As a healthcare provider, your main goal is to provide quality, affordable care for patients while generating a profit at the same time. In today’s fluctuating industry climate, however, navigating the complicated landscape surrounding new trends, regulations and legislation can make this harder than it needs to be. The key to remaining solvent and relevant in healthcare is adaptability. If your organization doesn’t manage patients to create the lowest possible cost, you could end up missing out on certain opportunities.
One cutting-edge trend that has recently emerged in healthcare is the concept of narrow networking. Many payors today organize collaborations of hospitals and physicians based on patient outcomes – they choose which doctors are in their networks, and the list is perpetually shrinking. Hospitals and medical groups that prepare early for the arrival of narrow networking will be ready for its onset, and that will mitigate risk and allow for a much more competitive environment.
As we’ve worked with clients over the years, Clark Schaefer Hackett has learned what it takes to find success in the healthcare industry. During that time, our experienced professionals have spent a significant amount of effort keeping a close eye on current trends and shifts within the segment. Doing so allows us to provide crucial healthcare consulting and accounting services. We also offer valuable insights into profitable business operations and changes such as the increasing popularity of narrow networking.
Narrow networking requires different approach to data acquisition
As narrow networking becomes more popular across the country, problems begin to emerge for healthcare providers who are slow to adapt to the growing trend. In order to establish a network, payors measure the performance of providers, the financial impact and quality results. Those that make the cut are in, while those that don’t are left with a shortage of patients. The solution then becomes data acquisition. You will have to measure elements you may have never measured before – looking at the right information will shed light on the narrow networking process, and allow you to make educated decisions to remain prosperous in the industry.
The reemergence of narrow networking has been spurred along by several factors, including the desire to control costs. According to Managed Healthcare Executive, many professionals are unsatisfied with the current system in place in the U.S. Furthermore, a comprehensive approach to correcting any perceived issues can be achieved by collaborating with employers, health plans and providers. Therefore, you should be committed to assessing your own organization and finding ways to adapt to the new trend.
Improve quality of analysis to avoid problems
As narrow networking becomes more widespread, it is possible for providers to miss out on opportunities if they don’t address the key issues that payors are now looking at. This can include a focus on quality, improved measurements, costs and time management, to name a few.
For example, look at a diagnosis of a knee problem. Group A wants to perform surgery, while Group B wants to treat the problem with a series of injections. This latter method is the preferred choice for patients, as it is less invasive and more cost-effective. Thus, it is now the desirable option for payors as well. Group B is then chosen as the member of the narrow network, and Group A is left with a shortage of patients. To make matters more complicated, if Group A isn’t looking at this type of information, they may never know why they were left out.
In addition, certain doctors can be more suitable under the umbrella of narrow networking. Not all physicians are created equal. Some are great at diagnosing patients, while others may be better at the economic side of the business. In the future, medical groups and physicians will need to measure clinic decisions greater than the current trend to stay in payor networks. They will need to have ongoing utilization reviews against their respective specialty standards.
Information technology can facilitate change
Narrow networking is heavily reliant on access to information. Naturally, this has made quality technology more important for providers, medical groups and physicians. A better understanding of the ins and outs of the business will make it easier to adapt to this emerging trend in the industry.
At the moment, there is room for improvement regarding information technology. Better IT can mine data and determine which physicians are strong in certain sectors, and then that information can be shared with payors to make educated decisions about who is part of the network. Overall, it is likely that technology changes healthcare for the better. Access to in-depth data will allow you to stay ahead of the narrow networking curve and avoid missing out on opportunities – and patients. Narrow networking can also lead to more consolidation between organizations. By developing and implementing new strategies – such as alliances – hospitals and medical groups can maintain their leverage in the marketplace.
The key to finding success among narrow networks is how you transfer from your previous system to a new one. While there will be winners and losers, you can be on the right side by looking at the big picture, improving quality and providing accurate measurements of your performance.
Evolving healthcare climate highlights importance of advisors
Healthcare is one of the fastest evolving industries in the country, and all of those changes can be difficult to keep of track of at times. This rapid pace makes the value of assistance that much greater. For example, when working with a trusted advisor, it becomes easy to stay ahead of new trends – such as narrow networking – and adapt right alongside any substantial changes in the sector.
When you are looking for guidance on healthcare changes, make sure you work with a firm that has the experience and dedication to stay current with the shifts in the industry. Clark Schaefer Hackett is that company, and our experts can identify successful strategies and analyze the big picture for your organization. At CSH, our professionals don’t operate in silos. We look at everything going on within the healthcare industry, and as a result, can provide accurate guidance on how to respond to upcoming changes.