Healthcare Regulations

Major Challenges of the Healthcare Industry in 2020


The healthcare industry is one of the most rapidly changing industries in the world. Challenges, such as rising costs, value-based care delivery, payment reforms, data security and transformation to smart healthcare technologies have engaged healthcare professionals in recent times and there is more to come in 2020. Technology is transforming healthcare at a faster pace, constant changes in government policies, more patient control, transparency, and improving patient experience are complicating the way healthcare is perceived.

Health data interoperability, blockchain technologies, and telemedicine are some of the new areas to explore but also challenging the traditional healthcare processes. The new emerging technological changes will demand an environment that is not only conducive to medical providers but is able to maximize value which is beyond just delivering care services. It is important to watch out for any such traits that might create a challenge for your business. Keeping that in mind we present to you an overview of major challenges that the healthcare industry might experience in the year 2020.

Payment Reforms and the Challenge of Value-Based Payment Model

Transparency in payments is an important factor that customers would look for this year. Consumers want access to the pricing and quality of healthcare services in order to make better decisions. Patients would be expecting a complete breakdown of the cost before and after availing of the services. This lack of transparency is something that would challenge the care providers as there are multiple stakeholders contributing to it. Health providers would be challenged to make their pricing and payment system transparent this year.

A payment model with fewer options is going to decrease customers’ satisfaction. Providing payment transparency that caters to consumers’ interests is a challenge for healthcare providers. 

Increasing Demand in Customer-Based Experience

Healthcare consumers are more concerned about quality now and receiving real value. There has been a shift towards value-based customer experience and this trend is going to dominate the healthcare industry in 2020. This can be a challenge to healthcare providers as they need to adjust the traditional fee-for-service model to a more customer-centric model. This new model requires healthcare service providers to invest in the effectiveness of the services, pivoting from quantitative to more qualitative aspects.

This has made it important for healthcare providers to focus on accommodating patients with easy communication channels, reducing costs, creating a user-friendly portal, and training staff to be more conducive to deliver value-based care.

Medical Billing and the Challenge of Revenue Cycle Management

An increase in operational costs has left healthcare services providers more concerned about billing and improving their revenue collections. The use of traditional medical billing and collection approach is not enough to keep the business of the providers competitive and can even negatively impact the highly competitive market now. If providers don’t have proper medical billing resources including modern software and applications for managing customer support, quality of service, filing claims, and payment purposes, they would be facing challenges in providing valuable experience to their consumers. This can lead to a decrease in revenue generation making it difficult to achieve financial goals. Hence, the lack of billing resources and efficient financial management is going to be a competitive disadvantage for healthcare providers.  

Disruptive Technologies and Innovation

The constant innovation in technology is a growing challenge for the healthcare industry. The use of modern management software and AI-driven application is now at the heart of most healthcare companies. For an organization to stay relevant and ahead of others in the competition, it is important to incorporate modern technology in its healthcare operations. Only companies that are ready to take risks by experimenting and thinking outside the box can be successful in the future. Healthcare companies need to act as prospectors by doing things outside the unconventional spectrum in order to successfully incorporating modern technology in their day-to-day process to provide a quality experience to the patients. A challenge could be the cost associated with new technology and coming up with strategies to successfully adapt to consumer demands. 

Growing Demand for Data Processing and Data Analytics

The use of data analytics can transform the healthcare industry for good. Big data can unveil various patients’ trends and patterns that can help healthcare providers to come up with more customer-centric models, easy and cost-efficient payment methods, more transparency in pricing, and improved customer experiences. However, the healthcare industry has been very slow in the implementation of data analytics tools that are novel to medical care. There are many reasons for those types of decision-making in healthcare, such as misalignments in the goals of leadership, and miscommunication between healthcare and technology professionals.

One major challenge is the insufficiency of infrastructure and extensive staffing to back up the nature of decision-making in the healthcare industry. The difference between healthcare and other industries is that the prior deals with sensitive data and hence requires careful and timely actions. The healthcare industry lacks the technology that can process big data and achieve the scalability and functionality to reach the big data’s potential.

Due to these factors, constant monitoring and collection of classified information are challenging especially for small and medium-sized providers. The healthcare industry has faced several challenges but these are the most prominent and need to be addressed thoroughly. By keeping these challenges in mind and properly analyzing them the healthcare industry can formalize strategies to bring reform. Organizations need to invest in research and development and funding to tackle these challenges.