Healthcare Payer Digital Transformation: Top 3 Optimization Best Practices

December 1, 2023

Lisa Blake

Optimization: Go-Live is just the Beginning

It can be easy to implement a new platform and think, ‘Phew! Glad that’s over’. But in the world of digital transformation, it’s a journey, and Go-Live is not the destination.

Build continuous optimization into your plan. We always recommend an annual optimization assessment where we have a team of SMEs sit with you and evaluate how you use the product. From that evaluation, we identify recommendations to improve workflows, take advantage of new features, and add integrations or automation to remove manual or time-consuming activities. In addition, planning for upgrades enables you to stay current on the platform, giving you more features to drive your business to continuous improvement.

Follow these optimization best practices and avoid these common pitfalls:

Optimization Top 3 Best Practices

1. Adopt a Strategic Operating Model

Plan to move from Project Governance to a Strategic Operating Model with your ecosystem partners. Share your roadmap with HealthEdge so that we can consider the best ways to support your success and ongoing growth plans.

2. Annual Optimization Assessment

Plan for an annual optimization assessment. Evaluate how you are using the solution and develop a set of recommendations designed to drive optimization. Software improves, business evolves, and your needs may change. Adopt a continuous improvement approach to the operation.

3. Quarterly Business Reviews

Conduct quarterly business reviews (cross functional with CSE, Services and Product leadership). Maintain tight alignment of business and product roadmaps, upgrades, enhancements, and support needs. Consider any blockers to your success and how we can help remove them in the upcoming quarter. Set partnership goals to ensure the best path to success.

3 Common Optimization Pitfalls

1. Disbanding the “Project”

The project completion is just the beginning. Don’t stop fostering partnerships and influencing roadmaps. Don’t adopt an implemented and “done” mentality. Continue to use our partnership to meet your goals through consulting or customization.

2. Diminishing Return on Investment

Don’t allow your investment value to decrease, your software to get outdated, or your teams to struggle. Be proactive rather than reactive.

3. Lagging Behind

Waiting too long to upgrade results in additional cost and effort. Don’t miss out on improvements requested by the customer base. Take advantage of our technical-only upgrades that can be completed in 4-5 months. Actively review release notes for features that may enhance your business and ask for help in identifying and implementing new features that fit your needs.

HealthEdge & Healthcare Payer Digital Transformation

By implementing the HealthEdge solutions you will transform your business and operations. Our solutions will automate your business workflows and seamlessly exchange data in real-time across the ecosystem, allowing you to experience the business benefits of:

Improved End-User & Consumer Centricity
Ever Reducing Transaction Costs
Ever Increasing Quality
Ever increasing service levels
Business transparency

HealthEdge Professional Services

HealthEdge’s Professional services provides expertise and support to accelerate your digital transformation. To become a next-generation health plan, you need a digital foundation that enables you to provide a transparent and person-centric experience at lower cost, higher quality, and higher service levels. HealthEdge® solutions provide that foundation – and HealthEdge Professional Services deliver the expertise and support to make the process swift, sure, and effective.

Learn more about HealthEdge Professional Services.