Healthcare Reform Technology Tips for Payers, Providers

Scott Kornhauser, for HealthLeaders Media , January 24, 2011

Amid all these changes, many payer organizations find themselves saddled with an inflexible and inefficient tangle of disparate administrative systems and related software. Acquired through merger and acquisition activity or as point-solutions over the years, many of these systems are at the edge of their useful life, and are highly inefficient, extremely costly to maintain, largely batch processing oriented, and are poorly integrated.

System-wide changes like ICD-10 require updating and reconfiguring numerous systems in a variety of locations that the task is virtually impossible for many. Consolidating these disparate systems onto a central system represents the clear path to a successful future. 

Future-Proofing Technology

As payers seek to consolidate systems in order to survive, they are also looking to what the future may hold. That means seeking the best tools—those that “future-proof” their core technologies, so today’s investments can sustain a competitive advantage for decades to come.

How do organizations determine where to go from here? Though the payment path is uncertain in healthcare at the moment, there are a number of critical success factors to consider for the future. The system must:

  • Enable the efficient administration of healthcare benefits in a new and innovative performance-based delivery system.
  • Efficiently interoperate with the entire healthcare delivery system, and do so in real-time at the point of sale, care, and decision.
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