Five mistakes payers make in risk-sharing arrangements

How to turn new regulations into opportunities

Consumerism is steadily gaining momentum in the healthcare space. Payers are under constant pressure to improve member experiences and health outcomes by implementing patient-centric business models. However, there is no one way to cater to the entire member population. Member needs can be quite diverse. On one hand, the U.S. population is aging, and it’s estimated that by 2040 there will be 80 million people above the age of 65. Payers need to keep conventional channels of communication open. On the other hand, Deloitte’s 2020 Survey of U.S. Health Care Consumers revealed that 42% of Medicare Advantage (MA) plan enrollees used technology for health improvements, and those who enroll over the next 10 years will be even more likely to do so. This indicates that health plans will need to build on their digital capabilities. In particular, payers must undergo a digital transformation to accommodate the differing needs of the population and offer personalized services.

As part of the healthcare industry’s growing shift toward holistic patient care, the role of social determinants of health (SDoH)—the conditions in which people are born, grow, live, work, and age—has also increased.

Networks that store medical data between multiple providers are susceptible to data breaches. Because of this, data security has always been an integral part of our product development and updates. InNote cuts through the noise to deliver the right information from EHRs and other third-party data sources at the point of care, thereby enabling users to close gaps in real-time and deliver quality outcomes efficiently.

As the healthcare industry turns to new innovations to streamline care delivery and improve stakeholder experience, it’s essential to understand how to build a foundation for a stable healthcare data platform. Digitizing healthcare data and processes took nearly a decade, and the next step is to unlock siloed health information on a cloud platform to build new digital services and solutions with native interoperability.

A report by the Centers for Medicare and Medicaid Services (CMS) stated that more than 45% of the locations listed in provider directories are inaccurate. These errors can prevent members from accessing the care they need, leading to poor health outcomes and satisfaction levels.

The pandemic set a lot of things into motion in the healthcare system. Gaps in care delivery that seemed imperceptible, now seem to be staring the stakeholders right in their faces. Reforms such as telemedicine that appeared to be taking place slowly quickly changed their pace of adoption. To adapt to the changing healthcare landscape, payers need to work to optimize and improve care management solutions to adapt to the changing healthcare landscape.

Care Management and Value-Based Care are the top themes in Healthcare. These themes predominantly play out between Provider organisations and patients, with the former taking the sole responsibility of delivering care to the patients.

As the healthcare industry turns to new innovations to streamline care delivery and improve stakeholder experience, it’s essential to understand how to build a foundation for a stable healthcare data platform. Digitizing healthcare data and processes took nearly a decade, and the next step is to unlock siloed health information on a cloud platform to build new digital services and solutions with native interoperability.