When one considers the confluence of regulatory change, digital technology, and capital forces affecting medical professionals today, it’s safe to say there has been no other time in healthcare quite like the period we are entering now.
Healthcare executives have the opportunity to lead the way to success in this time of increasing financial risk and performance-based reimbursement. Although only 42% of hospitals reported that 10% or more of their revenue is tied to value-based contracts, momentum towards taking on risk for lowering costs and improving outcomes is building. Risk is being shifted to providers from payers under programs such as Medicare Shared Savings on the public side, and Blue Cross Blue Shield of Massachusetts’ Alternative Quality Contract (AQC) on the commercial side. Under these arrangements, payment is for quality, not volume.
Why does health IT matter so much? Clinical analytics to learn what works best is critical to improving care and bending the cost curve. But the challenge is not only achieving better outcomes, but documenting and reporting on those outcomes. Reimbursement under value-based models is directly linked to the ability to report on quality measures. If your reports don’t match the quality of the care you deliver, you are simply out of luck. If your reporting requires highly trained clinical personnel to spend time populating fields and reading records manually, that’s wasting resources.
Hospitals will no longer stay in business if they persist in old ways of operating: essentially, throwing expensive clinical labor at problems.
Smart technology is the only way to survive in this time of change. So the CFO should care about health IT as much as the CIO.