Programs addressing care coordination, transportation and food insecurity are disrupting traditional healthcare delivery, according to Change Healthcare and the HealthCare Executive Group’s 9th Annual Industry Pulse Survey report.
Nearly 40% of respondents said a market in which the majority of value-base relationships include both upside and downside shared-risk remains three to five years off. That indicates payers and providers continue to struggle to scale complex, value-based care and reimbursement models from pilot to production.
“As if insurance market changes, value-based care, consumerization and regulatory uncertainty weren’t enough, this year the industry is facing a new breed of market entrants and innovators whose impact remains unknown but could be substantial,” said David Gallegos, SVP, Consulting Services, Change Healthcare. “Even the largest healthcare organizations don’t have the people and processes to move on all these fronts alone, yet they can’t ignore these changes.”
Consumers are increasingly demanding better access, price/cost transparency, and convenience, the report said, and Artificial Intelligence and advances in analytics will address lagging business models. At the same time, cybersecurity is a lower funding priority, as 40% of respondents cited sophistication of attack outpacing prevention capabilities.