By Toby Hatch, Senior Product Marketing Director, Oracle EPM Cloud
Healthcare is a complex business. Whether you are a healthcare payor or a provider, you have cost and revenue/funding complexities that are difficult to track—and therefore, difficult to change. So how can you simplify those complexities to ensure you are getting the biggest bang for your healthcare buck?
Put the power in the hands of the business users—not IT. Enable them to analyze data and test scenarios to determine the best ways forward without having to depend on IT (they have enough to do!).
Does this sound like you?
You need to gain visibility and understand the cost to serve different healthcare plans, groups, and members. Getting an accurate understanding of profitability by member segment, healthcare plan, and distribution channel is where you can start. But based on this new insight, you need to improve your marketing programs through better member segmentation, and make confident operational decisions about plan design and services.
What if you could also provide finance and operating staff with more complete documentation and audit trails for regulatory reporting, and visually justify medical loss ratio results?
Is this what you’re experiencing?
Everything is constantly changing, but yet you need to continue to provide superior healthcare to your patients.
Although payors and providers are different parts of the healthcare system, it is easy to see they have many common needs. Both have scarce resources and need to allocate them where they will have the biggest impact. Both must understand their sources of cost and minimize them while maintaining efficiency and effectiveness. This must be done on a fairly frequent basis as procedures and health needs change. Both must promote a culture of accountability for everyone to ensure favorable outcomes while keeping costs in line. Both must have adequate tools for analysis and scenario testing, but they also need to keep the total cost of ownership (TCO) low—spending less time on data sourcing, spreadsheet wizardry, and coding changes.
Although healthcare payors and providers have different purposes, they have similar needs. So, what are the 6 important things healthcare payors and providers must do well in order to succeed?
Oracle has worked with healthcare payors and providers for many years and understands these important needs. Oracle Profitability and Cost Management Cloud can address all of these needs and more, and provide more complete documentation and audit trails for regulatory reporting at the same time.
To learn more, I invite you to read the following papers:
|Improving Cost Management and Profitability in the Healthcare Provider Industry|
|Improving Profitability and Cost Management in the Healthcare Insurance Industry|