The evolution of ACOs in the market has led to an increase in provider based payer organizations, the addition of some 400 this year require a new level of data sharing and analytics. The ability to analyze impacts of changing payment models and care guidelines on healthcare delivery and payment will define the stability and growth of the integrated organization.
Kathy McCarthy, Director of Sales Consulting for Oracle Health Insurance, discusses the topic in today’s post:
With the ACO model, healthcare organizations will continue to acquire groups and services within a specific demography. Using integrated analytics to predict the impacts when entering new markets where different services and payment models overlap will be a key for accelerated expansion.
Providers need to consider several criteria before entering the payer market. The provider organizations needs to:
Research has shown that there is no correlation between success and market share, location or deep pockets.
Providers need to:
Providers will require systems that can:
Operational efficiency will be a key to success. Payers will need to have IT and analytics that will play an important role .Being able to merge clinical and financial data will be crucial to success. They need to improve the overall IT efficiency and gain more predictable costs and outcomes.
IT needs providers should consider:
Oracle Health Insurance components help address these issues by providing:
Learn more by watching the recent webcast, How to Navigate the Emerging Trend of Providers Shifting Focus to Healthcare Financing.
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