Payers are caught in a rapidly evolving healthcare industry. From advances in precision medicine and artificial intelligence to new consumer preferences and clinical studies, staying updated on the latest in medical information and trends can be complex and challenging. Ultimately, payer teams are trying to make the best business decisions for their organization and to improve care outcomes for their members.
To do this, teams need access to the best medical evidence available. Grounding business decisions in the latest information can provide payers with a range of benefits such as:
- Improved margins and cost management
- Efficient decision-making with evidence-based content
- Improved member health outcomes and satisfaction
- Aligned medical and drug information with clinical teams
- Consistency across a broad organization to align decision-making
- Reduced data and information fragmentation
Investing in a clinical decision support solution can empower payers to drive ROI, streamline partnerships, and help their members get the right care at the right time.
Key features in clinical decision support for payers
With all of the technology options available in the market, how can you know which one is best? When considering decision support, health plan leaders should consider a solution that provides evidence-based recommendations that are aligned with the daily decision-making of providers, with the ability to scale across a complex organization.
1. Reference the same clinical content as providers
One of the key challenges of medical management in the U.S. is the collaboration between payers and providers. Addressing this friction and fragmented data can result in better processes and improved member satisfaction.
Clinical decision support is used by a wide majority of providers to make the best possible care decisions for their patients using the latest medical evidence. With access to the same clinical content as providers, payers can have a better understanding of care decisions to support a range of business needs from claims verifications to assessing coverage for ground-breaking treatments.
2. Access current, evidence-based medical evidence
New clinical information and research is continually increasing, making it challenging for the healthcare industry to keep up with medical advances. Having decision support with a rigorous editorial process to sift through the research is crucial to understanding the best care decisions and member experiences. When medical topics are updated in a balanced, unbiased manner, teams can feel confident in the information and data to support business decisions.
3. Standardize and scale decision-making across teams
Having the clinical information across complex, matrixed organizations is crucial to standardize business decisions, reduce overhead costs, and improve member health journeys and experiences. Decision support should be easy to use, embedded in current workflows, and accessible wherever the information is needed. When teams across a company are working from the same foundation, information and processes are less fragmented and more reliable.
Access trusted decision support
Payers with embedded, evidence-based clinical information scaled across teams are in a position to improve business processes, save costs, and improve their members’ experience and outcomes. For over 30 years, clinicians have trusted the quality, evidence-based content from UpToDate® and its user-friendly, embedded platform to answer key questions at the point-of-care. With access to the same information as over two million clinicians, payer teams can make meaningful business impact, improve ROI, and enhance their members’ care experience.
To learn more about how UpToDate can support your medical management teams, download the eBook “Achieve value, efficiency, and scale with evidence-based clinical content.”
