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COVER STORY · STATE OF THE INDUSTRY


System, and also the current chairman of the board of the Ann Arbor, Mich.- based CHIME (College of Healthcare Information Management Executives), said, “I think that’s very important, especially with regard to its impact on cybersecurity. At Geisinger,” he notes, “we’ve stayed the same; we’ve had nei- ther a decrease nor an increase. But we’ve had solid cybersecurity applications in


Tim Zoph


place. And we’re always, continuously surveilling for malware and intrusions. That’s one reason we didn’t change. And speaking from the CHIME Chair perspective now, COVID has proven a


“Those results may not end up being refl ective of what those budget needs are going to be in the coming year. Certainly, one of the ways the pandemic was mitigated was by putting additional money into virtualizing access to care, and that mitigated some impacts. But what you’ll see is continued margin pressure in healthcare, and I don’t think IT is going to be immune.” —Tim Zoph


real fi nancial strain for many hospitals, especially small and rural hospitals, so the fact it didn’t go down is a good sign.” Still, Tim Zoph, client executive and strategist at the Naperville, Ill.-based


Impact Advisors consulting fi rm, cau- tions, “Those results may not end up being refl ective of what those budget needs are going to be in the coming year. Certainly, one of the ways the pandemic was mitigated was by put- ting additional money into virtualiz- ing access to care, and that mitigated some impacts. But what you’ll see is continued margin pressure in health- care, and I don’t think IT is going to be immune. They’ll need to operate their core systems very well. So, standardiza- tion, modernization, and automation of information systems will continue to need to happen. Those systems are still fragmented and not optimized, so we’re seeing clients now starting to cycle back from this implementation to optimization. The need is to create capacity. There’s no better time to be brilliant at the basics.” Indeed, says John Klare, a vice presi- dent at Impact Advisors, “From my per- spective, it’s an interesting result that budgets are increasing. It makes sense, because it’s a balance. No question that COVID has had a negative impact on health systems across the country. It’s been wildly different, though, from very serious impacts to less serious ones. But the net effect is that it’s been causing hospitals to have to reduce expenses. One of the saving graces or key initia- tives health systems have engaged in to deal with COVID has been digitization and automation, to prevent infection


very quickly, because you can quickly speed elements to market as you go digital. Markets can shift very quickly, and your market share can be impacted if you’re behind.” What about the pricing transparency


regulations that will be fully imple- mented during 2021? Results are all over the map. In terms of what activities respondents say their organizations have participated in so far, 20 percent have assembled a task force to understand the regulatory requirements; 11 percent have conducted a comprehensive review of all payer contracts; 10 percent have revisited their pricing strategy; 21 percent have developed a plan to communicate more effectively with patients about their share of the cost; yet 37 percent have done “none of the above,” so far. Per that, “We’re in the same boat


with everyone else,” Geisinger’s Kravitz reports. “We’re determining how we’re going to demonstrate that transparency. We’re putting in a new revenue cycle management system that will help us; but it is a TBD item to be discussed in the industry.”


Value-based contracting moving forward


Respondents were asked a number of key questions around their participa- tion in value-based contracting, and their data-facilitated population health management and care management work, including: What kinds of value-based contracts are


your organization currently involved in? (respondents named all that applied) Medicare Shared Savings Program: 35


percent percent


Next Generation ACO Program: 22 Medicaid ACO: 27 percent


• Private health insurer ACO contract: 42 percent • None of the above: 38 percent What percentage of your overall reim-


John Klare


spread while expanding care. The one other observation I’d offer is that it will be interesting to see the impact on capital versus operating budgets. You’re seeing people freezing capital budgets.” And, Zoph adds, “It’s important to


understand that every market is dif- ferent. Some markets are mature and competitive; others are just emerging. So this is highly dependent on the nature of your market and where you are. Our view is that markets can change


bursement involves two-sided/downside risk? • 0-5 percent: 22 percent • 5-10 percent: 12 percent • 10-15 percent: 18 percent • 15-20 percent: 4 percent • More than 20 percent: 4 percent • Don’t know/not applicable: 40 percent Have you begun using analytics to sup-


port population health management and care management work? • Yes, we’re advanced in our analytics development: 37 percent • We are early on in our analytics jour- ney: 38 percent • We have not used data analytics until now: 12 percent


JANUARY/FEBRUARY 2021 | hcinnovationgroup.com 9


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