Each year, HealthEdge surveys hundreds of health plan leaders to better understand the market’s top priorities and business challenges. This year’s study captured data from more than 300 leaders and revealed a heightened priority among CEOs and CIOs when it comes to implementing modern technology to achieve organizational objectives. The full report can be accessed here.
Top Challenges Reported
Today’s healthcare insurance market is highly dynamic due to rising healthcare consumer expectations, workforce shortages, growing complexities of the regulatory environment, shifting payment models, and rising administrative costs. Survey respondents ranked the following as the top challenges they are facing this year:
- Managing costs
- Operational efficiencies
- Alignment between IT and business
- Member satisfaction
When asked about their plans are to overcome these challenges, more than half of respondents indicated they are focused on making significant investments in innovation (53%), modernizing technology (51%), and aligning the business and IT organizations (53%).
The most common theme across these approaches is technology, or as some experts describe it – digital transformation.
For those who can leverage modern technology to become nimbler and more efficient in today’s highly dynamic market, there is significant opportunity to creative competitive advantages, improve the member and provider experience, reduce administrative burdens, and ultimately increase profitability.
Aligning for Success
Health plan leaders also highlighted the need for better alignment between their IT and business resources. In 2021, survey respondents indicated aligning the business and IT organization was the lowest priority when it came to steps needed to achieve business goals. However, in 2022, this priority jumped to the top 3, only slightly behind managing costs and creating operational efficiencies.
The shift indicates that leaders are acknowledging the vital role technology now plays in their ability to achieve their business and revenue goals. Together, CEOs and CIOs can evaluate how technology can support strategic business needs:
- How can our IT systems allow us to do more with less?
- What more can we get out of our technology investments?
- How can we adapt faster to changing market conditions?
- How can we use technology to better connect our disjointed member and provider experiences?
The Answers are Clear
Three common themes have emerged among some of the most successful leaders leveraging modern technology today are true integration, advanced automation, and access to real-time data.
- True Integration: Through a fully integrated ecosystem, digital payers can lead the way in shaping the member-centric, connected healthcare ecosystem of the future. Continued innovation is enabling digital payers to break down siloes and improve access to real-time data among payers, providers, partners, and members. Next-generation payers are investing now in platforms that facilitate this heightened level of connectivity across their own organizations as well as the entire healthcare delivery system.
- Advanced Automation: Automated processes improve accuracy, while reducing manual intervention and operating costs. Investing in modern technology with automation capabilities to improve claims accuracy and remove manual processes that often prohibit health plans from being nimble enough to explore new market opportunities.
- Real-time data: By enabling greater access to the real-time data, whether it be claims data, benefits information, and eligibility checks, or provider performance metrics, all stakeholders will be better equipped to improve the way care is delivered and paid for. In fact, survey respondents say that lack access to real-time data is the number one issue negatively impacting provider relationships. With better, more timely data comes better outcomes and a better experience for all. Health plans leading the way in delivering real-time data improve clinical and business outcomes for all.
Accelerating your Digital Transformation Journey
Learn more about why health plan executives are prioritizing modern technology investments and how HealthEdge supports the digital transformation for payers in our latest white paper: Annual Market Survey Reveals What 300+ Health Plan Leaders are Thinking.