Perhaps one of the most common misconceptions today is that health insurance providers are profiting at the expense of sick people, but that’s simply not the case. Insurance companies are required to spend the majority of their revenues on medical claims and healthcare improvements. As a result, they operate under the slimmest margins imaginable – making $.027 to $.03 on the dollar with Medicare and Medicaid falling at the lowest end of reimbursement rates. These “pennies on the dollar” only add to the challenge as payers look at ways to leverage technology toward greater efficiencies, cost savings and ultimately, patient care.
Population health management strategies are expanding to address “cradle to grave” coordination with a close eye on continuity of care across multiple providers and payer organizations. Insurance providers are looking to eliminate waste, and a baseline is making sure everyone has the same set of information, which is not the norm today. Paul Smith NetApp National Practice Leader, Healthcare Insurance, explains in a recent interview with Future Healthcare Today, “A patient will go to one doctor to treat his knee, then to another doctor for a procedure – which may or may not be related. Both physicians are totally unaware of what came before or after, leading to duplicate testing and even treatment. We need a system for easily and securely sharing data between patients, payers, and providers. We’ll never achieve effective coordination of care until everyone is operating from the same playbook.”
New technology platforms including NetApp Data Fabric are already enabling change, and leveraging other cost-saving infrastructure environments such as hybrid cloud. With hybrid cloud, payers reap the benefits of cloud computing and data sharing without compromising data security. Smith notes, “NetApp’s solution to hybrid cloud is through NetApp Private Storage (NPS), a secure, private storage system located with our partner Equinix , a gateway to all of the popular hyperscalers like AWS, Azure, and IBM Bluemix. This approach is the best of all worlds as it gives burst access to cloud computing horsepower, yet data storage and security remains private. Healthcare providers and insurers safeguard their brand and their protected health information (PHI) while meeting HIPAA compliance standards, representing the best of public cloud and private cloud alternatives.”
To take advantage of amortization and depreciation of their investments over an extended period of time, and eventually increase their returns, many insurance companies and payers are looking to move from a CapEx to an OpEx investment model. Smith frequently hears payers asking for help with cost-effective alternatives to the “traditional procurement of storage arrays,” and shares, “there are always peaks and valleys associated with data needs. NetApp is responding by offering flexible consumption pricing models, or on demand pricing, as more payers embrace the notion of buying only what is needed, when it is needed.”
As the industry continues to experience growth, both organic and through acquisition, payers bear the burden of siloed or compartmentalized data stores. The problem with this, Smith says, is that “Many times, disparate data give rise to over provisioning, inefficient storage and ‘orphaned volumes’. In other words, waste. NetApp OnCommand Insight (OCI) is an analytics tool that provides payers with full visibility into their storage environment, eliminating blind spots in availability, performance, usage and risk. For payers providing claims management as a service, OCI can also be used to track use to identify billing opportunities based on storage consumption and compute cycles. Not only are the cost savings associated with OCI significant, it also automates management in key revenue streams,” Smith concludes.
In addition to the right technology, payers continue to lean on suppliers who bring proven expertise in the payer marketplace. “The complex regulations that guide Medicare and Medicaid claims administration require robust security and reporting, delivered at a cost even the most cost-conscious organization can afford,” Smith says. “We have a history of giving our customer ‘more for less’.”
Find out more about NetApp’s healthcare solutions here.