Health IT for Emerging “Payviders”

Health IT for Emerging “Payviders”Health IT for Emerging “Payviders”
Priscilla Sandberg, Healthcare Alliance Manager, Pure Storage

Though doubts about the benefits of the “payvider” model certainly exist, the success of recent payer-provider partnerships showcases the potential of these programs to improve the patient and provider experience. A study of Aetna’s integrated program, for example, found that plan members could realize significant savings for high-cost chronic conditions and experience fewer hospital admissions. A similar report from Cigna echoed these conclusions, finding that integrated benefit plans resulted in increased patient engagement. Synthesizing data from payers and providers increases visibility into the patient, giving healthcare professionals the context they need to improve health outcomes and streamline care.

The slow expansion of payvider networks is not out of a lack of interest in emulating programs like CVS Health/Aetna or Cigna. In fact, according to a survey by the Healthcare Financial Management Association, 60% of providers aim to follow suit and become payviders this year. However, the same report shows that data and technology costs pose significant barriers to implementation. 

The main benefit of this model is the ability to share population and individual information to create a more holistic view of a patient, but if data is splintered across various networks, neither partner will be able to capitalize on these opportunities. For payers and providers to access and analyze information from care coordination platforms, pharmacy benefit reports, and electronic health records, they need interoperable and flexible data storage solutions.

Future-ready IT for growing organizations

The healthcare industry generates approximately 30% of the world’s data volume, and data growth in this sector will continue to increase exponentially. Payviders need solutions that securely store all this data and also keep patient charts, notes, images, patient-generated data, and other clinical information accessible and shareable. To provide this comprehensive care to their members, payviders must first expand their network reach. Acquiring clinics and in some cases, other plans, allows them to grow their business and increase member satisfaction.  

With acquisitions comes the challenge of managing disparate application sets and often separate infrastructures. To control costs, payviders should consolidate infrastructure to support their different business units. When bringing on a new physician practice or plan, data storage grows, often in unpredictable ways. Traditional management methods often require organizations to rip and replace infrastructure that is not capable of supporting new workloads, resulting in costly and time-consuming conversions. With patient data at risk, conversions may cause interruptions in care and jeopardize the validity of clinical data.

A storage infrastructure model that allows these organizations to expand their footprint without conversions or downtime not only saves time and money but also puts the patient data first.  Members demand real-time access to their EHR and Insurance information, and downtime compromises their ability to manage their care. To effectively scale out their infrastructure support, organizations must consolidate their data storage in a centralized, always-on solution rather than in separate infrastructure locations. On-demand storage-as-a-service solutions are the key to managing massive amounts of data, ensuring that the organization’s IT can grow alongside the company itself.

Artificial intelligence and machine learning capabilities for next-gen analytics

Compiling and streamlining data is nearly useless without a method of analyzing the information to uncover actionable insights. Although traditional analytical models are useful for hypothesis-driven research, organizations of the future need to leverage artificial intelligence and machine learning to find patterns in massive data sets. With visibility into the payer and provider side of healthcare delivery, data teams can predict crisis events, promote personalized care, and determine patients at risk. AI systems can pinpoint population-level data to identify predictors of certain chronic conditions or analyze a patient’s records to better inform accurate diagnosing. Ultimately, these technologies provide organizations with the information they need to provide better preventative care and reduce hospital and emergency department admissions. 

Despite all of these benefits, few organizations are using these artificial intelligence capabilities in a meaningful way. According to a Deloitte report, 90% of healthcare professionals surveyed believe AI is important to their organization, but many cannot capitalize on the technology because of siloed, unintegrated data sets.

For healthcare organizations to maximize the potential of these next-gen analytical tools, they need AI-ready storage solutions.  Whether it’s on-premises or in the cloud, much of the existing legacy infrastructure technology requires teams of data scientists to run analytics and transfer data to ML-supported platforms, leading to significant delays. Implementing new, AI-ready infrastructure can accelerate the speed to insight, facilitating innovation and producing actionable, modern analytics. 

Expanding the functionality of healthcare IT

As the healthcare industry continues to undergo digital transformation, investing in flexible, multi-purpose IT across the entire organization will be paramount. Healthcare technologies no longer serve singular purposes. An EHR is not just a collection of visit summaries, but a compilation of patient-generated data, physician notes, and clinical images that are integrated into a comprehensive view of a patient’s health. Telehealth platforms have expanded beyond video chats to include asynchronous care delivery, voice analytics, and automatic clinical note generation. Similar innovation exists in the data storage space, helping organizations store, protect, and analyze the billions of gigabytes of information that are generated on patients.

For payviders particularly, future-ready IT is a must. The benefits of closer payer-provider relationships are becoming clear as these newer organizations continue to expand and report patient outcomes and business performance data. The future of healthcare is always unpredictable, so why should organizations invest in solutions that can’t adapt and grow with them? Every day, data becomes more crucial to understanding patient populations and improving their treatment and coverage. With flexible, AI, and cloud-ready storage, these organizations can ensure that their IT is prepared to support their evolution.


About Priscilla Sandberg

Priscilla Sandberg is a Senior Healthcare Strategic Alliances Manager at Pure Storage, helping to expand the company’s Healthcare Vertical, with the goal of providing state-of-the-art storage infrastructure to organizations, ensuring that clients have the tools to meet the ever-changing data capture and reporting requirements of today’s healthcare environment.