As healthcare reform continues across the nation, healthcare organizations have to rethink how they analyze and utilize their clinical, financial, and operational data. The current healthcare policy is shifting provider services from a fee-for-service reimbursement model to a value-based model. This substantial payment shift will ultimately result in large laboratory reimbursement cuts, forcing organizations to adapt new practice models in order to thrive. These changes can be mitigated with advanced analytics solutions. Adopting advanced analytics will allow organizations to gain competitive advantages by improving their current operations and enhancing their quality of care.
Reimbursement cuts are inevitable
Under the Affordable Care Act, there will be 35-37% cuts to the Clinical Laboratory Fee Schedule on average over the next decade. Faced with these significant decreases in reimbursement, laboratories are looking for ways to cut costs and improve efficiency. Advanced analytics solutions enable laboratories to monitor these reimbursement changes so they can proactively respond and minimize the impact of these fluctuations.
Returning the focus to quality of care
Quality of care is measured on both patient satisfaction as well as population-based health outcomes. As the laboratory is a critical part of every patient’s care continuum, it has an opportunity to drive the patient experience. For example, patient wait times and turn-around-times (TATs) of test results can have a significant impact on their perception of the lab. Analytics solutions can track TAT, wait-time in the draw station/PSC, call-backs, and more, helping create substantial value to build relationships with your customers. These solutions can also mine laboratory data to provide population result analyses, especially for chronic disease populations, empowering the health system at large to more effectively monitor population-health statistics in real-time.
Encouraging greater transparency and accountability
Transparency is critical for holding providers accountable for the quality of care they are expected to deliver. Hospitals, individual practitioners, and private healthcare organizations have formed Accountable Care Organizations (ACOs) as a step towards achieving transparency of quality patient care. ACOs are paid through a Shared Savings Program contingent upon meeting performance standards, instead of the sheer number of services provided to an individual patient. These organizations are incentivized to focus on patient quality of care to reduce hospital readmissions and become more proactive about monitoring performance measures. Sharing service performance indicators among providers and customers can help organizations understand whether they’re receiving what they’ve paid for.
To learn more, download our comprehensive guide: Strategic Planning for Laboratories.