Doctors, nurses and other clinical healthcare professionals are heroes – and they are enabled to do their heroic work by the individuals in healthcare finance, operations and administration. At MacroHealth, we respectfully call the business professionals in these critical health industry roles “HealthOps Professionals ”.
It’s difficult to overstate the importance of these business professionals, who have a tremendous amount of responsibility resting on their shoulders. They’re responsible for optimizing the buying and selling of healthcare services, supporting clinical healthcare workers so they can do their jobs. They’re responsible for responding to competitive pressures and government mandates in an ever changing healthcare ecosystem. Their responsibilities include allocating finite resources, and guiding members and patients to the best care, at the best price, for the best outcomes. HealthOps professionals are responsible for making consequential financial decisions that impact peoples’ health and lives every day.
More than 80 cents out of every dollar spent at an insurance company is tied to cost of claims. If you want to move the needle on cost and innovation in healthcare, that’s where to begin.
For such an instrumental role, you would assume that there is a plethora of cutting-edge tools and data available to enable them to do their jobs effectively. However, the vast majority of HealthOps professionals are using antiquated technologies, often gathering and analyzing data with spreadsheets or even pen and paper. A confluence of trends in the industry is creating more data and an increased need for collaboration across Payers, Providers and consumers; however, that data is still being delivered via mail or fax, practices nearly extinct in all other industries. When information is being exchanged electronically, it’s being done using pre-internet data, architecture and EDI protocols.
Because HealthOps professionals aren’t working with a modern data and technology backbone, they’re only able to reactively pay claims, rather than proactively manage health care spending. This makes it nearly impossible to provide the kind of analytics and experiences that customers have come to expect – and even take for granted in virtually every other industry. HealthOps professionals deserve better – much better.
The Retail Industry Runs Like a Well-Oiled (Modern) Machine
When customers visit a major department store, they expect to be able to find the items they’re looking for, in the color they want, in the size they need. Data and technology make it all possible.
Retailers use data and systems to strategically and proactively buy clothing, housewares, beauty products and more. They know that if customers don’t find what they’re looking for at their store, they’ll find it somewhere else. With the technology in place to support their employees, retailers are able to determine how much inventory is required, in what colors and sizes, and when it needs to arrive at the store – all in order to keep shoppers happy and the business profitable.
This simply doesn’t happen in healthcare – but it should. If HealthOps professionals had access to modern, real-time information (the way retailers do) they would be able to proactively share information with the rest of their organizations to make actionable, insight-driven decisions. Without this data, HealthOps professionals are at a terrible disadvantage.
Imagine if Uber Only Updated its Data Once a Day
If you’ve ever tried to catch a taxi in the street of a major city when it’s raining, you’ll know what a nightmare it can be. You can wave your hand out in the street and hope to catch a cab, or you can simply book an Uber from your phone – preferably from someplace dry. With Uber, you know exactly when your ride is coming. If it’s fifteen minutes away, you know you have enough time to wait inside where it’s comfortable. It’s a much nicer experience than being stuck outside in the rain. But imagine if the data on Uber’s app only updated once a day – that is the state of data in the healthcare industry today.
Uber is able to provide customers with a better experience than waving down yellow cabs because the technology infrastructure underneath it has made it possible. Today’s HealthOps professionals are using technologies that are 30-40 years old. Their systems are receiving data updates once a day – at best – making it impossible to apply the same modern data-driven decision making and innovative customer experiences that are common in just about every other industry, from transportation to finance.
No Longer Out in the Rain
Customer experiences have been changing rapidly in nearly every industry – and underpinning all of it is modern technology. For too long, HealthOps professionals have had to perform their critically important job without the modern tools that are expected in every other area of our lives. It is time for this to change.
With so much on the line – HealthOps professionals deserve the very best in modern tools and data. At MacroHealth, it is our mission to modernize the buying and selling of healthcare, making it simple and powerful for the HealthOps professionals who have dedicated their careers to supporting clinical healthcare professionals and ensuring their members have access to quality, cost efficient care. With modern tools, HealthOps professionals can access the information needed to innovate our industry, make their operation run smoother and save significantly on costs.
MacroHealth’s first-of-its-kind platform enables real-time data to flow, giving healthcare operations professionals access to the intelligent tools and information they deserve – enabling them to fuel innovation and growth at their organizations.
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