The current healthcare delivery landscape is changing dramatically. Major regulatory reimbursement models are evolving from fee-for-service to fee-for outcomes and value. This transformation to value- based contracting involves multiple facets of the organization and an even greater demand for data. This shift requires health systems to leverage actionable patient outcome and cost analytics, as well as manage several other constraining challenges to address value based contracting, quality measure performance, internal costs, and care team effectiveness. Each health system must maintain market share in an environment of ever-increasing competition and ensure quality of care at reduced costs.
Today, many organizations have an agnostic analytic strategy. They align their actionable intelligence to explore patient information, provider recommendations, resource utilization, and care outcomes. All this information is evidence-based and demonstrates wise stewardship of resources. With this strategy, these organizations believe they’ll be prepared for the future. Over the past three decades, there has been a constant reformulation of acronyms for reporting mandates, a flurry of new scoring measures, and an expanding list of organizations that require reporting on utilization, treatment patterns, care outcomes, internal cost analysis, and reimbursement models.
To ensure that patient care at the point of care uses the right guidelines and the right utilization of service, with the right access to care without delay, deft organizations with agnostic analytic strategies should aggregate their enterprise data once and employ data governance to control its variability. These processes will ensure better clinical and financial decision making to optimize treatment planning. In this way, these organizations will be more prepared for the inevitable changes in the future by employing nimble and flexible capabilities that can help meet the unpredictable legislation and reporting mandates ahead. The ability to deliver optimal care is dependent on data availability, actionable insight, and effective prioritization.
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Adams is Director, Healthcare Strategy for Oracle Health Sciences.