Integrated healthcare is an emerging approach to care delivery designed to improve quality of care, reduce overall costs, and enable payers and providers to share in the corresponding savings. It encompasses a number of new care-delivery models, all featuring some form of payment tied to both cost and quality outcomes. One recent research report has suggested that the migration to these new models could lead to a trillion dollars in savings in the United States healthcare industry over the next decade.1 And while the industry is clearly moving in this direction, the administrative needs are daunting, as are the implications to processing healthcare payments. As healthcare organizations evolve into this new model, payers and providers alike will need to address the workflow and business process implications of the new transaction models.
For financial managers at payers and providers, it’s important not to overlook how these new care delivery and contracting models will impact business operations and transaction flows.