Notes from Availity Connects

After a two-year pause due to the pandemic, Availity Connects returned. More than 227 friends, customers, and colleagues from health plans, vendor partners, and provider organizations across the country reunited on Amelia Island, FL, to define healthcare’s path forward in the new normal.

Grateful to connect after a long hiatus, broad smiles and warm embraces were the first order of business. But it was impossible to ignore the crackling sense of urgency and purpose in every attendee’s face. It was time to get to work.

‘Wellness Within’

The theme for this year’s event was Wellness Within, which reflects our belief that individuals, organizations, and the broader healthcare industry need to be mindful of the external and internal factors that inhibit our ability to perform at our best.

From an industry perspective, we focused on the wellness of our healthcare system (or lack thereof). Creative thinking, technology innovations, and a cultural shift toward integrated, patient-centered care are moving the needle in the right direction, but a peek under the hood tells a different story.

Chronic conditions like cumbersome prior-authorization processes, obsolete communication methods, and unnecessary abrasion in the payer-provider relationship reverberate across organizations.

The lines between front- and back-office operations have blurred. Inefficiencies in claims management are not a revenue cycle problem. Bottlenecks in prior auth processes aren’t health plan problems. Uncertainty in eligibility is not a patient access problem.

These are health industry problems.

This reality forces us to change our perspective. Clinicians can’t perform at the top of their license absent the coordination and harmonization of healthcare’s administrative and financial levers. Health plans and providers are under increasing market and regulatory pressure to surface and share actionable information from an ever-expanding ocean of data. Consumers aren’t reacting to bespoke encounters, but to the totality of their healthcare journey.

The good news is that we can innovate with technology and make meaningful improvements quickly when we put our minds together and shoulders into the work. We have delivered very positive improvements in how payers and providers collaborate. We have continued to automate historically manual processes in many areas of the healthcare administrative workflow. There’s a lot of road still to travel, but our direction is clear.

Healthcare’s wellness check

Improving the wellness of our health system requires recognizing how emerging trends, innovations, and perceptions are shaping our industry and how it affects the way providers and payers engage with each other and with patients.

Emerging trends. We see the most significant shift in care delivery improvements and options. The pandemic ignited demand for virtual care to an unprecedented degree. Similarly, site-of-service optimization continues to grow as inpatient-oriented services move to ambulatory encounters; healthcare consumers will demand the advantage of this improved care delivery. Keeping patients in their homes as they consume care is likely to gain traction with expanded in-home services. All these trends tie back to delivering the appropriate care, at the right time, in the optimal care setting.

Supporting these macro trends at scale requires acceleration of technology and innovation. We can only support this newly formed ecosystem of payers, providers, and consumers by embracing both. Data must be actionable and delivered with timeliness that puts the patient first.

Technology—use vs. application. Walk any health IT conference’s exhibit hall, and it’s hard to miss how much the industry loves the next shiny object. Everywhere I turn, one point solution or another promises “disruption,” “transformation,” “paradigm shifts,” or all three. With few exceptions, you can toss it all in the bucket labeled “a mile wide and an inch deep.”

Technology is table stakes. The actual game is how technology is applied. For me, using technology for positive outcomes is all about creating a delightful experience for the end-user.

We are asking payers, providers, and patients to change the way they interact with each other. Such behavioral change can only happen with a renewed emphasis on delighting consumers. The underlying technology—artificial intelligence, an intuitive interface, or just a well-designed workflow—is important but only to the extent that it enables a seamless and meaningful user experience.

(i)nteroperability. I intentionally use small case “i” to distinguish the kind of interoperability mandated by the government from the interoperability required to accelerate the adoption of digital capabilities. When evaluating a government mandate, I always ask, “does this help or hurt the patient experience?” With the current crop of mandates coming out of D.C. I am cautiously optimistic that market acceleration toward an “interoperable” healthcare system will follow.

The evolved user experience. From check-in to discharge, patients demand more than they did in 2019, and why shouldn’t they? In consumer services, you can see where your food is on a map in real time, know your driver’s name (personalization), your order history, and just how they allocated your payment (transparency). Your ability to interact with that experience has also evolved (convenience); you can now pay, tip, and rate the service you receive as it occurs. Healthcare delivery can and should strive to live up to that expectation.

Patient centricity is another overused concept developed out of this evolved experience. The basic tenants of that are convenience, transparency, and personalization, which are all manifestations of the consumer journey described above. But at the end of the day, every claim, every eligibility, every prior authorization is a person trying to get care for themselves or someone for which they are responsible.

The urgency of now—putting ideas into action

I’ll leave with a final thought on where we go from here.

Healthcare conferences are great—from inspiring keynotes and networking with peers to continuing education and technology demos. But too often, all that potential is squandered because there’s no clear next step.

Healthcare is an inherently collaborative industry. There is plenty of fierce competition in the marketplace, but few of us pass up the opportunity to convene and collaborate. We knew that Availity Connects could only be successful if we harnessed the collective superpowers of some of healthcare's brightest leaders to meet challenges, surface opportunities, and put ideas into action.

Connects featured a lot of talking. It also asked each of us to listen.

We live in a world of trying to translate the subjective practice of medicine into the objective administration of healthcare. that translation then becomes the foundation for cost and revenue. So there exists ample room for interpretation, which can become mistrust if not managed carefully.

Against that backdrop, there is a tremendous opportunity to reduce unnecessary cost, abrasion, and frustration in the healthcare process—literally hundreds of billions of dollars of opportunity.

Daunting as it may sound, the people who attended Availity Connects 2022 are the right people to solve the issues plaguing our healthcare system. Looking out at the faces in the audience, I saw connections to nearly every patient in the country. You are the healthcare industry, representing health plans, provider organizations, and technology developers. Now is the time to harness our individual and our collective superpowers to effect meaningful improvements in our healthcare system.

Promises are only as good as the accountability attached to them. Every attendee at Connects is an essential constituent in bringing this promise to life, so let’s not disappoint.

Russ Thomas, CEO of Availity.

Photo credits: Aly Bouck