Obama’s Re-elected: What’s next for Healthcare?

By many of the “Election Pundits,” Obama’s re-election bid was in a way thought to be a washout. But now that Obama has been re-elected can we expect a similar disruption to the popular belief that healthcare is complicated and no one changes it. With Obama Care, could cause a huge change in how the healthcare system operates and rightfully “accelerate this change to impact millions of lives.  I would like to base my discussion on three key dimensions: government, healthcare systems and IT. The first critical dimension will be the healthcare system and the following five (5) areas that could be impacted the most:

  1. Member Enrollment
  2. Fraud & Abuse
  3. Patient Care
  4. Real-time payments
  5. Disease Management

While discussing the above impact areas I will talk about how the other two dimensions play a key role in accelerating this change. The second dimension will be related to healthcare IT and so the following key items will be discussed in detail:

  1. Business Process Management
  2. Data Warehouse and Business Intelligence
  3. Enterprise Content Management
  4. Cloud Computing
  5. Mobility

The third dimension I would like to discuss is the role of federal government in accelerating these changes. Recent mandates like HITECH, HIE, ACO, HIPAA 5010, ICD-10, Summary of Benefits and Affordable Care Act are all focused on reducing waste and increasing care by producing valuable outcomes. Obama will change the healthcare landscape like no other president in the past has done and it comes during a time when the country is reeling in a 16 trillion dollar debt, 50% of which is due to the healthcare cost.

I believe that if you do not see these changes coming you will be left out in the competition.  I would like to hear your thoughts on how your organization is preparing for these changes.

Baskar Mohan

Director - Healthcare Practice, Virtusa. Baskar has more than 18 years of professional IT experience with over 13 years of US project experience. He has worked in the Healthcare industry for the past 11 years both on the payer and the provider systems. He has extensive knowledge of the Blues and has worked with them in many corporate initiatives including the HIPAA 4010A1 conversion, SSNE and the NPI project. On the payer side, Baskar has worked on EDI and core claims systems. During his tenure at BCBSMI, Baskar has worked in EDI, Membership & Billing, Facility, Professional, Dental, FEP & NASCO to name a few. Baskar has also very good exposure to the government run Medicare & Medicaid programs and has worked for the Dept of Health Services, Sacramento, California. He also has executed a number of projects in healthcare related to BPM. Baskar is very knowledgeable of the Pega platform and in specific the Healthcare payer framework, Insurance Industry framework & CPM. More recently he has executed projects related Governance, Risk and Compliance using Pega for providers very specific to CoBIT & HIPAA. As a Chief Architect, Baskar is responsible for designing solutions for 5010 & ICD10 solutions. He has created go to market solutions to help customers transition to 5010 & ICD10. As a Program Manager, he is responsible for delivery & execution of all projects both onsite & offshore and currently manages a team of resources. As a Client Services Director, Baskar is responsible for revenues for healthcare book of business, assist the sales team with pre-sales, account radiation and client management. Baskar has experience working with global clients across, USA, UK, France & Netherlands.

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