5 Challenges Currently Being Faced by the Healthcare Industry

Just like any other industry, the healthcare industry faces many challenges that could threaten its financial viability as well as its operational capacity. Some are age-old and have been plaguing the industry ever since its inception, while some are new and brought about by the availability of certain modern tools and techniques.

Hospital administrators, healthcare organization leaders, and health payers are placed in an urgent position to meet these challenges, as not only the job security of many professionals are at stake but also the health and well-being of millions of patients.

The following is a list of the bigger challenges this industry faces today.

Preventing healthcare fraud

Fraud is an age-old challenge that makes a victim of everyone in the healthcare industry, be it health payers who get duped by unscrupulous healthcare providers, legitimate providers who mistakenly provide their services to unscrupulous fraudsters, or actual patients who would often be denied their treatment because of said fraudsters getting the service in their stead. It’s a lamentable waste of time and resources that could delay the saving of lives. Only through employee training, a strong legal team, and a strict enforcement of anti-fraud policies can this be mitigated.

AI counter-fraud solutions can also help massively in this regard, allowing organizations to automatically find suspicious links and fraudulent behavior through predictive analytics without needing to dedicate huge amounts of resources to do so. This results in health payers and hospitals being able to predict when and where fraud might happen, and prevent it from taking place to begin with.

Compliance with new government requirements and mandates

All over the world, many governments are enforcing new requirements and regulations that will have the healthcare industry scrambling to comply lest it faces costly consequences. Besides the Trump administration’s gradual repeal of the Affordable Care Act, there is also the new European Global Data Protection Regulation (GDPR) about to be enacted in May 2018, which mandates that all organizations are to handle the personal information of all EU citizens in a much more specific and protective manner.

Failure to comply to new rules and regulation often results in stiff penalties that no healthcare organization can truly afford. As such, healthcare industry officials and leaders must make compliance a priority while at the same time continuing to focus on providing the highest quality healthcare to their patients.

Preventing data breaches and other cybercrimes

Cybersecurity is a concern that many industries face, not just the healthcare industry. This is due to cybercriminals shifting their focus from simply attacking end-users to targeting businesses as well, choosing to go after the customer information that these businesses inevitably store within their servers.

From there, they can leak this information out into the media or extort these businesses for the information’s return – both scenarios inevitably compromising the organization’s reputation and customer perception, not to mention their financial resources. The healthcare industry in particular needs to take this challenge head-on. 

Competition between traditional and novel providers

Competition is rising all over. High-profile retailers such as CVS and Walgreens have begun to make their push into the healthcare sector by providing easy-access clinics to their customers. Traditional health providers and hospitals will have to adapt to this by making their own services just as easily accessible as these competitors, as well as providing incentives to their customers to remain loyal to their services.

Examples of such incentives may include improved and tailored customer experience, increased emphasis on follow-ups after treatments and consultation, and so on. They may also offer financial benefits or discounts as part of a loyalty reward program for patients that choose to be treated in their institutions.

Switching from fee-for-service to value-based payment schemes

The industry-wide call to shift away from fee-for-service healthcare to a more value-based system is also another challenge that healthcare organizations will have to contend with. The value-based model, in a nutshell, is a system in which health providers and hospitals are paid according to the quality and outcome of healthcare given, instead of quantity. Health providers will then have to focus on giving the highest level of healthcare that promises the best outcome, while also ensuring that the most cost-effective measures are taken.

This shift carries with it enormous difficulties, as it relies on all sectors of the healthcare industry working together in order to make it financially viable – while also preserving or even increasing the quality of care for patients. Healthcare organizations should therefore invest in the necessary data infrastructure and data analysis solutions that can help ease this shift and streamline the processes that will be needed for this new model to work.

The healthcare sector is just like any other industry in that it has to contend with its own unique challenges in order to grow and prosper. By meeting these challenges head-on and addressing them as they come, healthcare industry players stand not only to preserve their financial viability in the long term but also drastically improve the health of an increasingly health-conscious but also aging populations.

 

Image courtesy of [hin255] at FreeDigitalPhotos.net

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