Here are the challenges facing health care… Leave a comment

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Executives in health care organization report some progress on their top priorities, a new report from Optum has found. The pharmacy benefit manager, part of UnitedHealth Group, said its yearly survey seeks to understand how current market forces affect the decision-making of health organizations. It noted that the industry is currently dealing with supply-chain issues, pandemic-related changes, and new expectations from consumers.

To measure progress in moving forward in this challenging environment, Optum collected insights from 153 health care leaders from health plans, provider groups, employers, life science organizations, and government agencies. Of the respondents, 35% were members of the C-suite, 31% were senior vice presidents, and 33% were vice presidents

Areas of progress and innovation

The analysis found that the biggest areas of progress in the past year were infrastructure innovation and modernization, and care delivery innovation.

“Seventy-six percent of leaders believe that progress has been made in infrastructure innovation and modernization,” the report said. “This includes advancing interoperability, administrative simplification, and staffing models.”

Care delivery innovation was another area of progress, with 65% of respondents agreeing that the health care industry has made progress in areas such as virtual health, in-home care, and reducing unnecessary care.

“While there’s still some friction around reimbursement levels, compensation is beginning to normalize for these new care channels,” the report noted. “To further progress, care payment and funding will need to evolve in tandem with care delivery innovation.”

Progress was also found in the area of health ecosystem innovation, where collaboration and partnerships with health-related companies has increased agility, according to the report. “By combining resources and capabilities, partnerships have closed gaps and increased resilience to supply chain disruption and staffing demands,” the report said. “They’ve explored ways to apply the innovations brought forward by new market entrants.”

Areas of limited progress

Other areas, the report found, did not see as much progress in the past year. For example, after strong progress in customer engagement in 2021’s report, progress in that area dropped significantly this year. That survey showed that 73% of c-suite executives felt the industry had made progress in customer engagement, but this year, only 52% reported improvement.

“It appears that the health industry is still learning how to sustain a strong consumer experience and may need new ways to measure success,” the study said. “This can be challenging when consumers move in and out of coverage and care systems. Health care is still striving to put the consumer in front of the process and find affordable ways to offer more access, choice and control.”

Care payment and funding was another area of concern. The analysis found that fewer than half of the respondents (48%) believed the industry has made progress in care payment and funding evolution. It added that mixed incentives created by fee-for-service and value-based arrangements are creating barriers to further progress.

For the greatest challenges facing health care organizations, survey respondents listed supply chain disruption and price transparency as two of the most difficult issues. Health care leaders said they were prioritizing new products or services; consumer acquisition and retention; and digital solutions for consumers as the top three areas of investment. The study also said rising consumer expectations and the impact of technology has increased fragmentation and complexity in health care.

The report concludes by noting the importance of partnerships within the industry, saying it enhances resilience. “Partnerships are required to remain competitive; to access new capabilities, new talent, and new markets. And partnerships spread risk, making organizations less susceptible to a single point of failure,” said Craig Savage, senior vice president with Optum Advisory Services.


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