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Payers and providers are the captains of two different ships sailing in similar waters. Both oversee incredibly relevant aspects of the healthcare system. Both the providers and payers are administering care from a quality perspective while keeping a sharp eye on the cost. Cost, quality, and care experience are essential elements that make up the entire landscape of the 21st century US healthcare. The significant disruptions in healthcare are a direct result of recent innovations brought in by the payer-provider dynamics. A lot has been accomplished, and a lot remains to be done.

Since its inception in 1965, the Centers for Medicare and Medicaid Services has been focused on driving quality care and making the healthcare space efficient for its members. Upholding their goal of empowering patients and enhancing the healthcare efficiency, CMS keeps on introducing new regulations and rules. Last few months witnessed some major shifts in healthcare regulations, disrupting nearly every domain. Here are a few that caught everyone’s attention:

Lidia is a Nebraskan in her mid-thirties, who recently discovered that her body had been predisposed to sickness due to a genetic disorder. One of the genes in her body that’s supposed to fix DNA-copying errors during cell division is not functional, and if the body can’t make up for those minor mistakes, the cells could replicate and snowball into a malignant tumor. Lidia’s PCP and her care team realized Lidia’s health status and were fully aware what it could lead to if ignored. A prepared care team and targeted interventions have empowered Lidia to take full charge of her lifestyle habits to improve her odds.

The last few decades have been dominated by technological advancements and the paradigm shifts that came along. As these technologies were implemented, the organization leaders played a pivotal role in the industry-wide transitions.

If  curiosity is the engine of achievement, then humans are at the wheel of the train. . Our curiosity has led us to ask questions, learn new things and create innovations for our own betterment. The only thing that has remained constant is change. However, the million dollar question is- at what cost are we bringing the change?

It isn’t hard to notice how the highly competitive consumer industry nowadays leaves no stones unturned in its pursuit of attaining maximum customer satisfaction. I can’t help but draw an unlikely analogy between the consumer industry and the healthcare space. Although they would probably fit like chalk and cheese if we were ever to draw an actual comparison, but the one common thing that got me thinking was how differently they treat the receivers of their services, i.e., customers and patients respectively.