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Weather the storm

Is Your Organization Prepared for the Storm?

June 11, 2015 // Erik Nelson

Is Your Organization Ready to Weather the Impending Storm?

Healthcare systems—as we know them today—must change or face a financial crisis in the next three-to-five years. The perfect storm of healthcare reform, radical reimbursement changes, medical breakthroughs and “big data” insights is fast approaching. It will quickly devastate organizations that are not prepared.

The Winds of Change Are Already Blowing

Considering the following:

  • Reimbursement changes are reaching a tipping point. HHS recently announced that, by the end of 2018, 50% of Medicare’s payments will go to providers participating in alternative payment models. These programs, which essentially shift the “total cost of care” risk to providers, will require organizations to possess an entirely new set of preventative and post-acute care capabilities that do not exist in most provider organizations today.
  • Breakthroughs in nanotechnology and pharmacogenetics will usher in a new era of “personalized medicine.” This will move the industry away from a reactionary hospital-centric model to a system that delivers preventative services in a number of different retail, clinic and other non-hospital settings.
  • Payer demands for value-based care will require provider organizations to use data in a more sophisticated manner to improve outcomes and achieve efficiencies. This will require advanced analytics and data integration capabilities that do not exist today.

Timing Is Everything

The challenge for healthcare delivery organizations will be to time the development and implementation of new capabilities in such a way that it coincides with the tipping point of new at-risk payment models.

  • If they change too quickly, current reimbursement practices will penalize them.
  • If they move too slowly, they face the risk of being irrelevant.

With so much at stake, healthcare organizations need to take action now by developing a flexible roadmap that provides clear direction and dedicating talented leaders to ensure that this strategic effort is successful.