To improve health outcomes, payer organizations need to organize, maintain, and effectively use provider data to enhance care management and delivery—and effectively comply with ongoing healthcare regulations. Mandates such as the Patient Protection and Affordable Care Act [PPACA] are driving payer organizations to build and implement more efficient provider network systems.

The dynamic world of regulatory changes is ever-evolving. Most recently, the Centers for Medicare & Medicaid Services (CMS) issued the Interoperability and Patient Access final rule (CMS 9115-F) in March 2020, with enforcement of the Patient Access and Provider Directory API requirements beginning July 1, 2021. The Interoperability and Patient Access final rule, when implemented effectively, has the potential to change the way healthcare organizations operate. With increased access to information on their health status and healthcare opportunities, members will be empowered to manage their healthcare journeys.

The COVID-19 pandemic made healthcare data management difficult and overwhelmed existing IT infrastructure. Making data accessible in desired formats—after sourcing, refining, and transforming—adds more load to the infrastructure. To mitigate these challenges, CIOs need to take a fresh approach to data management, whether that’s through an on-premises storage system, the cloud, or a hybrid model.

As a leading healthcare cloud platform, Innovaccer drives healthcare efficiency through its Platform-as-a-Service and Software-as-a-Service solutions. Innovaccer’s InNote is an efficient digital collaboration and communication tool for physicians.

InCare is the Innovaccer’s robust care management and coordination solution that helps care teams simplify redundant tasks, bridge care and coding gaps, improve patient engagement and deliver better care outcomes.

Patient 360—one of the major building blocks of Innovaccer’s InCare platform—helps provide care managers with a holistic view of patient data by streamlining processes and saving time. The tool houses actionable data and helps users drill down into patients’ claims, risk models, and personal information, ultimately enabling a higher quality of care.

As the healthcare industry shifts toward more holistic patient care, work needs to be evenly distributed among providers, increasing the need for streamlined workflows.

Value-based contracts (VBC) offer significant incentives for healthcare organizations willing to adopt change, but to drive meaningful change quickly, organizations need to be laser-focused on improving clinical quality, lower the cost of care, and creating consistently positive member experiences. Sounds pretty easy, right? It’s not. However, with the right pieces in place, organizations can find early success much more quickly and start to prepare their organizations for the rapidly approaching VBC future.

The healthcare industry is constantly evolving. Stakeholders are regularly met with—and must adapt to—new ideologies, perspectives, and practices. Along with varying patient expectations and market competition, government regulations regularly impact the way organizations envision and implement their ongoing business strategies.

It’s hard to describe the past year and a half. It has been unlike anything most of us have experienced in our lifetime. One can hardly recall another event that has impacted almost every single person and every single industry at this scale. COVID-19 tested both our limits—and our prowess. And the signs today point toward a future of immunity and freedom. Everyone has played their part in getting us the path forward to tomorrow, and one industry, in particular, has helped deliver hope for the future: the pharmaceutical industry.