Sponsored: The Post-ACA World at a Glance
Healthcare is among the most highly regulated industries. To further complicate matters, the regulations are ever-changing. Today, healthcare organizations must possess the agility to transform current practices and constantly navigate new waters. Following the Affordable Care Act (ACA), key changes must now be made to the current care paradigm. These changes center around three initiatives in 1) expanding preventive care programs, 2) adopting a pay-for-performance (P4P) reimbursement system, and 3) increasing the focus on patient-centered outcomes. These sweeping changes will require significant improvements to healthcare’s current workflows and IT infrastructures.
So, how can healthcare organizations effectively respond to these evolving regulations? The answer lies in establishing a strategic approach to care coordination. The technologies that can enable these outcomes – enterprise resource planning (ERP), electronic medical record (EMR), and customer relationship management (CRM) solutions – are no longer nice to have. Understanding the need for these technologies are key to surviving the post-ACA world.
1. Preventive Care
In accordance with the first initiative, health plans are now being urged to cover a host of preventive care services including vaccines and screening tests, at no additional cost to the patient. This requires state-of-the-art systems that not only register more patients for additional services, but also track this additional data over time, and securely share with all involved in the patient’s care. This is where coordinating care at the organizational level becomes key. Organizations need to adopt ERP/EMR/CRM solutions that allow full integration to their existing IT infrastructures. Fortunately, this is a viable option and one that can meet the demands for expanding preventive care.
2. Pay for Performance
Secondly, the P4P initiative requires healthcare organizations to shift to a “quality-based” care model in which compensation is no longer simply tied to the service rendered, but to the outcomes of that service. In the past, healthcare organizations have been notorious for lacking transparency into procedural costs, inventory, and patient outcomes. However, hiding this information will no longer be tolerated in the post-ACA world. Again, the technology is available to embrace the P4P initiative. Modern ERP solutions that can regulate supply chain management, revenue cycle management, and also report key performance indicators are essential to meeting this second requirement.
3. Patient-Centered Outcomes
Lastly, achieving patient-centered outcomes means that patient relationship management systems are now more essential than ever. Currently, most healthcare organizations rely on EMRs to manage all patient health information. However, EMR systems contain highly sensitive information and the systems and its security controls are complex. As a result, patient access is limited. Instead, CRM systems can improve patient access to their health records via user friendly patient portals. When CRM systems complement EMR systems, a complete view of the patient can be achieved and patient-centered outcomes can be fully realized.
Healthcare is complex. The regulations are high and demand continuous improvements to existing infrastructures. Fortunately, we have the technology to survive the post-ACA environment; knowing how to harness the technology you have is your key to thriving.
When care coordination programs are effective, patient satisfaction, key performance indicators, and the bottom line are all improved. We can help you thrive in the post-ACA world. For more information, please visit:
