Change Healthcare

Change Healthcare

Change Healthcare is a technology company whose main objective is to help providers thrive in the value-based healthcare system. The organization offers its clients a range of technology-based services, software, analytics, and network solutions that assist them in the creation of collaborative systems (Change Healthcare, 2020). Through these offerings, it is able to deliver value in terms of reduced costs, increased efficiency, and higher quality. Change Healthcare prides itself on its understanding of the current healthcare landscape and the choices that providers need to make in order to guarantee their success. An analysis of its strategies will thus help determine whether its operations are suitable to its mission. It will also identify the other domains it should address to remain relevant in the face of healthcare reform.

Current strategy

Change Healthcare’s current strategy is focused on payers and providers. The firm aims to improve the integration of health providers while also helping them make the shift to value-based care. As such, it makes use of artificial intelligence (AI) and other technological innovations to offer solutions that optimize their processes, enhance their care quality, and improve patient satisfaction. These include services that facilitate revenue improvement, financial clearance, payment management, enterprise medical imaging, clinical decision support, and healthcare data and analytics (Change Management, 2020b).  The firm also recently unveiled a medical claim attachments capability that will enable providers to submit data to all their payers electronically (Pennic, 2020). This innovation will also automate the review of documents detailing risk adjustment and payment integrity, facilitating significant improvements in productivity. Change healthcare is thus strategically well-positioned to fulfil its goal of assisting providers as they shift to value-based systems.

The organization also offers comprehensive solutions that address the latest trends in healthcare management. These services cover four main areas: consumer engagement; risk, quality, and utilization performance; provider network and payment management; and transformation services (Change Healthcare, 2020c). These options are structured to help payers engage their partners from the point of enrollment throughout the health management process. They help improve quality management, risk adjustment, and resource utilization. Additionally, they streamline payment efficiency and offer advisory services to help in the execution of value-based payment methods. As such, it is evident that change healthcare’s strategy aims to improve the collaborative operations of providers and payers. By helping them improve their individual and joint activities, it accelerates their transition to value-based models. Consequently, it ensures that these key stakeholders are well-positioned to provide competent services that reflect industry standards.

Proposed future strategy

In the future, Change Healthcare should offer solutions that focus on patient perspectives. As the industry shifts to value-based care, the perspectives of these individuals become increasingly important. This can be seen in the fact that patient satisfaction scores are one of the metrics tied to reimbursement protocols. As such, Change healthcare should provide services that help their partners improve patient experiences and outcomes. These include technological patient engagement tools that help individuals take a more active role in their treatment. Heath (2019) recognizes that health IT is crucial in patient activation and engagement. For instance, patient portals can facilitate two-way interactions between patients and their physicians, allowing the former to ask questions, voice their concerns, and articulate their preferences. Similarly, medication adherence apps can ensure that they follow clinical guidelines and avoid any potential adverse outcomes. Consequently, Change Healthcare should consider incorporating such provisions into its portfolio. It should work with providers to determine the best clinical tools for their organizations, help in the implementation process, and avail maintenance services that track the progress of these facilities.

The company should also look into population health management. The industry focus on value places pressure on healthcare providers to elevate the health and wellbeing of people in their communities. They, subsequently, need access to tools that can acquire and process data about the health needs of these individuals, their potentially dangerous behaviors, and their preferences when it comes to clinical care. Aminzadeh (2018) identifies three classes of data that can help in the management of population health: traditional, consumer and survey. While traditional data delivers information on general aspects such as medical history, demographic characteristics, and utilization patterns, consumer data provides insight into the behaviors of members of a healthcare organization. Conversely, survey data is obtained from consumer devices such as mobile health apps. Since these various sources of information can identify the conditions that increase disease prevalence in certain populations, they can help determine appropriate solutions to deal with them. Change Healthcare should thus focus on helping providers manage population data for improved performance. It should leverage its AI and technical capabilities to offer data analytics services that effectively track and manage population health metrics.

In the same way, the organization should address disparities in healthcare provision. The unequal distribution of healthcare has been a problem in the industry for decades. These differences in access and quality of care create vulnerable populations whose health and general wellbeing are far below those of their fellow citizens. In response to this crisis, digital technologies have emerged as an effective way of reaching and catering to their various needs. Mobile and wireless devices such as smartphones, tablets and cloud-based software can help community health workers and care coordinators improve services such as screening, health education, and care plan delineation (West, 2014). These tools are desirable because they can overcome the physical barriers that prevent certain communities from accessing the healthcare they require. They can also help providers obtain a better understanding of the contextual and behavioral factors that create disparities in health outcomes (West, 2014). Change Healthcare should thus create strategies that can help its partners address the conditions that cause disparities among their patient populations.

Another important area of focus in the current healthcare environment is the management of costs. Value-based care models emphasize both quality improvement and cost management during service provision. This second priority is influenced by the continually increasing costs of healthcare in the country and the burden it imposes on the economy. It is, therefore, important for providers to determine the cause of unnecessary expenses in their operations and take appropriate steps to eliminate them. Brown and Hansmann (2018) attribute the high cost of healthcare to high labor costs, poor patient workflow, low productivity, unexpected costs of new technologies, and the burden of risks and reimbursements. They, subsequently, recommend solutions that include labor management, changing the patient encounter environment, standardizing approaches to technology, and managing patient flow through the healthcare system. Change Healthcare should consider working with providers to implement protocols and technologies that address these different aspects of the care process. In so doing, it will help them adopt best practices that minimize their overall costs.

The current strategy of Change Healthcare is based on helping providers and payers adapt to value-based payment models. It is, therefore, well suited to help the organization navigate the current healthcare environment. However, to fully address the requirements of value-based healthcare models, the company needs to incorporate solutions that address patient perspectives. It should thus consider developing initiatives in the fields of patient engagement, population health, reduction of health disparities, and management of costs.

Value based purchasing (VBP)

VBP offers an opportunity for providers to increase their revenue while also improving their standards of care. unlike fee-for-service models, the program incentivizes hospitals by rewarding them based on the quality of care they deliver. Although providers need to make a significant initial investment in these services, their benefits in the long run facilitate higher efficiency and savings. VBP allows providers to manage their expenditure and achieve patient satisfaction by pushing them to focus on prevention-based services and patient-engagement (NEJM Catalyst, 2017). It motivates them to enhance the effectiveness and safety of their activities by eliminating adverse events, adopting evidence-based care models, increasing their transparency, and adopting processes that enhance patient experiences (CMS, 2020). This helps them improve the health outcomes of their patients and avoid the costs of treating chronic conditions.  Furthermore, providers can earn bonuses if they attain high scores in the measures considered during reimbursement under VBP. The program thus benefits them by helping them manage their expenditures, earn extra revenue, and achieve high-quality care.

In addition to this, VBP introduces several care delivery models that can also help providers attain quality and cost-effectiveness. These approaches emphasize collaboration and coordination through sharing of patient data (NEJM Catalyst, 2017). They can, therefore, help in the management of population health for improved outcomes examples of these models are the medical home and accountable care organizations (ACOs), and bundled payment methods. While data-sharing in medical homes has the capacity to reduce redundant services and the costs they produce, ACOs facilitate the collaboration of doctors, hospitals, and other healthcare providers to work as a team in the improvement of population health outcomes (NEJM Catalyst, 2017). Bundled payments, on the other hand, improve efficiency as they cover a patient’s entire care cycle. They thus encourage providers to utilize competent strategies at every point of the care process.

Use of Data

Data is a crucial part of any business strategy. It is a valuable source of insight on the various factors that can affect implemented changes, how these barriers can be overcome, and the methods that should be applied to increase the probability of success. As a result, data should be central to Change Healthcare’s strategic initiatives. The company can rely on data analytics to boost their patient engagement, cost-saving, and population health initiatives. As noted above, providers depend on data capture to measure determinants and risks in population health and act upon the information promptly (West, 2014). This knowledge helps them prioritize services and interventions that improve public health by addressing the specific needs of different communities. Consequently, focusing on population metrics such as demographic and socio-cultural characteristics can help Change Healthcare attain its goal of meeting population health needs.

In the same way, data can be used to enhance its patient engagement and cost-saving strategies. Kent (2018) explains that big data analytic tools such as artificial intelligence and machine learning can be used to draw meaningful conclusions about patient behavior and ensure that they participate in their treatment. She further notes that the information they generate can be used to design individualized treatment plans and develop predictive risk scores. It can, therefore, help Change Healthcare and its partners improve patient outcomes by prioritizing at-risk individuals and offering services that are suited to their individual needs. Similarly, data can minimize operational costs by improving various processes across the healthcare supply chain system.  Health Catalyst (2019) reports that hospital supply chain spending is the second-highest cause of expenditure in these facilities. It also notes that top performers in the industry usually leverage data analytics to minimize variations in pricing, product use, and clinical outcomes. Hence, Change Healthcare should emphasize data related to the supply chain when developing cost-saving strategies for its partners.

Retrieved from

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Pennic, F. (2020). Change Healthcare unveils breakthrough all-payer medical claim attachments capability. Retrieved from

West, J. (2014). Advancing innovation to eliminate health disparities. Health Affairs. Retrieved from