The healthcare industry’s transition toward value-based care is forcing providers to adopt new and emerging business models in lieu of traditional fee-for-service payment. At their core, these business models have the principle of value-based reimbursement, in which providers must meet certain quality care standards while controlling costs in order to get paid.
And while the election means that the Affordable Care Act will likely be changed, we at GE Ventures, don’t believe the fundamental driving force of providing better outcomes at lower costs will be stymied.
In other words, the fundamental challenge facing healthcare providers —improving quality while cutting costs — remains. Compounding this challenge are numerous competitive and regulatory factors, many of which are constantly evolving. In addition to meeting current quality reporting standards set by the Centers for Medicare and Medicaid Services (CMS), many hospitals and private practices now must meet the value-based requirements of multiple health plans and accountable care organizations (ACOs).
If that weren’t enough unless the healthcare law is severely revised, providers will continue to deal with increased patient volume as millions of uninsured Americans now have coverage. And since many of these current plans carry high deductibles, patient choices for providers are based less on loyalty and convenience and more on price and perceived quality of care. Patients are becoming healthcare consumers.
Success in this new landscape requires healthcare providers to harness the power of data and automation. Fortunately, technology giants and startups alike are working on analytics solutions designed to improve how clinicians treat patients, optimize the revenue cycle, and increase operational efficiency.
Our firm is committed to providing initial funding for the startups focused on improving healthcare. We have invested in more than two dozen healthcare companies, including a number specializing in analytics. While the ways in which analytics can be applied to healthcare are almost limitless, GE Ventures is focusing its investments on several broad categories within the healthcare realm. These categories, outlined below, span the clinical, operational and financial elements of healthcare.
Risk adjusting and management Predictive analytics has been used in the healthcare industry over the past several years to help establish rates and identify patients with chronic conditions.