Earlier this year, Blue Cross and Blue Shield of North Carolina announced it had acquired the North Carolina locations of FastMed, a national chain of urgent care clinics. Another insurer, Elevance Health, had closed on a deal to buy Paragon Healthcare and its network of 40 infusion centers across eight states. And Humana also was pushing further into the provider world via a partnership with primary care provider Patina Health.
The deals are indeed coming fast and furious in the healthcare industry, collapsing traditional lines of business to create a class of entities known as “payviders” that assume the dual roles of payer and provider. Looming large over all the recent merger, acquisition and partnering activity among companies staking their future on this new, blended business model is an overarching question: Can they deliver on the promises of a seamless, higher-value patient experience and improved patient outcomes, delivered profitably?
To answer that question in the affirmative, payvider companies will need to lean heavily on digital technology; in particular, capabilities that enable them to provide a superior patient experience (PX), while at the same time integrating core processes, systems and data to connect the payer side of the business with the clinical care delivery side. The goal is to do so within a single digital environment in order to streamline operations across the enterprise (finance, HR, procurement/supply chain, workforce management, facility/operations, sustainability) so they can get a clear picture of total cost of care.
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