From the August 2016 issue of HealthCare Business News magazine
By Bipin Thomas
There are a large number of stakeholders and other participants who play an important role in the new health care ecosystem, and who must adapt to the new consumer-centric imperative in concert with one another. Medical device companies, pharmacies, pharmaceutical companies, home health enterprises, employers and many others need to be interconnected and exchange data seamlessly. The success of this massive new undertaking clearly hinges on technology and continuous advances in data intelligence.
Each one of these interconnected entities is charged with a mission to improve the quality of care while lowering its cost. To ensure patient safety and quality care while realizing savings, these stakeholders are driving innovation across these new relationships — often outside the four walls of the hospital. Here are a few of the new relationships that are taking shape:
Payer-provider relationship
The convergence of payer and provider is one relationship that has attracted a lot of attention recently. The payer-provider collaboration is at the heart of the new consumer-centric model of health care. The Accountable Care Organizations are the most explicit example of this collaboration, but the relationship is evolving across the industry. A wary distance between payer and provider must give way to a symbiotic relationship focused on wellness.
New collaborative care teams may include representatives from payers and providers. What those teams can learn about each consumer will help tailor service to that consumer’s needs. Meanwhile, insurance companies will offer customized policies that take into account specific patient health conditions and incentivize specific behaviors.
Provider-pharmacist relationship
With real-time data sharing, health care providers have started thinking of pharmacists as direct partners in patient care, not just the executors of their orders. Consumer adherence to prescriptions and new information about adverse interactions will arise when providers leverage this new relationship to learn more about their patients — even after they leave the hospital premises. Pharmacists, in turn, will help consumers minimize clinic visits by adjusting dosage and prescriptions when needed. New access to real-time data, and a closer relationship with a patient’s physician, will help integrate pharmacists into the web of care — saving money and resources while improving patient satisfaction.
