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Can Providers Survive If They Don’t Get Population Health Management Right?

Posted on August 27, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Most providers know that they won’t succeed with population health management unless they get some traction in a few important areas — and that if not, they could face disaster as their volume of value-based payment share grows. The thing is, getting PHM right is proving to be a mindboggling problem for many.

Let’s start with some numbers which give us at least one perspective on the situation.

According to a survey by Health Leaders Media, 87% of respondents said that improving their population health management chops was very important. Though the article summarizing the study doesn’t say this explicitly, we all know that they have to get smart about PHM if they want to have a prayer of prospering under value-based reimbursement.

However, it seems that the respondents aren’t making nearly as much PHM progress as they’d like. For example, just 38% of respondents told Health Leaders that they attributed 25% or more of their organization’s net revenue to risk-based pop health management activities, a share which has fallen two percent from last year’s results.

More than half (51%) said that their top barrier to successfully deploying or expanding pop health programs was up-front funding for care management, IT and infrastructure. They also said that engaging patients in their own care (45%) and getting meaningful data into providers’ hands (33%) weren’t proving to be easy tasks.

At this point it’s time for some discussion.

Obviously, providers grapple with competing priorities every time they try something new, but the internal conflicts are especially clear in this case.

On the one hand, it takes smart care management to make value-based contracts feasible. That could call for a time-consuming and expensive redesign of workflow and processes, patient education and outreach, hiring case managers and more.

Meanwhile, no PHM effort will blossom without the right IT support, and that could mean making some substantial investments, including custom-developed or third-party PHM software, integrating systems into a central data repository, sophisticated data analytics and a whole lot more.

Putting all of this in place is a huge challenge. Usually, providers lay the groundwork for a next-gen strategy in advance, then put infrastructure, people and processes into place over time. But that’s a little tough in this case. We’re talking about a huge problem here!

I get it that vendors began offering off-the-shelf PHM systems or add-on modules years ago, that one can hire consultants to change up workflow and that new staff should be on-board and trained by now. And obviously, no one can say that the advent of value-based care snuck up on them completely unannounced. (In fact, it’s gotten more attention than virtually any other healthcare issue I’ve tracked.) Shouldn’t that have done the trick?

Well, yes and no. Yes, in that in many cases, any decently-run organization will adapt if they see a trend coming at them years in advance. No, in that the shift to value-based payment is such a big shift that it could be decades before everyone can play effectively.

When you think about it, there are few things more disruptive to an organization than changing not just how much it’s paid but when and how along with what they have to do in return. Yes, I too am sick of hearing tech startups beat that term to death, but I think it applies in a fairly material sense this time around.

As readers will probably agree, health IT can certainly do something to ease the transition to value-based care. But HIT leaders won’t get the chance if their organization underestimates the scope of the overall problem.

Investors Competing For Health IT Opportunities

Posted on June 28, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study has concluded that investors are hungry for health IT investment opportunities, in some cases battling competitors for particularly attractive companies. The report concluded that investment firms see health IT as a lower-risk way to get a cut of the healthcare market than other possible targets.

The analysis by Bain & Company, which looks at 2017 numbers, said that the number of health IT investment deals completed last year rose to 32 from 23 in 2016.

The value of disclosed deals fell from $15.5 billion in 2016 to $1.9 billion in 2017. This is not a sign of weakness in the sector, however. The 2016 deals volume was pumped up by two megadeals (acquisitions of MultiPlan and Press Ganey), which were valued collectively at $9.9 billion. Meanwhile, in 2017 only one deal exceeded $800 million.

Deal counts and volume aside, there’s no question that investors are still very interested in acquiring or taking a stake in health IT companies, Bain reports. According to its study, there are many good reasons for their excitement.

“Investors find HCIT target attractive not only because HCIT companies play a vital role in promoting technology adoption in healthcare but also because they bear less of the direct reimbursement and regulatory risk that affect other healthcare sectors,” the report says. “With a limited set of scale assets on the market and corporate buyers willing to pay premiums for those that do become available, valuations remain high and competition intense.”

The report notes that most of the health IT buyouts in 2017 involved biopharma investments, particularly among companies using IT solutions and advanced analytics to streamline development a testing of drugs. Such deals include the buyout of Certara, which offers decision support technology for optimizing drug development, and Bracket, which sells technology for managing clinical trials.

However, investors were also interested in EMR and practice management vendors. Given that just a handful of big vendors block of the market for hospital IT, they looked elsewhere.

In particular, investment firms were interested in consolidating some of the many vendors selling ambulatory care EMRs platforms supporting specialties like gastroenterology. For example, investors picked up a $230 million stake in Modernizing Medicine, which offers EMR and practice management systems for specialties such as dermatology and ophthalmology, Bain said.

In the future, investors will gain interest in revenue cycle management software. In addition to investing in or acquiring RCM tools for providers, investors may target RCM software helping patients pay their bills. For example, private equity firm Frontier Capital bought a majority stake in medical card company AccessOne last year.

Bain also predicts that Investors will pay growing attention to clinical decision support platforms, driven in part by legislation requiring doctors to use clinical decision support tools before ordering complex diagnostic imaging of Medicare patients.

In addition, investment firms are keeping their eye on population health management software vendors. It’s not clear yet which companies will dominate the sector, and how these platforms will evolve, so dealmakers are hanging back. Still, within a few years they may well begin to throw money at PHM companies.

Improving Clinical Workflow Can Boost Health IT Quality

Posted on August 18, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

At this point, the great majority of providers have made very substantial investments in EMRs and ancillary systems. Now, many are struggling to squeeze the most value out of those investments, and they’re not sure how to attack the problem.

However, according to at least one piece of research, there’s a couple of approaches that are likely to pan out. According to a new survey by the American Society for Quality, most healthcare quality experts believe that improving clinical workflow and supporting patients online can make a big diference.

As ASQ noted, providers are spending massive amounts of case on IT, with the North American healthcare IT market forecast to hit $31.3 by 2017, up from $21.9 billion in 2012. But healthcare organizations are struggling to realize a return on their spending. The study data, however, suggests that providers may be able to make progress by looking at internal issues.

Researchers who conducted the survey, an online poll of about 170 ASQ members, said that 78% of respondents said improving workflow efficiency is the top way for healthcare organizations to improve the quality of their technology implementations. Meanwhile, 71% said that providers can strengthen their health IT use by nurturing strong leaders who champion new HIT initiatives.

Meanwhile, survey participants listed a handful of evolving health IT options which could have the most impact on patient experience and care coordination, including:

  • Incorporation of wearables, remote patient monitoring and caregiver collaboration tools (71%)
  • Leveraging smartphones, tablets and apps (69%)
  • Putting online tools in place that touch every step of patient processes like registration and payment (69%)

Despite their promise, there are a number of hurdles healthcare organizations must get over to implement new processes (such as better workflows) or new technologies. According to ASQ, these include:

  • Physician and staff resistance to change due to concerns about the impact on time and workflow, or unwillingness to learn new skills (70%)
  • High cost of rolling out IT infrastructure and services, and unproven ROI (64%)
  • Concerns that integrating complex new devices could lead to poor interfaces between multiple technologies, or that haphazard rollouts of new devices could cause patient errors (61%)

But if providers can get past these issues, there are several types of health IT that can boost ROI or cut cost, the ASQ respondents said. According to these participants, the following HIT tools can have the biggest impact:

  • Remote patient monitoring can cut down on the need for office visits, while improving patient outcomes (69%)
  • Patient engagement platforms that encourage patients to get more involved in the long-term management of their own health conditions (68%)
  • EMRs/EHRs that eliminate the need to perform some time-consuming tasks (68%)

Perhaps the most interesting part of the survey report outlined specific strategies to strengthen health IT use recommended by respondents, such as:

  • Embedding a quality expert in every department to learn use needs before deciding what IT tools to implement. This gives users a sense of investment in any changes made.
  • Improving available software with easier navigation, better organization of medical record types, more use of FTP servers for convenience, the ability to upload records to requesting facilities and a universal notification system offering updates on medical record status
  • Creating healthcare apps for professional use, such as medication calculators, med reconciliation tools and easy-to-use mobile apps which offer access to clinical pathways

Of course, most readers of this blog already know about these options, and if they’re not currently taking this advice they’re probably thinking about it. Heck, some of this should already be old hat – FTP servers? But it’s still good to be reminded that progress in boosting the value of health IT investments may be with reach. (To get some here-and-now advice on redesigning EMR workflow, check out this excellent piece by Chuck Webster – he gets it!)