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Fiscal cliff and Medicare cuts drive need for increased efficiency in healthcare system

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If you’ve picked up a newspaper or turned on the news over the past few weeks, you’re aware that the federal government is speeding towards what political and economic pundits are referring to as the fiscal cliff.

As President Obama and Congress are locked in negotiations to determine an appropriate plan and reach a compromise on a combination of tax increases and spending cuts to help the federal government avoid sequestration, Medicare faces roughly 2 percent across the board cuts to physician reimbursements. With Medicare accounting for approximately 15 percent of the total federal budget, any successful budget negotiations will likely impact that program.

Multiple plans and ideas for trimming Medicare costs have been initiated through reform and continue to be proposed. The collaborative care model focuses on switching the payment model so that healthcare providers are compensated for the overall care of the patient, not per service or treatment performed. Recent discussions on reducing costs have reintroduced the idea of upping the age for Medicare eligibility.

Regardless of what changes are made, one simple fact remains – healthcare providers and payers are going to need to begin operating more effectively and efficiently.

In my previous posts on EngageHealthcareToday, I’ve described some of the different and innovative ways that the healthcare community can leverage communication technology to help accomplish this. Ultimately, it comes down to eliminating waste, becoming more proactive in providing care and working to coordinate all healthcare organizations involved in providing care to the patient to identify and eliminate redundancies in care.

Collaboration and communication in the delivery of care is instrumental in eliminating redundancies and waste. Luckily, today’s master data management (MDM) and customer communication management (CCM) solutions help providers to share information in a timely manner, communicate with each other regarding prescribed treatment, and engage patients through consistent messaging and monitoring. This can ensure that information is shared among caregivers, redundant tests and treatments are avoided, and the patient is kept on the correct track to wellness with timely and targeted messages.

A shift away from the treatment of conditions to a more proactive and preventative medicine, centered around keeping the patient healthy, is also important in reducing cost within the healthcare system. Analyzing the data from newly available sources, healthcare providers and payers can identify patients that are at risk for certain chronic conditions. Utilizing the same MDM and CCM solutions, automated triggers can send targeted, personalized, timely messages to encourage patients to participate in their own healthcare and actively work to avoid getting sick.

The rapidly approaching fiscal cliff has put healthcare costs in the spotlight again, but the country doesn’t need to go over the edge to drive dramatic changes to current healthcare business models. Healthcare providers, insurers and other stakeholders continue to strive to leverage technology to engage patients in their own care, shifting to more preventative care and increasing the collaboration between healthcare companies to identify and eliminate waste and redundancies in treatment. Today’s advanced CCM and MDM solutions give healthcare providers and payers the tools they need to realize these efficiencies.

by Deb Purcell

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