As the healthcare ecosystem evolves, organizations must also. This evolution requires a more strategic perspective on resources, expertise and focus. Prioritizing development in an environment already stretched thin can be challenging, particularly as healthcare reckons with challenges emerging in the aftermath of the COVID-19 pandemic. Yet, these issues must remain top-of-mind for healthcare executives. Outsourced partnerships in this space can alleviate some of the burden in areas that otherwise may strain resources in a hospital that employs physicians and advanced practice clinicians across multiple specialties. Four of the most notable areas to consider are regulation, population, innovation and education.
Regulation: Dispute Resolution
Healthcare reimbursement and regulation are changing. The changes highlight the widening gap between insurers and healthcare providers as court challenges and policy debates continue. Arbitration is one of the most impactful changes for healthcare organizations, as it offers an independent dispute resolution (IDR) process for insurers and providers without impact on patients receiving care. Hospital and health system leaders who choose to employ their hospital-based and other clinicians must ask: Do we have an arbitration strategy? Are we prepared to make the necessary financial investments to be successful in this new paradigm? Do we have the resources to challenge future headwinds in reimbursement? These questions lay a foundation for response to the fluctuating regulatory ecosystem.
Population: Medicare and Medicaid Enrollment
An increase in Medicare enrollment will continue as a large sector of our population ages into qualification. Medicaid enrollment is also surging, partly due to the qualification expansion in response to the COVID-19 pandemic. These trends parallel the ongoing adoption of a refreshed value-based care (VBC) system, which emphasizes high-quality care, lower costs and population health management. To meet the needs of the VBC environment, healthcare organizations must evolve, and new skill sets must be developed. Technological and analytical advances must drive the change, and a renewed focus on preventative care is critical.
Innovation: Technology and Analytics
As chronic care needs and acuity levels evolve, so too technology must drive healthcare advances today and beyond. Perhaps most notably, healthcare must adapt as the rest of the world embraces revolutionary technology like artificial intelligence (AI). Innovation must happen at both small and large scales. The COVID-19 pandemic forced many innovations on both scales, from fast-tracked vaccine manufacturing to local telehealth adoption. In a post-pandemic environment, healthcare organizations must have a safety net of resources and expertise to implement tech-driven solutions.
Education: Diversity, Equity and Inclusion
Areas that traditionally have not been broadly recognized deserve more attention and education. One of these areas is health equity, an objective of CMS’s value-based care strategy refresh. For example, maternal mortality, which reached staggering heights in the United States over the last several decades, affects women differently based on race and socioeconomic status. Research has shown that diversity and healthcare correlate to better patient outcomes. Healthcare leaders and educators should sharpen and maintain focus on a wide range of issues surrounding diversity, equity and inclusion and the related disparate trends in patient outcomes.
Where Do We Go From Here?
The healthcare industry must champion a forward-looking strategy that tackles present challenges while anticipating future roadblocks. That means forging partnerships that sustain the necessary expertise and resources to respond to changes in regulatory statutes, patient populations, technological advancements and healthcare disparities. Outsourced clinical services partnerships in particular can provide viable alternatives and offer expanded solutions in a complex system. Strong partnerships among dedicated clinical, administrative and operational healthcare workers will ensure a healthier patient population and improve the industry.
Meeting the Demand of a Changing Healthcare Landscape
TeamHealth’s scale across the care continuum and decades of experience mean we have the expertise and resources to position our clients for success as the industry changes. Our teams are proactively implementing innovative solutions in the value-based care and telehealth spaces. Moreover, our educational experts provide hundreds of diverse units, including newly updated courses on maternal mortality and disparities in care. Finally, we have the resources to respond to regulatory changes and fight for fair front-line clinician compensation – our victories and ongoing legal cases prove this. Finding the right partner with the right tools is vital. Connect with our team to learn more about building a partnership with us.