Health Care Convergence: Are You Ready for This New Model?

July 23, 2015 In pursuit of high-quality, cost-effective care that revolves around the patient, many health care organizations seek new ways to foster system-wide collaboration. This concept involves breaking down barriers that have traditionally separated payers, providers, and patients to enable everyone to work more closely together to meet common goals.

Such a way of doing business, commonly referred to as “health care convergence,” also incorporates a major shift from getting paid per service unit to instead getting paid for achieving good outcomes, says Mark Fish, Managing Director, Health Solutions for FTI Consulting.

This new way of thinking and of doing business doesn’t come about naturally but requires a lot of preparation. That’s why Fish and his colleagues work with organizations that want to better understand and apply the concept of convergence, and they also help them figure out how to make this model work within their current reality.

While some forward-thinking organizations have already embraced this blurring of roles and have adoped a style that incorporates multiple roles, many other groups are taking baby steps in this direction and still have a long way to go before this more value-based approach becomes a standard part of how they do business.

If the latter describes your organization, Fish says to take heart, since you are not alone. He also stresses that there is limited time to begin moving in this direction, in large part because of incentives—and penalties—from private insurance providers and from Medicaid and Medicare that will continue to grow in coming years. In addition, he points out that the current health care system won’t continue to be sustainable as we move forward, so this form of growing collaboration among all of the key players centered around providing value-driven care will be increasingly necessary for survival.

To find out where you stand on the “convergence readiness” scale, and how you measure up compared to other health systems, read our new article: Is Your Organization Well Positioned to Adopt Value-Based Care? These 7 Questions Can Help You Assess Your Readiness.

Best regards,
Matt Humphrey
President