Health Plans Bring Innovation to The Forefront In Strategic Planning

With the rise of telehealth and virtual care, innovative ideas are getting a big push forward in 2020. 

I recently moderated a webinar with HealthEdge customers Eric Decker, SVP of Information Technology and CIO at Independent Health and John Church, VP and CIO at NeuGen to discuss the results of the Voice of The Market Survey- Modernizing Infrastructure the New IT Mandate, shedding light on their organizations' strategic and innovative initiatives.

While most health plan IT leaders who responded to the survey are focused on improving key business metrics such as auto-adjudication rates, Eric mentioned Independent Health is fortunate to have high auto adjudication rates—in the low 90s. Instead, his primary focus is on enhancing the consumer digital experience. 

"We're trying to remove as much technical debt and manual labor as possible," said Eric. "We're retiring legacy systems, then leveraging infrastructure software as a service. We're not doing those things to save money, but to allow my team to focus on more transformative priorities, rather than say, patching a server or updating a database."

Eric continued, "The overall increase in the consumer digital experience will require us to move faster and require more capacity from my team in the future."

NeuGen is launching a massive digital transformation. John Church's team was looking at NeuGen's overall digital engagement process. As COVID-19 hit, they realized they needed to accelerate their timelines to get offerings to market quickly.

As part of the long-term digital engagement, NeuGen is moving to offer more services like psychiatry, nutrition, and others as part of the telehealth platform. The organization is also focused on getting its current providers on the platform to provide a primary care virtual experience. 

Without the burden of a legacy system in place, their resources are freed up. "We're focused on the customer experience," said John. "As we think about innovation, we're looking at how to package this together in a way that won't require members to download seven different apps to engage with both our plan and the physicians."

He continued, "We're trying to create that seamless experience for everyone such that we can get a higher degree of digital engagement on the front end to hopefully lower costs on the backend."

Similar to NeuGen, Independent Health understands the importance of a streamlined customer experience. In January, the organization started working on a digital-first mobile app with a local physician group set to launch in 2021. The app will offer a chat capability, where the physician group can provide telehealth consultations, and Independent Health can answer administrative questions about co-pay and medical costs in one location.

"We've had a telehealth benefit in place for the past few years but saw very low utilization," said Eric. "That utilization went up dramatically in 2020. We got lucky with the timing with this app, as we were already on the path of development, now this product will be the start of other telehealth-driven products."

Business and IT Leaders Agree: Value-Based is the Game-Changer

With the right technology platform, health plans can quickly pivot to new products and drive new membership, all while increasing efficiencies, reducing costs, and enhancing customer and employee satisfaction. Download this infographic to learn how technology innovation will give your organization a competitive edge in a value-based world. 

About the Author

Len Rosignoli

Len Rosignoli, Account Executive

Len Rosignoli is a healthcare technology and operations executive with extensive managed care insurance expertise spanning more than twenty-five years. He joined HealthEdge in early 2020 as an Account Executive, supporting the strategic needs of a portfolio of HealthEdge customers. Prior to joining HealthEdge, Len spent the prior six-and-a-half years as the Chief Information Officer for CalOptima, one of the largest Medi-Cal health plans in the country. Len also held executive IT roles for a variety of health plans supporting all lines of business in a range of geographic areas on many technology platforms. His experience includes mergers & acquisitions, large scale core system migrations and implementations, and support of the full scope of the technology, including application development/support, project management, infrastructure, and cybersecurity.

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