Vertical Integration: Strategies to Align Care

Today’s guest post comes from Garry Marshall, Senior Director of Business Strategy at Wolters Kluwer, Health.

Garry discusses healthcare business vertical integration and its effect on care quality for patients and on providers' work experiences.

To learn more, download the Wolters Kluwer Expert Insight article Vertical Integration Strategies: Using Data to Align Partners and Reduce Variation in Care.

Read on for Garry’s insights.

Vertical Integration: Strategies to Align Care
By Garry Marshall, MBA, Senior Director, Business Strategy, Wolters Kluwer, Health

Vertical integration has become a buzz phrase to encapsulate the healthcare industry’s commercial consolidation and merger mania over the last decade. But simply linking a health plan, PBM, a specialty pharmacy, and a clinic under the same corporate umbrella isn’t true integration.

While most market watchers are interested in the long-term financial outcomes of these mergers and acquisitions, vertical integration in healthcare creates potential for consolidation of care quality goals as well.

Data can be a useful tool for unifying acquired partners who formerly functioned as disparate business entities. If one or more partners are referencing outdated resources to support drug safety, clinical, and formulary decisions, there’s potential for costly and unwarranted variation in healthcare within the vertical and inconsistent, inefficient communication between partner organizations.

Vertical integration in healthcare works best if all partners are aligned using a holistic decision support solution suite with consistent content. It enables you to set three goals to improve outcomes for all member organizations in the vertical.

1. REDUCE VARIATION IN CARE

By nature, a well-constructed vertical should have more control over a patient’s journey, enabling you to set goals to reduce unwarranted variation in care. The first step is to align all partners onto the same data platform, using consistent clinical content. With aligned drug vocabularies, clinical recommendations, and even unified drug pricing data, your partners will be more likely to follow consistent best practices, formulary protocols, and established standards of practice.

Any confusion—such as different ratings, conflicting recommendations, or missing information between partner organizations—will create a breakdown of trust and communication between members of your own vertical, while the additional time spent researching the information will slow down workflow and may jeopardize care.

If partners are called upon to adopt new systems, remind them of the importance of one organization speaking the same language.

2. ENHANCE ACCESS TO EVIDENCE AND SCREENING

As a patient travels through your vertical, you’re going to know more about them than if they were to hop across to other providers and pharmacies that aren’t vertically integrated within your channels. And the more you know about an individual patient, the more you are going to be able to provide personalized care and precision medicine.

In the simplest form, that could mean you know that Patient A is 55 years old, so your system won’t need to fire an alert about medication risks to pediatric patients during any of her contact points with your organizations. In more complex terms, it could extend to more personalized pharmacogenomic screening. That kind of precision medicine isn’t happening regularly today. It’s an aspiration for the future of medication safety screening, but one for which vertical integration could help open the door.

Not only would access to greater contextual information increase patient safety, but also, as you move toward more personalized care, you should, in theory, move away from alert fatigue. Without context, a clinical or pharmacy screening system doesn’t know enough about a patient, so it’s going to assume the worst and hit the physician or pharmacist with every alert that could be relevant. That’s why studies have found alert override rates of anywhere from 49-96%.

3. BUILD A BETTER HEALTHCARE EXPERIENCE

Your vertical is serving hundreds of people a day—your employees. With the ability to unite partners on a single solution suite, be sure to select one that offers an exceptional user experience.

Curated content that reduces inconsistencies also serves as a valuable timesaver. You do not want unhappy employees diverted from primary business and patient care functions due to issues solving data gaps, normalizing communications with new partners, or managing technical glitches.

Bringing together multiple businesses and care teams to function as a unit with a single purpose seems impossible, especially when each partner brings its own legacy. Finding a data solution that considers each partner’s needs can go a long way in better aligning the vertical.

To learn more, download the Wolters Kluwer Expert Insight article Vertical Integration Strategies: Using Data to Align Partners and Reduce Variation in Care.

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