HealthEdge “State of the Payor” Survey Finds Insurers Undertaking Transformative, Technology-Driven Change

Increased demand for superior customer experiences, significant cost reductions and enhanced care coordination make the transition to a digital health plan a necessity

Burlington, MA, December 9, 2015 — HealthEdge®, provider of the only integrated financial, administrative and clinical platform for health insurers, today announced the latest results from its “State of the Payor” industry survey, that show health insurers are planning to respond to strong market and member demands by using technology to drive significant organizational change. The survey results, which are available in an infographic and a formal report, support the need for health plans to leverage modern technology to remain competitive in today’s evolving healthcare marketplace.

“An overwhelming majority (73 percent) of the health insurance executives surveyed are planning major, technology-driven transformation at their organizations,” said Ray Desrochers, Executive Vice President at HealthEdge. “The transition to a digital business is now required to provide members with the consumer-friendly, retail-like experiences they expect, effectively participate in new healthcare business models and drive new levels of operational efficiency.”

The survey results show that while health insurers understand the significance of participating in a variety of new healthcare business models including Value-Based Payments (80 percent), Exchanges (69 percent) and Accountable Care Organizations (55 percent), they remain hampered by a number of key factors that prevent them from effectively participating in these new approaches. These include a continued reliance on manual business processes, legacy technology and hard-to-maintain satellite systems, all of which are also contributing to the high administrative costs that currently plague the industry.

Further, health insurers face mounting pressure from consumers to provide an experience that mirrors that of every other major industry, such as retail, travel and banking. Also, the majority of senior health insurance executives surveyed (77 percent) are seeking ways to improve care coordination at their organizations, and are investing in approaches including member-facing social and mobile tools as well as wearables to promote member self-management, shared decision-making and collaboration.

The “State of the Payor” industry survey benchmarks the views of senior health insurance executives on important industry topics including upcoming business imperatives, technology investments and market trends. Approximately 100 senior leaders from regional and national health plans of various types and sizes participated in this latest online survey. To view the infographic, request the full results or learn more about the survey, please visit www.healthedge.com/survey.

About HealthEdge

HealthEdge® provides modern, disruptive technology that delivers for the first time, a suite of products that enables healthcare payors to leverage new business models, improve outcomes, drastically reduce administrative costs and connect everyone in the healthcare delivery cycle. Our next-generation enterprise product suite, HealthRules®, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or on-site deployment. An award-winning company, HealthEdge empowers payors to capitalize on the innovations, challenges and opportunities that await in the new healthcare economy. For more information, visit http://www.healthedge.com.