Transparency in healthcare industry has become a major and growing concern for everyone. Physicians, payers and health organizations across the board are diligently working on strategies and methods to ensure and achieve healthcare transparency.
Let’s take a closer look at what these professionals are doing to play their role in improving transparency in healthcare:
§ Physicians
In a fee for service system, physicians had no responsibility for the service and quality of care offered by their referral partners to patients which has been a big challenge in ensuring transparency in the healthcare sector. However, the good thing is that physicians are now shifting from fee for service system to more accountable care/value-based care systems.
Under accountable care, physicians are not just responsible for the quality of service and care that they offer personally to patients but are also accountable for the quality of care offered by their referral partners. Therefore, these physicians pay attention and put extra efforts when seeking for and selecting referral healthcare service partners. They prefer to collaborate with referral partners who share the same values as they do and offer quality care to patients.
§ Payers & Providers
Payers & providers alike are also playing a pivotal role in overcoming the challenges of healthcare transparency. Transparency has also been a challenge between providers and payers as they guarded proprietary information to secure competitive positions in cost negotiations. However, we are now seeing unprecedented collaborations between the two parties because of the shift from fee for service reimbursement systems to accountable/value-based care.
It’s good to know that providers and payers are collaborating and taking effective steps to overcome cultural-barriers related to data sharing. They are collaborating on quality, patient satisfaction and efficiency metrics, and prioritizing these factors jointly.
§ Healthcare Organizations
To improve quality and lower cost, transparency within healthcare organizations is imperative. But this is easier said than done. However, to improve transparency, healthcare organizations are taking initiatives at their own end. The adoption of right technologies such as EDW (Enterprise data warehousing) technology, and innovative team processes and structures are helping them improve operational transparency.
A good example here would be of the Pediatric Radiology department of Texas Children’s Hospital. This is the largest pediatric radiology center where approximately 220K procedures take place, yearly. Radiologists at this hospital actively use EDW technology with advanced analytics to improve their services and keep the cost low.
Using these tools, they are able to extract information like average duration of the procedures, anesthesia utilization, patient flow cycle-time and utilization of different pieces of equipment. All this has helped them maximize utilization and minimize scheduling lags—improving organizational efficiency, quality of service and patient satisfaction.
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