With the passage of the Patient Protection and Affordable Care Act, healthcare providers must transform their operations now to prepare for the more demanding market conditions, such as tighter reimbursement, that lie ahead. To thrive in this environment, providers must find ways to bend the cost curve now by increasing the efficiency of their operations, measuring quality outcomes and how they will relate to reimbursement, controlling utilization and reducing costs across the board.
In a reformed healthcare environment, the following traits in healthcare providers will be more important than ever:
Quality - public payors will shift away from the Fee for Service model to models that will reward quality and hold low performers accountable by withholding reimbursement. Bundled payments and pay for performance (P4P) models will be prevalent in the future for both public and private payors.
Transparency - the U.S. government will make quality metrics move available than ever to U.S. healthcare consumers, allowing them more choice as to where to spend their healthcare dollars. Patients will also want to know more about their cost for healthcare since many patients are now self-pay or on high-deductable plans.
Efficiency - most of the 32 million additional people who will be insured by 2019 will be on public payor plans such as Medicaid, which currently reimburses at rates below costs for most healthcare providers. Healthcare providers must find ways to reduce costs and increase efficiency in order to survive in a world where reimbursement rates are tighter than ever before.
Adaptability - CMS is investigating new models to improve quality in the way that healthcare is delivered. All of the models will require that healthcare providers be adaptable to new ways of doing business. Models such as Accountable Care Organizations (ACOs) will require more physician alignment and engagement than ever before.
How MedAssets Helps
MedAssets offers customized solutions that help healthcare providers better manage their margins through increased efficiency and reduced costs. We’ve helped some of the leading healthcare providers achieve more than $1 billion in financial improvement.
With MedAssets, you can:
- Measure potentially avoidable complications and bridge from fee-for-service to new payment models with MedAssets Bundled Payment Solution.
- Engage physicians in the cost-reduction process using clinical data and manage clinical costs across service lines using Service Line Analytics
- Accelerate cash flow and reduce bad debt using MedAssets’ Revenue Cycle Services