Transparency no longer refers to Casper the Friendly Ghost or those plastic sheets we used on overhead projectors. Transparency became a popular buzzword in the early 2000’s driven mostly by politics. It has since become an important standard in business models and strategies. A recent J.P. Morgan survey identified several industry-wide challenges facing healthcare executives. Top healthcare trends of 2019 that are of particular concern to executives include revenue growth, talent shortage and the shifting strategies needed to stay competitive. Among these is the need for transparency. Transparency is defined as being “free from pretense or deceit, easily detected or seen through-readily understood. Characterized by visibility or accessibility or information especially concerning business practices.”
4 PERSPECTIVES ON HEALTHCARE TRANSPARENCY
More and more consumers are asking for access to information regarding test results, pricing and quality of service measures. Often questions are asked concerning true out-of-pocket expenses, impact on deductibles, what happens if insurance won’t pay for a test or drug or simply won’t pay at all. Unfortunately, many patients don’t know the actual cost of care until after they’ve received it. The healthcare industry is starting to implement practices centered around consumer information transparency, as the demand for this will surely increase.
Clinical staff themselves are often unsure about costs of care for particular drugs or tests ordered for patients, what might or might not be covered and the appropriate medical coding that needs to take place for proper reimbursement. Physicians increasingly have entered into accountable care contracts that have them accountable not only for the care, but costs and quality of delivery. These value-based contracts require the transparency of information.
Payers and Providers
Transparency represents a major challenge between these 2 parties who have previously guarded such proprietary information closely. To facilitate transparency, “One of the most important things they can do to get started is to agree on what quality, efficiency and patient satisfaction metrics they will jointly prioritize and track.”
Improving quality and costs requires transparency within an organization. Again, staff within a facility frequently have no idea what actual costs are. In addition to cost transparency, outcomes need to be communicated before quality initiatives can be implemented with any hope of success. Culturally, control of this type of data has been held by a very few and information slow to trickle down. However, when the process dynamics and resultant quality improvements are communicated “the organization can become more efficient, reduce variation, improve quality, reduce costs and improve patient and staff satisfaction.”https://www.healthcatalyst.com/Key-Overcoming-Challenges-Transparency-in-Healthcare
In this climate of immediate data availability, potential healthcare clients are increasingly using a consumer-based mindset when making healthcare decisions as well as in every other purchasing decision. Transparency can mean different things to different people depending on perspective, but the free flow of information will only increase the outlook for success in the future. As the culture shift in the healthcare industry continues to demand higher quality at a lower cost, healthcare leaders are facing this challenge as never before.
NHS Solutions has a deep pool on Interim Healthcare Executives who are experts at managing these challenges. Our Interim Healthcare Leaders are sought out to step into a facility, assess situations, advise, implement or maintain leadership of a unit in transition. Don’t hesitate to contact us with your needs. Alternatively, if you are a healthcare leader interested in hearing more about working as an interim leader with NHS Solutions, visit our candidate webpage for more information. We invite you to securely upload your resume for a free review.