Friday, July 9, 2010

A Reason for Collaboration

Here's a scary stat that industry and providers should be paying attention to:

A recent McKinsey Quarterly article says consumers are paying for more of their own healthcare costs than their employers do! It caught our attention because the example the authors used was a multi-facility hospital system and its inability to collect the debt owed.  The so-called balance after insurance was growing at 30% a year and it was growing less for those without insurance - 19%. The balance after insurance is the fastest growing portion of healthcare-related bad debt, and will probably continue to grow as "more insured patients enter the market following passage of the new health care law."  This is scary to our industry because the burden is falling on the patients. If they are not going to pay their own healthcare bills, who will?   

But the authors also talk about how an automated payment network would reduce bad debt, cut administrative costs and save money.The authors state that less than 20% of clinical data today is available in electronic forms.
"Digitizing, standardizing, and normalizing this data so that they can be used for operational and clinical decision making will require large capital investments and create ongoing operating costs. Few health care industry players have the scale or sophistication to manage these issues on their own," the article says. Might it make sense for industry to help lead that charge?  Finding innovative solutions with medicine is not just based on taking a pill or using a device, it is finding out what works and what does not.   

As the pharma, biotech, and medical device companies move toward outcome-based risk sharing payment arrangements, willingly or unwillingly, we all must have access to this information so we can analyze normalized clinical, claims, and payments data. I encourage the industry to not miss a seat at the HIE discussion table as it has done with the EHR debate.  

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