The healthcare industry is making a fundamental shift in how physicians and hospitals provide care and receive payment for it. The fee-for-service or volume-based care model will give way to the value-based care model.
Before the Affordable Care Act (ACA), physicians and healthcare facilities almost exclusively billed Medicare or insurers for the individual services they provided — each appointment, each test, each procedure. With that fee-for-service model, however, there is more potential reward for physicians who provide the greatest number of services, not necessarily for those that provide care that results in the best patient outcomes. Stakeholders in organizations paying for healthcare realized that they were spending more, but patient outcomes weren’t necessarily better.
The value-based care model, however, bases payment to physicians and healthcare facilities based on performance. Healthcare providers are rewarded with incentives for better patient outcomes, fewer readmissions or complications, and providing care in the most cost-effective way.
As a MedTech marketer or sales professional, you know that selling to a hospital can often mean dealing with a larger organization. Between 72 percent and 80 percent of hospitals and nursing homes’ non-labor expenditures are through group purchasing organizations (GPOs) and integrated delivery networks (IDNs).
Ground-breaking advances in prosthetics and orthotics are giving patients capabilities that few people imagined a decade ago. The goal is no longer to simply replace a limb or correct biomechanical issues. Research in prosthetics and orthotics advancements is aiming for people to use artificial limbs just as anyone uses their arms or legs.
These seven advances in prosthetics and orthotics are promising greater functionality and improved quality of life:
Concerns over medical device shortages are again at the forefront for providers and for health professionals. Though there are always worries over the availability of certain types of medical technology, the current, looming crisis began with state environmental protection agencies issuing orders for sterilization facilities to stop using ethylene oxide (EtO) in their processes.
November is National Diabetes Month. Diabetes is a chronic disease that continues to be an epidemic in the U.S. According to the Centers for Disease Control (CDC), approximately 9.4% of the country’s population (equivalent to around 30.3 million people) have diabetes. Those afflicted with the disease suffer complications, and it is currently the seventh leading cause of death in the U.S. As with any disease, technology has the potential to make an impact in diabetes treatment. Diabetes technology could provide significant advantages to those afflicted with it and the clinicians who treat them.
Integrated delivery networks (IDNs) offer both health care services and health insurance plans. That simple definition, however, doesn’t do justice to the impact IDN healthcare has had on the industry. When the Affordable Care Act (ACA) put more emphasis on accountable and integrated healthcare, IDNs emerged as a model to meet the challenge of providing quality care at a reasonable price.
Although IDNs’ organizations can vary, they typically provide comprehensive healthcare services and leverage EHRs to share information about the patient with facilities and physicians and other practitioners in the network.
IDN patients usually have access to the full spectrum of services — preventive, acute, rehabilitation, and specialized care — all from one healthcare brand. Furthermore, patients who subscribe to the IDN’s healthcare plan understand that services within the network are covered according to the terms of their plans, and there’ll be no surprises when it comes to billing. The model can also be successful at minimizing patient leakage. By providing a one-stop shop, as it were, for healthcare, satisfied patient-consumers never have to look outside the network.
Integrated delivery networks typically operate in specific U.S. regions. This strategy allows them to build healthcare systems that offer most services that patients need and can take advantage of close to home.
The IDN model also creates a powerful negotiating position with Medtech companies and other suppliers. Marketing to providers who are part of an IDN typically means dealing in volume and scale.
The story of the Theranos fraud allegations and fallout is likely to color decisions around healthcare diagnostics companies’ R&D, operations, marketing, and funding for years to come. Although Theranos shuttered in 2018, the rise and fall of this company, which claimed to have technology capable of performing hundreds of tests on only a few drops of blood, continues to capture attention, make headlines, and cause founders and investors to think twice about their decisions.
The cautionary tale continues as Theranos CEO Elizabeth Holmes and president Ramesh Balwani prepare to stand trial in Aug 2020 on 11 counts, including wire fraud and conspiracy to commit wire fraud. If they’re found guilty, they could be fined millions of dollars and face up to 20 years in prison.