Written by Kelly Gooch
CareCloud, a provider of a comprehensive cloud-based platform offering revenue cycle management, practice management, electronic health record services for high-performance medical groups, recently completed a $31.5 million Series C funding round. To put this funding news into perspective, the company released a briefing report defining the five trends it sees shaping the new medical economy.
This new medical economy refers to the shift from fee-for-service to value-based care and the new economic realities the industry will face as macro forces play out in the business of medicine.
Here are the five trends identified by CareCloud.
1. Patients as payers. Patients are taking more control over their healthcare costs amid higher deductibles and increases in out-of-pocket medical expenses. Therefore, patients want to get the best treatment for their buck, which includes precise information on what specific services will cost, what options are available and what it all means in the context of their overall care plan and budget. Additionally, patients are becoming more proactive in managing their care. Patients are becoming more informed, armed with near-endless information on diagnoses and treatments online, and more engaged, with a wealth of health apps, data and devices. Given this trend, CareCloud expects a surge in new provider models such as retail urgent care clinics and concierge practices that target consumer-minded patients.
2. Physicians as digital innovators. Healthcare providers are increasingly adopting EHR systems. Additionally, these providers have shifted away from server-based systems and toward cloud technology aimed at faster upgrade cycles, improved usability and more innovation, CareCloud said. Given this trend, CareCloud expects to see more providers use specialized technologies capable of being implemented across multiple EHR platforms. “As the post-EHR health technology market matures, an increased focus on open APIs [application programming interface] will help medical groups to enhance their services without having to ‘rip-and-replace’ base systems,” CareCloud said.
3. Fiscal stewardship. As hospitals and health systems shift from fee-for-service to value-based care, they are looking to reduce costs. But CareCloud notes that managing for quality and removing unnecessary costs requires a whole new level of data sharing and collaboration between payers, providers and consumers. “Open platforms that facilitate information flow in a secure, compliant way are essential to success in a value-based system of care. Entrepreneurial-minded medical practice leaders are looking at intelligent apps to turn data into user-friendly tools to support care coordination and decision-making,” CareCloud said. Given this trend, the company expects to see more innovation and more investment from family practice medical groups and health technology that focuses on the patient care beyond the exam or hospital room.
4. Era of entrepreneurs. Physician entrepreneurs are seeing enticing opportunities for growth. In the new healthcare environment, medical professionals are finding opportunities to either build new medical groups from scratch or acquire established practices, CareCloud said. “Specialties including family practice, orthopedics, dermatology and urgent care are appealing areas of medical group entrepreneurship both for their strategic position in the new reimbursement landscape and for posting strong year-over-year increases in net-collections,” the company added. Given this trend, CareCloud encourages those in the healthcare industry to keep an eye on private equity–acquiring medical groups, especially in primary care.
5. Data is king. CareCloud notes the key role data has played in healthcare policy in the last decade, including the EHR incentive program digitizing medical records and the rapid shift to value-based care. The real challenge now, according to the company, is how to effectively use and analyze this plethora of information. “Medical groups sit at the intersection of two competing but important forces in this new healthcare data world: population health management and personalized medicine. Population health management has the potential to make healthcare proactive instead of reactive; identifying at-risk patients and promoting early intervention. Personalized medicine promises each patient a care plan custom tailored for their medical history,” CareCloud said. “To support payers and patients at both the population and individual levels requires technology that can take action with the right data.” Given this trend, the company expects to see some interesting developments in how medical practices exploit intelligent apps that leverage data and analytics tools to support both macro- and micro-care management needs.