The healthcare industry is at a turning point. For such a heavily data-driven industry, it has notoriously lagged in adopting modern technologies. Following the pandemic, the pressures on the 3 Ps – providers, payers, and products has mounted, as huge disparities across the industry were revealed. At the same time, patients are expecting more from the 3 Ps, and rightly so – so we will add them as the 4th P in this scenario. It is a complex landscape, full of regulations, technological changes, and expectations. Let’s take a look.
Challenges Facing the Healthcare Industry
While this is not an exhaustive list, we intend to provide a glimpse into the challenging times facing this industry. You will note some prevalent themes: rising costs, the need for improved technology, safeguarding data, siloed data, and maintaining quality care.
Provider Challenges:
- Doing More with Less: A Wall Street Journal article highlights that healthcare providers are being forced to cut back on assets, staffing, and services to address the rising costs and cash flow challenges following the pandemic.
- Maintaining Electronic Health Records (EHRs): For many providers, the move to electronic health records (EHRs) has been slow, but it is steadily growing. According to Harvard Public Health, the data overload providers are facing can be overwhelming. There are no universal standards for collecting, sharing, or safeguarding data, much less analyzing the data to make improvements.
- Meeting Rising Patient Expectations: As we will also discuss in the Patients section of this blog, there is pressure on providers to face the challenge of delivering improved patient outcomes while managing costs. Patients want to have access to a patient portal to access their health history and contact providers and expect privacy and security of their records.
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Payer Challenges:
- Remaining Regulatory Compliant: Faced with ever-increasing regulation, starting with the Affordable Care Act in 2010 to HIPPA the more recent Centers from Medicare and Medicaid Services (CMS) regulations including the Transparency in Coverage Act, Interoperability and Patient Access rule, and Medicare Advantage and Part D Final Rule there is a need to promote equity in coverage and ensure patient data is secure.
- Facing Rising Costs: A common theme across this industry, as the cost of healthcare continues to rise, payers must face reconciling expensive therapies, high-cost prescriptions, hospital care, and more.
- Maintaining Strong Cyber Security: While this need spans the entire industry, the 2024 ransomware attack against UnitedHealth Group’s Change Healthcare was deemed the most significant and consequential cyberattack on the U.S. healthcare system in American history, according to The American Hospital Association. UnitedHealth Group reported it cost $22M to regain access to their data and systems. Payers are taking note and steps to stay protected from possible data breaches.
Product Challenges:
- Dealing With a Disrupted Supply Chain: We are all aware that the pandemic disrupted global supply chains, which continues to lead to delayed deliveries and rising material costs. Despite increased demand for medical devices, manufacturers face production limitations until supply chains stabilize. This article from Medical Life Sciences News provides hope but also points out there is a long way to go.
- Facing Regulatory Challenges: The medical device market faces inconsistent regulation, making it difficult for manufacturers to navigate. Striking the right balance between safety and innovation remains a challenge.
- Addressing Recalls and Lawsuits: In keeping with the nature of this highly critical market, recalls and lawsuits are a frequent occurrence. Many manufacturers will recall old models as a precautionary measure—an expensive move, but it can also save more in the long run by avoiding a lawsuit. Likewise, lawsuits are common in a market where definitive medical claims may draw scrutiny from the FDA and customer expectations are high.
Let's talk about the 4th P: the patient
Patient Challenges:
- Getting More Engagement and Access: Ensuring active patient engagement remains a challenge. Factors like accessibility to their own healthcare data, health literacy, and technology impact patient participation in their own care.
- Paying the Price of Healthcare Today: The rising costs of healthcare services, prescription drugs, and long-term care, as well as unexpected bills and out-of-pocket costs have many patients on edge.
- Quality of Care: While providers and payers are facing budget cuts, patients expect care that meets their needs, including timeliness, equity, and accessibility. They are looking for effective and passionate treatment amidst this dynamic landscape.
We believe that data integration, analysis, and project management can help healthcare organizations meet and rise above many of these challenges. And we also agree with a quote from this article that says, “Data and technology are creating a lot of bright spots for even more potential power for healthcare system transformation in order to drive access, engagement, and innovation.”
Minitab has helped many healthcare organizations achieve better products, care, service, compliance, efficiency, and savings. This is accomplished through leveraging data analysis to solve problems and identify areas of improvement at any facility, service, or organization. We are here to help you get the most out of Minitab. We offer three training tracks that dive in to statistical techniques and tools most relevant to your role in healthcare: