Healthcare Sector and Its Challenges in 2020

Over the years, the health industry has been hit by so many trends but still, it has been facing lots of problems. All these challenges to healthcare organizations are both small and big. In this fast-growing world, maintaining and running the medical practice in the factors affecting this industry like government regulations, technological innovations and patient expectations is not at all easy. Despite extraordinary improvements such as internet-connected medical device security and affordable pharmaceutical pricing, the healthcare sector is facing 6 big challenges. In this blog, you will get to know about these prominent challenges.

Healthcare Sector and the major challenges faced by it

While innovations assure to change healthcare rapidly but it will take some time to make these changes permanent. 

1. Information and Service Integration:

As already mentioned above, the advancement in the health sector technology has made big differences. But these changes are not implemented smoothly and in a flow. The medical community easily welcomes big data like non-relational databases that merge patient information from so many sources. 

There is only a small percentage of health organizations that have successfully implemented non-relational information technology. This technology helps care providers gain stronger insight into how patients use medical products by making details such as drug or equipment manufacturers. Speaking of the health sector scenario of the United States, some care provider networks have already deployed advanced non-relational databases to get the medical information of patients and save it in their database. Patients who understand the benefits of how information sharing reduces costs are more likely to share medical records with third parties. It is very important for care providers to educate patients. While primary care providers discover more information to help them discover solutions for current patients.

2. Cybersecurity:

The health sector became the soft target of cybercriminals and the online crime rate increased eventually. The reason for this was highly sensitive patient information collected by healthcare organizations. Employees are getting more comfortable working with electronic information which contains patient information consisting of billing, electronic medical records, email, etc. The more information is saved online, the more it is prone to get attacked by cybercriminals.

The US medical and healthcare sector experienced over 350 data breaches. This exposed over 4.93 million patient records in the year 2017. While last year in 2019, the number increased and reached 32 million patient records. The allocated systems make the database of these healthcare providers more exposed to cyber-attacks. Some of the cons of breach of the database are the substantial penalty that is charged from the culprit for violating the standards regulating the healthcare industry. 

In order to protect their systems completely from the cybercriminals, the healthcare providers can outsource billing to a HITRUST-certified third-party provider. The third-party provider has dedicated resources to ensure that its system is properly protected.

3. Payment processing:

Day by day, patients are becoming more and more responsible and careful about their medical bills. This has introduced the issue of collecting payment. It is the responsibility of the healthcare provider to make patient-friendly billing statements. This type of billing facility aims to meet the expectations of the patients as well as improve the user experience. One of the great choices to do so is by offering paperless payment options via an online patient portal. For that, you need to consider using the latest payment technologies using mobile devices.

Healthcare providers must follow strict guidelines to protect patient information. As a healthcare provider, it is your responsibility to fully secure the payment portal and processing system. In any case of cybercrime or breach of the database, you are liable to pay a penalty. The care provider authorities should implement plans for stopping an attack. Those who have been attacked should be notified as well.

4. Increase in the prices of specialty drugs:

This is one of the major challenges faced by the people, especially the people of the US who can’t afford high-profile medication. The prices of specialty drugs cost 50 times higher than traditional drugs. Americans are one of the reasons why the prices of specialty drugs increases. Diligently monitoring and understanding these changes is critical, as is making sure they are aligned with the best industry solutions in the space. Also, consider their effect on programs such as value-based care and established clinical pathways.

The Trump administration issued a strategy blueprint, “American Patients First” in May 2018. The blueprint was designed to tackle U.S. drug pricing and healthcare costs. Some of the reasons which have resulted in a decrease in drug pricing are as follows:

a. Promoting the use of biosimilars to reduce utilization barriers

b. Preventing branded drug manufacturers from gaming FDA risk management strategies

c. 180-day generic launch rules to forestall generic competition

d. Requiring drug rebates negotiated by pharmacy benefit managers

e. Need for drug companies to disclose list prices for their drugs in TV ads

5. Effective payment model:

The year 2020 will see a shift from fee-for-service repayment to value-based payment models like bundled payments, global payments, etc. But these payment modes will be a failure and unprofitable if not structured properly. But still, it is a tough task to apply these models and monitor the processes within the already existing systems. Healthcare providers should take satisfactory steps to develop this trend of value-based payment.

In addition to this, the care providers should ask the third parties to enter into agreements so that the providers can take on additional responsibilities and financial risk. 

6. Using big data:

Most medical practices are dependent on patients when they switch insurance plans or healthcare providers. Payers must adopt technology that creates contextual data to get meaningful data insights. The more the healthcare data is being generated, the more it is distributed on multiple parties and systems. Also, healthcare organizations need to implement non-relational information technology to fully take advantage of all the patient data from a variety of sources. In short, data from various sources can be utilized. In order to protect the data, healthcare organizations must protect this information under the Health Insurance Portability and Accountability Act. It can also be preserved under personal information under state privacy and security laws. 

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