Top 5 Strategic Considerations for the Evolving Health IT Landscape

Evolving Health IT Landscape

The health IT community is renowned for innovation and ingenuity. With trillions of dollars at stake and a moral imperative to help patients live happier, healthier lives, it’s no wonder that hundreds of health IT companies are launching in the market each year.

Many of these promising companies are able to secure funding from investors who believe in their potential. But not all have the agility and strategic knowhow to find long-term success in an industry as challenging as healthcare.

Companies that hope to maintain their upward growth trajectory need to stay in-tune with changing market dynamics, including new regulations, incentives, and expectations that are continually disrupting the status quo. With every shift, the competitive landscape transforms, calling for a seemingly endless cycle of business transformation.

How can health IT companies accelerate their success as they negotiate the tricky transition from start up to market leader? Here are the top 5 things you need to consider when designing your growth strategy for the complexities of today and tomorrow.

1. Reimbursement has become a hybrid as fee-for-service gives way to value-based care

Value-based care has been steadily growing for years as regulators, payers, and providers look for alternatives to the unsustainable fee-for-service (FFS) environment. While full capitation has its limits, a rising number of stakeholders are investing in models that blend volume and value in innovative ways.

Close to 60 percent of all reimbursements across Medicare, Medicare Advantage, Medicaid, and commercial payers are now linked to quality or value in some manner. Payers are shepherding providers into risk-bearing arrangements as quickly as they dare, leaving stakeholders with an urgent need for health IT tools and data analytics to maximize their opportunities for value-based incentives.

You need to have a clear idea of how your offerings fit into this major sea change. If you can deliver on the needs within today’s hybrid environment as well as the scale to accelerate on-pace with adoption of value models, you’ll have the market advantage.

 Do you have a product or service that delivers measurable value for organizations expanding their participation in value-based care? Do have the expertise to deeply understand the nuances of regulation, compliance, and reimbursement involved in the pay-for-performance environment? These competencies will be crucial for supporting clients in their search for shared savings.

2. Providers are actively searching for tools to provide interoperability and integration

Value-based care requires close coordination between stakeholders who may not have collaborated much before. As providers become more concerned with managing the total costs of care for an attributed population, they will need access to information about utilization and outcomes across the care continuum.

Not every health IT business needs to zero in on the thorny problems of data interoperability and infrastructure integration. But every business does need to be familiar with the challenges that providers face when attempting to assemble a comprehensive portrait of clinical quality and spending.

Your product or service must be able to account for the thirst for insights across the ecosystem, from point-of-care clinicians and risk-bearing entities to payers and technology service providers. Remember, too, that every nugget of information related to social determinants of health and health equity is gold right now.

3. Care is shifting from hospital to home, saturating the market for virtual solutions

The COVID-19 pandemic has accelerated the trend of moving care out of the hospital and into the home. Digital health solutions, including telehealth, remote monitoring, virtual care platforms, and clinical-grade medical devices, are increasingly in demand as providers and patients seek convenience and cost savings.

Health IT companies will need to take this shift into consideration as they engage partners in the industry. They will also need to be aware that telehealth is one of the most crowded and highly hyped segments in the healthcare industry, with a herd of at least 27 different billion-dollar unicorns thundering across the globe.

Companies that plan to court providers in the crowded digital-health market will need to have an extremely unique value proposition to gain attention. It’s not impossible, though. There are still plenty of tough problems to solve, including chronic disease management, medication adherence, home nursing care, and issues around the social determinants of health.

4. The consumer experience is tightly tied to success for provider and payer organizations

Consumer experiences haven’t always been top of mind in healthcare, but that’s changing rapidly as higher out-of-pocket costs (up to $17,400 for a family on the federal exchange in 2022) motivate patients to take a more active role in shopping for their care. Providers are keenly aware of the value of patient loyalty, and offering a positive experience is one way of maintaining that relationship.

For health plans, regulators are codifying the importance of the consumer experience by heavily weighting member satisfaction in Star Ratings. For example, in 2023, close to one-third of the Medicare Advantage Star Ratings will be directly tied to performance on CAHPS survey scores, giving health plans a strong motivation to make sure their members are happy.

How does your health IT offering enhance your customers’ ability to deliver an exceptional experience to their consumers? Consider how consumer preferences have become more entrenched in the way your clients choose their partners and be prepared to have that conversation.

5. In a crowded marketplace, you need to differentiate yourself with a compelling story and strategy

With so many companies vying for a slice of the healthcare pie, you need crystal-clear vision around your product, your ideal customers, and the results you will achieve together. Your odds of success hinge entirely on your ability to communicate your value to potential partners – and to cut through the noise of hundreds of other companies likely trying to do the same.

Do you have the market intelligence required to understand your customers’ needs and your competitors’ strengths and weaknesses? Do you have a complete go-to-market plan that capitalizes on existing relationships and draws new leads into your sales funnel?

Once you have a strategy and a great story to tell, recalibrate your vision often. The market is always changing, and it’s all to easy to get caught in a routine that stagnates over time. A brand refresh or a refined messaging approach based on emerging market needs can be the spark you need to boost your growth trajectory.

Balancing long-term and short-term strategies is tricky, especially in light of the pandemic. Your strategic considerations should always lean more on data and insight into the market and less on what seems like a novel idea.

Leading health IT businesses count on Canton & Company to accelerate their growth in the highly competitive healthcare landscape. Find out how our team can help you execute your business transformation. Start a conversation today.