As the healthcare industry continues to evolve at a rapid pace, we predict that the following trends will dominate the industry in 2015:
Continue the transition to value-based care models
In 2014, we saw provider organizations continue to expand reimbursement models from purely traditional fee-for-service to include value-based models of care. We anticipate that this trend will continue to gain traction in 2015 as organizations focus on profitability, sustainability and the Triple Aim.
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Big data analytics and population health management
Not only do we expect that organizations will continue to implement technologies that enable them to aggregate, normalize and analyze both clinical and financial data sets to manage the health of populations, providers will also leverage analytics to ensure operational efficiencies and optimal reimbursement to maximize financial performance.
Integration between health information systems (HIS)
Organizations will continue to implement technologies and services that enable the seamless integration between disparate HIS to securely and easily share data across systems and ultimately reduce revenue leakage and achieve revenue integrity.
The proliferation of audits
In the new year, provider organizations can expect to see even more audits—specifically, commercial payors’ audits are increasing, and while we don’t expect RAC audits to increase, we do anticipate an increase in physician audits. Providers will need to utilize tools and services that educate physicians about the latest payment rules and regulations to ensure compliance.
Transition to ICD-10
Preparing for the transition to ICD-10 will continue to be a top priority for provider organizations. Updating the charge description master (CDM) is one preventative measure providers should take when planning their transition strategy.
Consumerization of healthcare
With consumerism in healthcare and patient financial responsibility on the rise, patients are becoming more involved and engaged in their own healthcare decisions. To stay competitive, provider organizations need to be more transparent about the pricing of procedures, services and supplies that they offer in order to attract and retain more patients and ultimately to protect margin integrity and profitability.
Mark Montgomery is chief marketing officer at Craneware.
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