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ACO Model A Major Tech Challenge For Payer CIOs, Says Study

While many healthcare payer organizations plan to participate in the new healthcare business models, specifically Accountable Care Organizations (ACOs), most do not have the technology in place to reach this goal.

According to a recent HealthEdge Payer Market study, 55 percent of the executives surveyed said that they plan to implement ACOs within the next three years. However, 63 percent of those participants also said that they currently do not have the necessary technology to support those changes. HealthEdge surveyed more than 100 IT executives.

“We’ve got this very interesting industry situation where many of the payer organizations out there are quickly realizing that they must participate in the new healthcare business models if they are truly going to compete in the new economy. But at the same time, when the majority of those organizations are looking closer at what it takes to accomplish those goals, they are coming to a different reality,” said Raymond M. Desrochers, the executive vice president of sales and marketing at HealthEdge.

According to Healthcare IT News, there are six technology components that are essential for the successful operation of an ACO at a high level. These technology components are: role-based security, clinical data exchange, data aggregation, performance management, reporting infrastructure and financial infrastructure.

Payer organizations that plan to implement the new business models are going to have to adopt these next-generation technologies in order to move with the changing times in the healthcare industry, whether they like it or not, or whether they are prepared to or not. And, based on the survey data, more than two-thirds of the survey participants stated that their infrastructures are not ready, technologically. This is great news for vendors, like HealthEdge, who are ready and willing to provide those technology solutions.

 “The one-size-fits-all healthcare offerings of yesterday are being rapidly replaced by options that support new levels of individualization, personalization and customization, and new levels of risk-sharing between payers, providers and members,” said HealthEdge CEO Rob Gillette. “Given this reality, it is not surprising that the survey respondents clearly indicated the need for modern technology platforms that will enable them to successfully compete in the emerging healthcare economy.  We look forward to continuing to play a major role in the market’s technology transformation.”

The market’s transformation is a bright opportunity for all vendors in the healthcare IT space, especially for ACO solutions, as it was voted the No. 1 business model to be adopted by the participants over the course of the next three years. Healthcare CIOs need to take some time to begin thinking about their plans for the future and what technology solutions they will need to realize their ambitions. The times are changing—CIOs can either change with them or fall behind the pack.