Q&A with Peter Schmidt, Virsys12 Chief Customer Officer

Navigating the Evolution of Provider Network Management: Q&A with Peter Schmidt, Virsys12 Chief Customer Officer (CCO)

As a seasoned professional in the Provider Network Management (PNM) arena, Peter Schmidt sheds a light on the industry’s transformative journey and Virsys12’s pivotal role in shaping its trajectory.

From your experience in the PNM space, what have been the biggest changes you’ve witnessed in the industry over the years?

The PNM landscape has undergone remarkable shifts, notably driven by technology. We’ve transitioned from relying on bespoke applications to embracing commercially available software, marking a journey from legacy mainframes to the cloud. Today, the emphasis is on harnessing data intelligence for enhanced management processes, facilitating more efficient and cost-effective provider network management.

How has your experience with Portico and Salesforce shaped your understanding of PNM enterprise software?

My experience working with Portico and Salesforce was instrumental in shaping my understanding of PNM enterprise software. Working with Portico gave me insight into the challenges of implementing large-scale projects for major healthcare insurers. Despite the initial efforts, sustaining such enterprise software in the marketplace proved daunting. This experience highlighted the need for solutions that could address complex needs efficiently. Salesforce and Virsys12 entered the market with cloud-based solutions that encapsulated many features of legacy systems while offering richer functionality. This journey underscored the importance of scalability, sustainability, and expertise in both subject matter and software engineering for successful PNM solutions.

Why is technological advancement in healthcare, especially in PNM, crucial?

Technological advancements, particularly in PNM, are crucial for several reasons. Firstly, it facilitates the transition towards self-service models for providers, empowering them to manage their own data and updates efficiently. This not only streamlines processes but also improves provider satisfaction and engagement. Secondly, advancements in technology, such as robust data security measures, are essential for safeguarding sensitive healthcare information in an increasingly digitized environment.

Lastly, technological innovations enable the capture and analysis of complex relationships between healthcare organizations, enhancing operational efficiency and ultimately leading to better patient outcomes. Investing in technological advancement in PNM is paramount for driving innovation, improving efficiency, and ensuring high-quality care delivery in the healthcare industry.

What are the main challenges our healthcare customers face in PNM, and how are we assisting them?

In the realm of PNM, our healthcare customers confront a myriad of challenges spanning from ensuring provider accuracy and satisfaction to managing operational costs and IT maintenance. We actively engage with them by streamlining processes, enhancing accuracy, and providing specialized expertise to navigate the intricate web of relationships within the healthcare landscape. Through the utilization of our solutions, healthcare organizations can effectively address these challenges, optimizing their PNM strategies to deliver enhanced patient care and operational efficiency.

Furthermore, our V12 Network platform stands out by facilitating the efficient capture of complex relationships between healthcare entities, thus paving the path towards streamlined operations and ultimately improving patient outcomes. Virsys12’s unique combination of subject matter expertise and consulting capabilities enables us to not only address implementation challenges but also mitigate associated timelines and costs, ensuring our clients derive maximum value from their PNM initiatives.

How do regulatory mandates influence our strategies and solutions for clients?

Regulatory mandates significantly influence our strategies and solutions for our clients. CMS mandates for accurate provider directories has resulted in data accuracy becoming more salient at both the State and Federal level. Requirements around provider directory accuracy and payment accuracy via RFPs for Medicaid awards at the state levels are emphasizing the importance of improving provider data to the Healthcare ecosystem. This shapes our solutions to ensure compliance and efficiency in the healthcare ecosystem, enabling our clients to navigate regulatory requirements effectively while maintaining operational excellence.

Where do you see ROI when healthcare organizations modernize their PNM applications?

Healthcare organizations stand to gain substantial ROI by modernizing their PNM applications. Modernization can lead to the reduction of manual processes, reliance on legacy infrastructure, and duplicate data, along with the development of self-service applications. These improvements not only enhance operational efficiency but also contribute to cost savings and improved provider satisfaction, ultimately driving significant ROI for healthcare organizations.

Many of the individuals that have maintained PNM legacy applications are at retirement age or near retirement age, how are healthcare organizations navigating this issue?

Brain drain is one of the main issues facing the healthcare ecosystem; baby boomers leaving the workforce continues to be an urgent issue. To address this issue, organizations are shifting away from legacy applications and towards enterprise solutions with clear training paths for new entrants. By ensuring continuity and sustainability in the workforce, healthcare organizations can mitigate the impact of the brain drain phenomenon and ensure seamless operations in PNM.

To learn more about how Virsys12 can help your healthcare organization with enterprise provider data management efforts, please contact us today.

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About the Author

Tammy Hawes is CEO and Founder of Virsys12, a Healthcare Focused Salesforce AppExchange and Consulting Partner. Hawes launched Virsys12 in 2011, with a track record of more than 25 years of executive success.

Picture of About the Author

About the Author

Peter Schmidt is focused on Virsys12 strategic customers as the Chief Customer Officer, and he brings his deep understanding of the requirements of the Healthcare, Health Insurers, and Healthcare Provider ecosystem with his understanding of the V12 product and services for provider lifecycle management and customer success.