Pacing and prioritizing health plan renovation

This is the final blog in our three-part series, “The CIOs Role in Digital Transformation” 

An interview with David Chennisi, Senior Vice President of Optum Advisory Services

Dave Chennisi Headshot

As health care shifts from volume to value, CIOs are challenged to harmonize stakeholder needs, advance infrastructure to “free the data,” and build better digital experiences throughout the health ecosystem. This final blog in our three-part series, “The CIOs Role in Digital Transformation,” offers practical advice on whom to engage and how to succeed in the value-based paradigm.

Q.How much time do CIOs have to modernize the payer organization?

Chennisi: The employer-sponsored insurance model and the processes to support group risk and fee-for-service have been in place a long time. And the relationship among payers, providers, employers and members is deep-seated. But health care reform is exacting changes in the way outcomes are achieved in the health ecosystem — which necessitates better collaboration and interoperability. Cloud technology has already begun to give payers, providers and consumers a common view.

The shift to value-based care won’t be instantaneous. But in order to compete, payers have to make decisions now about transforming their capabilities — while maintaining their existing business. The payers and providers who figure out how to collaborate, how to share information and use technology to enable higher quality and lower costs will win in this race. But it won’t be easy — and not everyone will make it.

Q. How do mid-size payers win in the new value-based paradigm?

Chennisi: Once the business case has been established, the CIO is responsible for defining and enabling the technology to deliver what each stakeholder needs — for financial predictability, clinical quality, population health management, and growth — without slowing down core operations.

The pace and prioritization is important and regular inputs from key stakeholders are critical. Most importantly, the CIO needs to understand where stakeholder needs intersect and how to synchronize multiple series of actions with technology.

In this climate, the CIO has a day job (business as usual) and a second, still primary focus: to ramp up rapidly but not recklessly. The CIO needs to consider which technologies are hindering coordination and growth, and which technology partners can match the demands of the organization in a responsible, affordable way.

Q. Who can support the CIO?

Chennisi: It’s a challenging reality. Payer organizations need to be able to respond and adapt — to become unstuck — or resign themselves to obsolescence. During my time as a CIO, I set a goal to meet weekly with company officers to discuss planned and in-play initiatives. I set another goal to meet monthly with the medical operations department, claims department and call center, and with each of the five or six different major parts of the health plan.

Because, like all CIOs, I was always very busy, I tapped my own network for answers, and often avoided new vendors and partners. If I could go back, I think I would do it differently. Instead of keeping such a high filter, I would advise CIOs to spend more time in periodic sustained conversation with health care technology consultants who have a depth of experience. It’s a lot less complicated when people who have done this before help you identify which infrastructure can be offloaded, where economies of scale can be achieved, and what is realistically do-able — rather than visionary — with existing resources and proven technology.

Learn more about how CIOs will streamline technology and operations to give health plans a competitive edge.

Learn more about the trends and technologies shaping the health care industry

Catch up on all the blogs in “The CIO’s Role in Digital Transformation” series

 

About the Author:

David Chennisi, Senior Vice President of Optum Advisory Services

David is a key leader in Advisory Services, with more than 30 years of experience in the health care industry. 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, David served as CIO at Texas Children’s Health Plan.

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