Part 3: Thriving in a regulated era — achieving go-to-market strategies

The final entry in our “Thriving in a regulated era” blog series concludes with the technology road map, sourcing strategies and go-to-market guidance. Our first two blogs in this series touched on developing the business vision, business plan and capabilities model.

Follow the technology road map.
While the business plan drives your entry into new markets, your IT solutions, processes and resources enable it.

This is where a technology road map becomes valuable. It clearly defines the projects, time frames, dependencies and resources that align IT strategies with your business drivers. At the same time, it enables a multi-release approach that can help increase clinical and operational efficiencies, reduce redundancies and minimize spend through a variety of strategies.
Bring it together with sourcing strategies.

Sourcing allows you drive high value and gain access to critical mass. Developing a sourcing strategy is challenging because it can limit your growth and the speed with which you can adapt to change. To avoid this, your sourcing strategy should focus on your business operations, support current and new health care business models, and efficiently manage your administrative costs.

From a technology perspective, sourcing strategies should include full-service core administrative systems and point solutions.

Full-service core administrative systems lock you into the process from start to finish. You also need to be clear about how you will connect to your user community, and influence changes in the vendor’s software product. With point solutions, each solution is a standalone function. You may have to customize and replicate data, which could create overlapping functionality and redundancy. Manage your single source of truth and data synchronization for accuracy.

Achieve your go-to-market strategy.
The last step on your path to creating value requires establishing metrics and reports through advanced analytics to:

• Monitor medical and administrative costs
• Address quality and risk
• Target areas of improvement
• Determine business alignment to your business vision

Data analytics is critical to improving your business processes. Capturing member data will help you improve quality of care and clinical performance. Just remember that if you are entering a new market or starting up a new plan, you are acquiring new members who may not have a documented history.

Another critical step in your strategy is to establish a continuous improvements team, which will help you evaluate business metrics against industry standards, benchmarks or best practices to achieve operational efficiencies.

Download our white paper, “Thriving in a regulated era: Key considerations to guide new value creation” for point-by-point guidance on the planning and considerations central to new value creation.


About the Author:

Jim MahJim Maher headshoter

Vice President, Optum, Optum Consulting Group
As part of the operations and administration consulting practice at Optum, Jim Maher is responsible for client advisory services. With 25 years of consulting experience, Jim’s core competencies include legacy transformation, business process reengineering, IT solution development and implementation, migration planning and complex program management.

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