There is an enormous amount of money being pumped into “digital health” to solve problems in healthcare from RCM to RPM to Quality. We all know the statistics as to how many start-ups fail (90+%) or run out of runway. PE and VC has allowed more people than ever before to try. (off topic- go to minute 26:50 https://youtu.be/yPKzoah6A4c unique thought)
This is a competitive space in healthcare. Many push the latest/greatest software, education, process, and “differentiation.”
This is all great, but is it solving a problem or just patching a larger issue that will have implications later? Is it adding value? Is it creating additional layers or more division? Does it make money (margin conscious)? Does it save money? Hospitals will spend the next 4 quarters coming to terms and trying to create new strategies, adopt software, and approaches fix what took 30+ years to create.
The immediate response is to cut expenses to attempt to balance budget. This can be a difficult decision…clinical, non-clinical, physicians? Just this week:
What is the end goal? What is the agenda? Who are the players? Temporary or Permanent? Who is accountable (is anyone? why?) These are all questions that must be addressed before a knee jerk reaction.
Example: Prior Auth- The concept = simple. The process is restrictive with numerous barriers (some justified based on data and abuse), but collectively as a whole needs and overhaul. The most common fix is to throw education and FTEs at the problem. The second is software, then process tracking. The actual solution accountability and disruption at the payer level.
But what is the bigger picture.
This is something many talk about, but few have an answer for or are dedicated to fixing. Why? Agendas, earnings, we have the data (how are we using it). Outcomes per cost?
Prior has no bearing on the uninsured or underinsured. This underlying epidemic and discrepancy will place further strain on providers and hospitals over the next several years. Indicators are that the new administration will expand Medicaid. Software will not fix this problem alone, nor will adding more FTEs.
Collaboration and bridging data to focused impact with transparency for a long-term goal/strategy is where the solution is. This has not new, it just isn’t done at scale. BUT Companies are aligning with a unique self-awareness to this…Stay Tuned!!!
Value & Influence = DataEmpathy + Collaboration(Speed2) + Relational Strategy