From an in-control consumer to digital experience and telemedicine, healthcare delivery continues to stretch the limits of what we thought possible. As health plans and health systems increasingly turn to outsourcing partners to compete and thrive in this ever-changing market, we’re here with Sagility’s on-the-ground assessment of Healthcare 2020. And, at the core of the market changes, our Sagility experts say that stakeholders should keep a sharp focus on the volume-to-value shift to care and wellness delivery, as supported by consumerization and technology.
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Care and Wellness Delivery
Trend 1: There will be more efforts to improve payer-provider collaboration to meet the Quadruple Aim.
Executive Vice President, Global Healthcare Operations, Solutions, and Practice, Sagility
Amitabh presents how 2020 will show focus on provider-payer alignment, as provider organizations interact with payer organizations across benefits and eligibility, prior authorization, clinical decision making, and claims denials, appeals, and grievances.
Trend 2: Modern healthcare organizations are increasingly building resources and strategies to address social determinants of health (SDoH).
Senior Vice President and Head of Population Health Management Solutions, Sagility
With this projection, Maryjane discusses how to successfully navigate the volume-to-value marketplace shift, as today’s healthcare organizations are closing care gaps and reducing the negative health impact of social risk factors.
Trend 3: The recent surge in healthcare merger and acquisition (M&A) activity is leading to significant market consolidation, particularly among health organizations.
Senior Vice President, Healthcare Sales and Business Development, Sagility
Anand provides 2020 insights into how, as antitrust challenges are presented to horizontal integration plays, larger healthcare organizations are increasingly looking to bring new capabilities to the table with vertical integration, for market power and leverage.
Trend 4: More providers will turn to point-of-service (POS) collections to improve patient satisfaction and keep costs down.
Senior Vice President, Provider Operations, Sagility
With this trend, Dan tells us how, as high-deductible plans have become more common, patient financial responsibility has grown — and in 2020, providers will be implementing POS strategies with improved payment options that encourage timely payment.
Trend 5: Both payers and providers will move faster toward a more engaged member/patient experience.
Senior Vice President, Healthcare Business Development, Sagility
Donna’s 2020 prediction focuses on the fact that, while healthcare has traditionally been more reactive in nature, we fully intend to see much greater focus on much more consumerized healthcare in 2020.
Trend 6: In 2020, healthcare organizations will increasingly realize the benefits of design thinking, especially as the industry shifts from volume- to value-based care.
Vice President, Healthcare Practice Office, Sagility
Here Krithika predicts that tomorrow’s healthcare design thinking will be founded on a three-pronged approach to problem-solving: empathy, multi-disciplinary thinking and rapid, iterative solutions deployment.
Trend 7: While healthcare organizations are focused on reducing waste and abuse, in 2020, smart organizations will be looking to deploy predictive analytics, machine learning, and neural network AI.
Senior Vice President, Global Healthcare Practice, Sagility
In 2020, Deepan forecasts that the probabilistic approach will hold enormous potential for quick recovery as compared to rules-based scenarios.
Trend 8: Provider database management is now a table-stakes solution.
Associate Vice President, Healthcare Practice, Sagility
In 2020, Priya predicts that health systems will rank a sound and accurate provider data management foundation higher on their priority list.
Trend 9: Claims optimization continues to provide health insurers an opportunity to reduce consistently high loss ratios, with today’s technology only strengthening return on investment.
Practice Lead, Claims Adjudication, Sagility
Tomorrow’s claims automation translates to breakthrough ROI in three areas, according to Manjunath: compliance adherence, improved financial performance, and enhanced provider engagement.
Read our trends here.