Across the health care industry, payers are asking themselves if their technology platform is ready for the future.
There are two avenues to explore where technology change is concerned – either upgrade your existing system or completely overhaul it. The drivers behind technology change can determine the extent to which change needs to happen. Complex efforts, such as platform consolidation, may fit your needs better than a focused project like auto-adjudication improvements.
There are benefits to restructuring technology systems. New technology can enable:
- Scalability for expanding membership, adding clients and accounts, and diversifying product portfolios.
- Cost effectiveness to help you stay competitive, avoid the need to maintain customized solutions and reduce costly manual workarounds.
- Flexibility that can support reimbursement methodologies, and provider network and benefits designs. Flexibility allows you to meet evolving government requirements, reduce implementation time and differentiate yourself from competitors.
Change doesn’t happen overnight
It should come as no surprise that the level of technology change you undertake will dictate how long it will take to complete it. Auto-adjudication projects can be implemented in months whereas larger initiatives, such as platform consolidation, can take years. But with careful preparation and planning, you can align your business processes with technology changes to achieve operational excellence.
Acknowledge the risks
Technology changes do not come without risks. Before you undertake such an initiative, consider the following, and prepare:
- Members and providers can be negatively affected if issues cannot be resolved quickly.
- Substantial financial investment and personnel time are necessary where technology changes are concerned.
- Enhancements are complex to implement, often requiring additional resources and strategies to stabilize them before they are fully operational.
- You may not have the right personnel to achieve a successful implementation or maintain current business requirements during implementation and stabilization periods.
- Technology changes can be disruptive, impacting people and processes across the organization.
In next week’s blog, we’ll cover the nine proven activities to help you prepare for technology change success.
To read more on prepping for technology change, download Optum white paper “Preparing for Major Technology Change”
About the Authors:
Chennisi has more than 30 years of experience in the health care industry and is a key leader in the Optum Payer Consulting Practice. His teams are responsible for successful systems implementation and integration projects spanning core administrative claims adjudication, medical management, business intelligence/data warehouse and customer relationship management applications. Prior to Optum, Mr. Chennisi served as CIO at Texas Children’s Health Plan.
Lusby has more than 20 years of experience in the health care industry with a strong background in leading payer operations, health plan strategy, technology implementations and process improvement. She brings clients a unique skill set with breadth and depth of knowledge in every aspect of the payer business. Ms. Lusby specializes in the Government payer sector, Medicaid and Medicare.