The Health Reform Legislation will have an effect on the health insurance industry. The PPACA law’s unprecedented changes will create serious challenges for the health insurance marketplace – increased competition for the group market, burgeoning numbers of insured patients, cost restrictions, complex compliance requirements, and new models of care.
The collaborative, integrated care approach of Patient Centered Medical Homes (PCMH), Accountable Care Organizations (ACOs) or any other emerging care delivery model requires highly developed technological infrastructure; access to accurate, timely, and comprehensive data; and integrated clinical and financial analytics. Tracking meaningful results for the patient population and per-capita spending will be critically important in charting the success of these approaches.
Payers have an opportunity to partner with ACOs because they have the critical claims data that ACOs need to better monitor patients’ health, identify gaps in care, and mange risk.
To understanding this change, other emerging trends and learn what distinctive capabilities are needed to compete in the new healthcare landscape, download the Emerging Healthcare Trends whitepaper.