Assessments of payers and providers on their AI investments in healthcare: 27 healthcare players (payers and providers) assessed on their AI investments
The future looks promising for AI-based automation…but barriers that restrict its universal acceptance remain
While the explosion of data, cognitive overload, endless documentation, and user burnout in the healthcare industry are driving demand for AI, it has implications far beyond technology: the majority of AI decisions impact business processes, customer experience, and cost – key concerns for chief executives
Demystifying Artificial Intelligence: Definition and Characteristics
It should come as no surprise that global services activity in the U.K. has dropped significantly in all sectors in the aftermath of the Brexit referendum. Indeed, according to our Transaction Intelligence database of sourcing deals, in the healthcare space, the U.K.’s National Health Service (NHS) awarded 13 outsourcing deals in 2015, 11 in 2016, but only four in the first half of 2017.
However, our research indicates that the policy of patient-centric care introduced by the National Institute for Health and Care Excellence in 2012 is likely to drive ample long-term opportunities for innovative IT service providers that offer technology enablers.
For example, under the NHS’s RightCare initiative, the NHS may look to accelerate the adoption of value-based care. Funding is focused on allocative value (how well assets are distributed to different areas of healthcare), technical value (how well resources are used to achieve valid outcomes), and personalized value (determined by how well an outcome matches patient expectation). Additionally, with increasing demand for telemedicine, NHS trusts will be on the lookout for providers that develop mobile applications aimed at remote healthcare management to support the growing importance of care at home for chronic conditions.
A robust cybersecurity network is equally imperative in the wake of recent instances of data breaches such as the March 2017 WannaCry attack, in which the medical records of 26 million NHS patients were hacked. Service providers can help the NHS protect its IT infrastructure from malicious cyber attacks by offering threat intelligence solutions, threat detection and mitigation applications, Blockchain-powered Electronic Health Records (EHRs), and persona-based security platforms.
While third-party providers can profit from these long-term opportunities, they need to be cognizant of the changing competitor landscape, particularly from tech start-ups that are testing the waters to realize potential demand in the U.K. healthcare sector. For instance, DeepMind, a London-based artificial intelligence start-up, worked with the NHS in 2016 on technology to improve care coordination.
To take advantage of growing consumerism in the U.K. healthcare space – e.g., e-Referral and e-Consult services – we recommend that IT service providers increase their investments in growing technological areas such as security, mobility, analytics, and IoT. But first and foremost, they must offer services that focus on patient care. Doing so would help the NHS avoid a repeat of its failed National Programme for IT, which was aimed at cost savings and efficiency, but was abandoned after nine years at a cost of £10 billion in 2011.
We will continue to watch this space and actively share our thoughts and perspectives. In the meantime, you can stay up-to-date on our latest insights in the healthcare domain through our dedicated research on the Healthcare & Life Sciences sector.
How Blockchain enables interoperability
The transition to value-based care models is driving healthcare spending across the board, and IT is no exception.
Among providers, IT investments to support value-based care are expected to grow 34% over the next eight years from $600 million in 2017 to $6.4 billion in 2025, according to a report by The Everest Group. By that time, value-based care IT investments will account for more than half of all health IT spending among providers, which is projected to reach $11.7 billion over the next eight years.
Everest Group Evaluates VBC Adoption, Financial Performance of 40 Largest Health Systems
After enduring a slump in recent years, demand in the healthcare provider IT market is rebounding, driven primarily by value-based care (VBC) initiatives. In fact, according to Everest Group, growth of the overall healthcare provider IT spend over the next eight years will be completely driven by VBC initiatives, and by the year 2025, VBC will account for more than 50 percent of all healthcare provider IT spending.
VBC refers to efforts to align physician and hospital rewards with cost, quality and outcomes measures rather than quantity of services provided.
More than 75 percent of provider organizations have either adopted or are looking to adopt VBC in the near future, a trend that will drive the next wave of IT investments among healthcare providers.
“We expect that the VBC reimbursement model will take over the traditional fee-for-service model by 2025,” said Abhishek Singh, practice director at Everest Group. “Between now and then, healthcare providers make their most significant IT investments in the areas of patient engagement and compliance. In fact, in the next eight years, we forecast that an additional $5.8 billion will be spent on VBC-driven initiatives. Of that, $2.1 billion will be tied to patient engagement initiatives, and $3.3 billion will be tied to compliance initiatives.”
Other VBC-driven IT investments will fall into one of two general categories: diagnostics, treatment and monitoring; and financials and network management.
These findings and more are discussed in a recently published Everest Group report, “Healthcare Provider Annual Report 2017: Will the Real Value-Based Care (VBC) Please Stand Up?”
This report describes the current state of value-based care and provides an evaluation of the 40 largest health systems with respect to their VBC and financial performance. The report also recommends a framework that health systems can use to accelerate their value-based care initiatives and describes the expertise and service capabilities required for service providers to serve the needs of the market.
The State of VBC Adoption: Key Takeaways
Background on VBC
In the past, the U.S. healthcare system operated primarily on a fee-for-service model, which rewards healthcare providers for the volume of services delivered; for example, a physician is paid for every visit or procedure, regardless of patient outcome, the provider’s operational efficiency or the quality of the providers’ service delivery.
In contrast, in a VBC model, healthcare providers are reimbursed and incentivized based on quality of care rather than quantity. Although there are many different models and approaches to VBC, the objectives are to provide better care for individuals, improve population health management strategies (that is, how providers coordinate to provide the best care for patients), and reduce healthcare costs.
The relative success of VBC initiatives can be measured in many ways. Common patient care objectives include lowering readmission rates, mortality rates, and Medicare spending per beneficiary (MSPB); increasing patient satisfaction; reducing the number of hospital acquired conditions (HACs); and minimizing the time between check-in and check-out at the Emergency Department.
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