Case Study 3.30.2016

Evaluating Readiness for Future Healthcare Business Models

Trexin helped a Regional Health Information Exchange evaluate their ability to support the new accountable care business models that were developing after the passage of the Affordable Care Act

Business Driver

Our Client, one of the oldest, self-sustaining Health Information Exchanges (HIE) in the country, was facing significant disruption in their industry. With the passage of the Affordable Care Act (ACA), the healthcare providers and accountable care organizations (ACO) that made up our Client’s customer base suddenly demanded more robust patient data sharing and analysis capabilities.

Because of this disruption, our Client not only needed to evaluate their technology infrastructure but also rethink and update the strategy their business was built around in order to retain their customers.

The Director of the HIE asked Trexin to do the following:

  1. Perform a market assessment to determine the types of metrics that were currently being used to evaluate care and to gain insight into how they were performing against their peers.
  2. Conduct a gap analysis to evaluate the capabilities of their current infrastructure and determine the areas of need where supporting their customers’ new requirements were concerned.

csEvaluatingReadinessforFutureHealthcareBusinessModels-infographic

Approach

Trexin began by first studying the existing government models for accountable care organizations (ACO). The information we gathered allowed us to determine what metrics were being used to evaluate care. After pairing this information with an analysis of the current trends and the offerings of the competition, we were able to to see how our Client was positioned in the market.

Then, working with the organization’s leaders, vendors, and partners, Trexin performed a gap analysis between the capabilities of our Client’s existing infrastructure and the requirements for supporting their customers’ future healthcare models.

We accomplished this by conducting a market scan of the current landscape for other regional health information organizations (RHIOs) and looking at how they were dealing with the changes surrounding accountable care.

Results

Because of Trexin’s specialized knowledge of the emerging healthcare payment systems, we were able to give our Client a detailed list of the types of information and additional features that their customers would need them to support. This maturity model and gap analysis gave them a high-level vision of how their HIE had to change in order to meet the evolving needs of their customers.

Tagged in: Aligned Enterprise, Healthcare, Life Sciences
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