Healthcare IT and Its Place in Today’s Changing Landscape

Dave Stalder recently joined Netgain as its Vice President of Healthcare and will be responsible for leading Netgain’s Healthcare business, aligning Netgain’s offerings with market needs, and driving the company’s Healthcare strategy and investments.

In my 30 years working with Healthcare organizations, I’ve witnessed new regulations, technology advancements, and economic imperatives drive tremendous change in this industry. And yet, across three decades, no change has seemed as impactful as the seismic shift the industry today is experiencing.

Re-Evaluating Healthcare’s Accepted “Norms”

Or perhaps, it’s more accurate to say that the past 30 years of change are culminating into today’s current landscape. Consider the following trends that have changed the face of traditional healthcare.

First, we’ve seen Healthcare’s unsustainable cost pressures span new revenue models that are creating an unanticipated opportunity to drive better outcomes, lower costs, and increase patient and provider satisfaction. By aligning physician incentives around better outcomes and costs, payers have created a new revenue model for providers to being the transition to what’s termed as “Value-Based Care.”

In recent years, the emergence of alternative reimbursement models – driven largely by Federal Programs such as Medicare Shared Savings Plans, Medicare Advantage, and Direct Contracting Entities (“DCE”) – have challenged the traditional Fee-for-Service (“FFS”) structure that’s been incumbent in the United States healthcare system for decades.

In addition, almost all the national and regional payers also offer their members products that reduce total healthcare spending by capitating the total annual payments for each practice’s assigned patient panels.

Finally, this shift in payment models has created a movement that places the clinician at the center of care. Yet that same model requires that providers and payers invest in a different set of tools and capabilities to succeed, e.g. scalable solutions that aggregate patient care management, leveraging tools, services, technology, data, and capabilities that enable the capture of value through risk-bearing arrangements.

Enabling IT vs Strategic IT in Healthcare

The net result of all these factors is an unprecedented flood of new entrants into healthcare’s newest “gold-rush.” Players that previously had little to no interest or credibility in healthcare have emerged as significant players while traditional healthcare organizations have embraced consolidation or innovation to remain relevant. Suddenly, the market is awash in players as diverse as new healthcare conglomerates created by traditional mergers and acquisitions, private equity-backed startups with enormous war chests, predatory regional hospitals that continue to expand, managed service organizations, data aggregators, clinically integrated networks…the list keeps going.

While each of these models have their own idiosyncrasies, advantages, and disadvantages, the success of all of them is predicated on leveraging scale – whether that’s in terms of data aggregation or measured in operational efficiencies. That scale in turn requires agility and flexibility to drive growth. That’s where technology comes in.

With the right IT foundation, you gain the ability to react more quickly and innovate faster. Instead of having growth inhibited by infrastructural, supply chain, or technological limitations, technology can become a critical, enabling extension of the organization’s strategic game plan.

I joined Netgain in part because of our ability to play this critical role in the future of the Healthcare industry. The shifting reimbursement model is altering the landscape of how healthcare is delivered in ways that we haven’t seen in decades. Netgain’s commitment to our clients and their needs for reliability, security and, yes, agility to scale help Healthcare organizations drive better patient care at lower costs through scalable IT-as-a-Service solutions.

I’m excited to be part of this journey.

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