Healthcare IT News just published its list of top issues for health plans in 2011:
1. Administrative Mandates (Compliance HIPAA 5010, ICD-10, etc.).
2. Care Management, Data Analytics, and Informatics.
3. Health Insurance Exchanges and Individual Markets.
4. New Provider Payment & Delivery Systems (ACOs, PCMHs, etc.).
5. Bend the Cost Trend.
6. Medicare and Medicaid.
7. Health Information Exchanges and EMRs.
8. Consumer’s Role in the Modernization of Healthcare.
9. Reform Uncertainties.
10. Payer/Provider Interoperability.
Dear health plan colleagues,
Wake up! The order of this list is totally out of whack.
#2: Care Management, Data Analytics, Informatics. Good…sounds about right.
#2 can’t happen before you address:
#7: HIEs and EMRs
#10: Payer/Provider Interoperability
Health plans can’t analyze the data and assist in care management unless they first have access to it. Payers need access to clinical data, and they are at risk of being cut out of the loop.
Please also take a look at priority #1: Administrative Mandates (Compliance HIPAA 5010, ICD-10, etc.). This is completely reactive!
In these times of great change, is this how health plans want to posture themselves in the community?