The Impact of Value-Based Care on Digital Strategy
TERRY MAYTIN | VP, Market Development & Commercialization]
The U.S. healthcare system is rapidly transitioning from fee-for-service to value-based care as part of massive and ongoing industry-wide transformation. Digital strategy is evolving to meet new challenges, help drive disruptive innovation, and better engage a large, growing audience of connected health consumers.
Already complex and fragmented, the healthcare sector will look very different over the next few years. Starting with the Affordable Care Act (ACA), new payment models continue to proliferate spurring rapid innovation and disruptive change across the entire care delivery ecosystem in an overarching quest for better quality care across the entire population at lower per capita cost. Commercial payers are also accelerating rollout of fee for value models with providers, and the shift to performance guarantee arrangements with Pharma companies is increasing as well.
Moving an entire industry from volume-oriented reimbursement requires aggressive, innovative approaches to shift from traditional, siloed care to collaborative models with system-wide provider coordination, patient engagement and proactive interventions. Technology will continue to act as a critical change agent, enabling large-scale improvements in process efficiency, automation, connectivity, collaboration, interoperability and advanced analytics. However, technology by itself isn’t the solution; significant workflow changes and resource realignments will be required as well.
With the convergence of healthcare and digital technology, industry stakeholders are reassessing their digital strategies to help tackle new business opportunities and challenges. Just a few years ago, digital health efforts largely focused either on acquisition marketing, community aggregation, or customer service portals designed to redirect volume from higher cost channels. Amid the current environment, however, digital offers much greater and far-reaching impact potential than ever before.
Digital investments are ramping up to support the shift from volume to value, particularly in the areas of care coordination, patient engagement, post-discharge monitoring, measurement, and behavior change. Since 2014, equity funding for digital health companies has surpassed $17B for clinical tools, analytics, consumer engagement, mHealth, telemedicine, wearables, and business services. In 2016 alone, firms raised a record $6B.
Two important trends drive home the relevance and importance of developing a comprehensive, well-articulated digital strategy: the rise of consumerism and nearly ubiquitous web/mobile adoption. Across all age groups, including seniors, large audiences not only already consume digital services but also expect high quality, omni-channel experiences. To deliver on this promise, companies must design optimized, journey-based experiences that balance customer needs, preferences, and behaviors against desired business objectives and outcomes. Companies must embrace the concept of “putting the customer first” throughout the organization and across functions (e.g. strategy, product development, marketing, operations and technology). This also must be accompanied by an insights-driven, decision-making approach.
Essentially, digital strategy will be most effective if viewed as an organizational imperative. Armed with a holistic vision and comprehensive strategy, stakeholders will be better able to leverage and capitalize on digital’s full disruptive potential to help solve some of the most pressing challenges facing healthcare today.