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What are Our Clients Saying? Top Problems Healthcare Execs are Facing

Excerpts from a national survey of healthcare stakeholders commissioned by the HealthCare Executive Group and Change Healthcare

The 9th Annual Industry Pulse Research Report shares the organizations’ insights on the critical issues, challenges and opportunities ranked by HCEG members on the 2019 HCEG Top 10 list. The report shows Data & Analytics ranking as the #1 opportunity: leveraging data (especially clinical) to manage health and drive individual, provider and payer decisions. Patient portals (73.1% of respondents are using them) and telehealth services (54%) top the list, establishing these as digital cornerstones.

Most respondents said clinical data integration is also key, with only 10.9% saying they have no plans to implement it. Pricing and payment have always been important to patients; the same now goes for healthcare stakeholders, with digital payment options and cost transparency apps making a strong showing here.

Automation in the form of machine learning and AI has the highest potential in the minds of respondents, with just over half planning to employ it. By contrast, robotic process automation drew the largest chorus of no’s, with 47.2% saying their organizations would not use it.

See the full report here: 9th Annual Industry Pulse Survey

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EXECUTIVE SUMMARY

Few industries have experienced the sustained disruption to their business models as has healthcare. No matter where you look—whether it’s care, cost, consumerism, consolidation, payment models, HIT, or regulation— healthcare is in a constant state of change. And the pace of change is accelerating.

Healthcare leaders must continually assess their organization’s strengths, weaknesses, opportunities, and threats to remain competitive. This year’s research draws from 185 healthcare leaders, 28% of whom are at the president or Csuite level, 48% VP-level or above, and includes HCEG members, Health Plan Alliance members, and Change Healthcare customers. The report provides a timely snapshot across 16 crucial topics, including market trends, population health, value-based care, consumer engagement, clinical and data analytics, risk sharing, social determinants, cybersecurity, and more.

While there are many insights and takeaways to consider in this year’s report, a few stand out:

  • Outside influences are intensifying. A confluence of forces – people, processes, and technology – will require healthcare to turn to new business models and market strategies. Most notable among these are non-healthcare entrants to the marketplace, whose consumer- centric innovations could help re-imagine patient engagement
  • A healthcare market where the majority of value-based relationships include both upside and downside shared risk still appears to be three to five years off. This might indicate payers and providers are struggling in their efforts to scale complex value-based care and reimbursement models from pilot to production
  • Consumer demand for better access, price/cost transparency, and convenience is opening doors for external competitors who can provide a retail consumer experience. Established players will be challenged to stay ahead

HEALTHCARE AMID CONTINUED UNCERTAINTY REFLECTED IN HCEG TOP 10 & INDUSTRY PULSE

  • External Market Disruption (#7) entered the HCEG Top 10 list for the first time and is confirmed by the Industry Pulse Report with 32.2% of respondents anticipating the greatest impact to be “disrupting current business models”
  • Payment Reform/Value-Based Payments (#4) has been on the HCEG Top 10 list every year for the last decade. 63.6% of the Industry Pulse Report respondents expect it will be 3 years or more before payments contain both upside and downside risk. The report goes deeper into what needs to happen to orchestrate high-value care
  • Consumerism (#2), Mobile/ Digital Health (#5) and member engagement have ranked high in the HCEG Top 10 for a number of years. This year’s Industry Pulse Report shows the tools and services being used to enhance member/ patient engagement and the best approaches for addressing passive patients, such as incentives, health literacy and cost transparency tools.
  • The Data & Analytics (#1) to support multiple healthcare priorities is highlighted this year. Progress in how primary sources of clinical data and analytics have recently been impacting the efficiency and effectiveness of healthcare quality and outcomes are also suggested
  • Population Health/Social Determinants of Health (SDoH) (#3) moved higher in the HCEG Top 10 as the industry transitioned from broad medical condition segments of the population to looking at what is called “barriers to better health.” Industry Pulse survey respondents shared how their organizations are integrating SDoH and which non-medical barriers to care their organizations will take action on in the next 12 months. Also noted are anticipated challenges to integrating SDoH into population and clinical care programs
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RESEARCH BACKGROUND AND METHODOLOGY

Survey, Screening Criteria, and Data Collection

See Pulse Chart 1

The Industry Pulse is an annual healthcare industry survey designed to provide directional insight on opportunities, challenges, and trends facing the healthcare market. The research focuses on payer organizations, but includes the perspectives of other industry stakeholders such as provider organizations and vendors.

Developed in partnership with the HealthCare Executive Group (HCEG), this is the 9th annual Industry Pulse survey. It mirrors the HCEG Top 10 priorities list compiled by HCEG members during their Annual Forum.

The national research sample draws from more than 2,000 Change Healthcare customers, including leading national and regional payers; nearly 40 HCEG member organizations; and 50 Health Plan Alliance members.

The researchers targeted the leaders of these organizations, 48.1% of whom are at the President, Vice President, and C-suite levels.

INCENTIVES HELP PEOPLE ENGAGE AS CONSUMERS

Rewarding healthy behaviors gets members and patients thinking

See Pulse Chart 2

How can organizations turn passive patients into active consumers of healthcare? Nearly half (49.3%) of respondents said that offering patients incentives for healthy behaviors is one of best tools for engaging them as consumers.

What’s the least effective move to make consumers of patients? Sign them up for a high-deductible health plan. Only 3.8% of respondents endorsed this as a consumer engagement strategy.

High-deductible health plans are great for cost control, but a poor means for getting patients to think about how to shop for and use their healthcare. As a whole, the ranking of options in this question matched last year’s results. This consistency suggests that healthcare leaders have a clear picture of how they believe the patient can become a consumer of healthcare.

BIG TECH AND RETAIL WILL DISRUPT HEALTHCARE–BUT HOW?

External market entrants bring strengths in care delivery and customer experience

See Pulse Chart 3

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2019 survey respondents have a wary eye on the disruptions that external market entrants like Amazon, Walmart, Google, and Apple will have on healthcare. Nearly one-third (32.2%) said the greatest impact of big tech and big retail will be on the business models that now dominate.

This response suggests that healthcare leaders recognize that external entrants will force the industry to change how it conducts business.

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What do you think?

Written by hsandm

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