Data from a recent study by the Employee Benefit Research Institute shows that individuals enrolled in high-deductible health plans are more likely to behave like consumers and seek data on price and quality before receiving care.1 This, combined with the effects of the Affordable Care Act, where trends are reflecting that more than 80% of individuals enrolled in exchange plans chose high cost sharing plans, are turning patients into consumers.2
The high-deductible health plans are reinforcing the need to provide accurate pricing and quality data to patient shoppers as well as the need for provider organizations to understand service line margin to be able to adjust their service offerings accordingly.
My colleague Melody Smith Jones, @MelSmithJones, recently wrote about this in her blog post, What the Market Says You Need in Your Patient Portal.
“The forward-thinking strategists in healthcare organizations nationwide should have their sites on the marketplace horizon.”
I invite you to read Melody’s entire blog for more about what features the market is demanding, but I would like to focus on the last item in her list: “Integration of clinical and financial data”…
Merging clinical and financial data requires organizational priority setting and a partnership to synchronize accounting and clinical systems to a degree that is likely unprecedented in most provider organizations. Some examples of what might be needed are:
- Claims data for diagnosis codes, patient demographics and encounter information and services provided; this data usually resides in the patient billing system
- Clinical data such as labs for quality and outcomes ; this data usually resides in the EMR, EHA or other ancillary clinical systems
- Accounting and finance data from the general ledger, budget and sub-ledger systems.
The Perficient High Performance Costing Expressway helps organizations gather this data and build decision support models iteratively to understand how to effectively apply resources to provide the value and the quality that consumers demand in addition to service line models that provide insights into how to adjust services to respond to the new marketplace. See my blog: The “Secret Sauce” for Financial Transparency to learn more about the Perficient High Performance Costing Expressway.
Perficient is an Oracle Platinum Partner with an industry leading healthcare solutions team. Perficient experts will be on hand in booth #1159 at HFMA National Institute 2014 #ANI2014 in Las Vegas and booth #206 at #INTERACT14 in Orlando June 22-25.
Join us to view a demo of our costing solution and hear our BIG IDEAS!
Follow me on Twitter @teriemc
1 Fronstein, P., Findings from the 2013 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey, Issue Brief, EBRI, 2013
2 Galewitz, P., “Nearly a Quarter of Health Marketplace Enrollees Are Young Adults”, Kasier Health News, January 13, 2014