The Importance of Patient Matching in Mergers and Acquisitions
Death and Taxes. We have all heard the inescapable phrase that binds us under a single truism. Mergers and Acquisitions (M&A) are another unavoidable event that we should care about.
Hospital administrators believe that consolidation improves efficiency, quality and access to care and should lead to lower overall costs. Gains from consumer health market share are expected when an individual hospital merges with a larger health system. This leads to higher negotiated payments for medical care and procedures, and consumers will ultimately cover these costs with higher premiums. Yeah, I care about that.
If any of this sounds familiar, it should. It looks a lot like other industries. Cable companies, banking and consumer packaged goods companies who engage in M&A have similar outcomes.
Long before an M&A hits the headlines and after regulatory approval allows hospitals to operate under a single flag, considerable due-diligence must be exercised in order to realize the benefits of the investment. The number of healthcare acquisitions may be flat year over year but the average deal size is trending up. While fragmentation still exists, vertical integration and sector specification are key focus areas such as specialty areas like Oncology or Behavior Health, where the focus on quality and outcomes are truly data-driven. When health systems merge, a choice must be made as to which system will remain. Specialized practices may be dependent on a very niche, specialized EHR system that suits their specific needs. Being forced to switch to an inferior or new platform are usually not part of the beginning stages but rather decisions that are made after the deal is made. And while the trend in healthcare is around consolidation of platforms, most organizations must still cope with heterogeneous third-party platforms for years to come.
Long after ink from a new logo has dried and the news has left the front page, hospital operations struggle to deliver under a unified brand. Buildings and people can be scattered. System interoperability may not exist, and those centralized services designed to reduce costs are not usually ready to work as one.
Reconciliation of patient identity is a pervasive problem. Hospitals have to ask, “Am I adding market share with an acquisition or am I eliminating competition? How will my business case erode if patient overlap isn’t completely understood?” Considerable time and attention is required to link together clinical information within and across EHRs. Even when the systems being merged are similar, customizations have made consolidations difficult. This is one reason “clean-ups” are required before hospital systems can merge. If each hospital has potential duplicates, the reconciled dataset is likely to have exponentially more.
But there is a better way. Verato offers two cloud-based solutions that use the power of Referential Matching to help you resolve and link patient identities during an M&A.
- Verato Auto-Steward™ is a simple cloud-based plug-in for your EHR, EMPI, or MDM technology that automatically finds and resolves its missed matches and duplicate records using Referential Matching. Verato Auto-Steward can even automatically resolve the “potential duplicate records” your EHR, EMPI, or MDM has flagged for manual resolution by HIM staff or data stewards. And M&A activity generates a lot of “potential duplicate records” as patient datasets are merged or integrated.
- The Verato Universal™ MPI is a HITRUST-certified SaaS solution that uses Referential Matching technology to match and link your patient or member records across your enterprise with the highest accuracy rates in the industry. Simply put, the Verato Universal MPI is the most accurate, most secure, easiest to implement, and most cost effective EMPI solution on the market—and you can deploy it in as little as six weeks. The Verato Universal MPI can reconcile all your patient identities before, during and after these corporate events are announced. As a cloud service, the Verato Universal MPI can provide temporary or permanent migration services to support various use cases including deferred consolidation.
Healthcare is in the middle of seismic disruptions from M&A. New players like Amazon, JPMC, Berkshire Hathaway, Apple, and others are looking to contain costs on the supply side and drive significant improvements to health outcomes for employees and consumers. The drivers are focused on managing benefits and coordinating care to drive better outcomes. As healthcare transforms, these drivers and benefits will place increasing demands on patient matching.
Death and taxes are not easy, and I can’t avoid paying my share of both. M&A isn’t easy either. Nothing worth doing usually is easy.