounts of complex, disparate data. That information must also be compared to established, science-based benchmarks.
In today’s digital world, technological innovations like telehealth, remote patient monitoring and digital front-door patient engagement platforms are transforming care delivery. Many patients also expect modern digital tools such as chat messaging and personalization.
As provider groups increasingly assume risk in a value-based care world, providing the highest quality of patient-centric care is critical. Organizations must also focus on both enhancing efficiency and boosting revenue.
A trusted partner like Carenet can support these efforts. They can leverage access to engagement data and their deep relationships with industry-wide clients to build and launch informed, consumer-specific solutions.
Leverage predictive insights
Once data is aggregated, deriving intelligent insights from it requires applying sophisticated healthcare analytics. Analytics can be harnessed to predict trends, challenges and opportunities. For example, predictive analytics can identify demographic shifts and forecast demand for services.
The right combination of analytics and third-party expertise will help provider organizations identify growth opportunities, operational efficiencies and strategies for accelerating revenue.
Maximize savings and efficiency
In the relentless quest for growth, provider groups sometimes overlook opportunities to generate savings through greater efficiencies. Trusted partners have a deep understanding of the patient’s healthcare journey. That knowledge allows them to quickly scale new solutions and optimize workflows in ways that will control costs and grow revenue.
Consider, for example, the challenge of managing referrals, which can be time-consuming and costly. One potential solution involves medical referral management software. This tool frees up front office staff for other tasks, closes the referral loop and ensures continuity of care.
Scheduling Management solutions are another example of an initiative to optimize efficiency. They help acquire new patients, retain existing ones, fill schedules and improve access to care in the venues and communication channels that consumers want.
Unfortunately, some of those solutions are too difficult for a standard provider group to implement without help. Many patient engagement and clinical support services are outside provider groups’ core competencies or beyond what internal resources can handle.
Working with a trusted advisor is smart. Together, you can standardize practices and protocols. You can also maximize staff productivity through streamlined processes and digital solutions.
Meet compliance and regulatory requirements
The healthcare regulatory environment is complex and ever-changing. Keeping abreast of government regulations, licensing requirements and service-level mandates, not to mention Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) accreditations, is time-consuming and loaded with risk.
New guidance and rules are continually handed down. For example, the Centers for Medicare and Medicaid Services (CMS) has finalized a rule to add a health equity index (HEI) to the 2027 Star ratings, which will be based on plan performance in 2024 and 2025. The ratings will compare outcomes for members with and without social risk factors.
Optimizing star ratings and monitoring and boosting Healthcare Effectiveness Data and Information Set (HEDIS) scores also takes time.
As provider organizations grow, many find they simply don’t have the capacity or expertise to stay on top of compliance requirements. Instead, they partner with an expert. This step frees up time to focus on growth and deliver quality care.
Plan and realize your business strategy
Providers face high demand for digitized, personalized service with staffing challenges. At the same time, health systems strive to advance patient acquisition, proactive care engagement and commitments to their communities. Achieving long-term visions for financially sustainable value-based care, population health and talent management requires a fortified, expert partner who can improve the patient and employee experience while allowing providers to focus on what they do best – care.
Carenet Health is here to help with unmatched perspective shaped by over 25 years of trusted relationships with more than 500 premier health systems, payers and health services organizations. By combining data, technology and unique engagement models, Carenet Health brings deep expertise to help provider groups plan and realize their business strategies.
To connect with Carenet for tailored solutions to your healthcare business needs, contact us at Carenethealth.com.
