Focused on Innovation? Start with Operational Efficiency

For health plans, operational efficiency could be the first step in their approach to innovation. While it may not be the most exciting aspect of the business, achieving operational efficiency will enable them to remain competitive in the long-term.

A health plan can have the most innovative ideas in the world, but without the resources to back it up, they most likely will not get very far. Operational efficiency, automation, and accuracy free an organization to focus on innovation. By prioritizing operational efficiency, organizations can redeploy the time and resources typically spent on routine  administrative tasks, and shift to transformative projects. 

Flexibility and agility are also incredibly important. A health plan with great ideas for new market-competitive products that advance the organization’s innovation goals requires the technology flexibility to configure and automate them, along with the ability to make changes quickly. Otherwise, they will end up losing momentum and missing out on crucial business opportunities.

Health plan innovation touches many aspects of the organization, including member engagement, payer-provider collaboration, and business processes, and in many cases, impacts benefit designs, provider contract designs, and other aspects that help drive behavior. To remain competitive, health plans must have the freedom to test new ideas, try modeling, make mistakes, and access their data in real-time to see what works and continue improving.

When it comes to implementing innovative ideas, a core administration system that breaks down product design barriers, increases efficiency, and delivers real-time transparency is a necessity. If the majority of an organization’s ecosystem is cutting-edge, but the core administration platform is outdated, everything else will fall behind. Healthcare moves fast, and health plans need the ability to be forward-thinking.

All of the health plans I talk to have incredibly innovative ideas. They want to invest in a meaningful member experience, they want to enhance payer-provider collaboration, and they want to transform their organizations. To achieve these goals, they need a system that empowers them to focus their skills, experience, and capabilities on actively impacting the true health of their individual members and the U.S. healthcare system as a whole.

About the Author

DIane Pascot

Diane Pascot, Director of Sales Solutions, HealthEdge

Diane Pascot is a senior healthcare technology professional with deep expertise and extensive experience collaborating with health plans and benefit administrators of all types and sizes on their technology strategies. Diane primarily focuses on core administration system replacements within the context of overall IT ecosystems. As Director of Sales Solutions for HealthEdge, she regularly engages with prospective payer clients to understand their current state, ascertain near-and long-term goals and objectives, and formulate and convey proposed solutions that will help them transform their business, ultimately to help facilitate seamless transitions to new client implementations. Prior to joining HealthEdge in 2017, Diane spent many years in the healthcare payer technology space with organizations that included Evolent Health (Aldera), Mphasis Eldorado, and Cognizant/TriZetto.

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The HealthRules® Payor core administration processing solution drives new levels of automation, speed and accuracy, enabling customers to reach unparalleled levels of operational efficiency in the face of shifting market dynamics. Download the data sheet to learn more. 

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