Realizing Investment Return Through Business Transformation Prioritization

A key variable in optimizing IT investment is the willingness and capacity to transform complex business processes and organizational structure. In short, the thoughtful identification of transformation objectives (and inclusion of well-defined measures from which to assess the transformation "progress") is essential in measuring complex project success.  

Accenture recently conducted a global survey of nearly 6,500 business and IT executives worldwide to gain insights into key business goals and priorities for technology investments. As Accenture's top technology trends for 2021 report stated, "Big changes today require bold leadership—and prioritizing tech. And it's not just about fixing the business but upending convention and creating a new vision for the future." 

An enterprise application, like a well-architected core system, for example, offers an enabling force for health plan transformation. In most cases, the opportunities are almost infinite – the real challenge is quantifying (and then prioritizing) which activities will net the most effective outcomes.

While health plan organization structure and its business process can many times be challenging, some basic building block measures can help to reduce (what is many times) self-inflicted complexity.

Prior to the actual procurement and implementation of a new core application, these steps include:

  1. Setting quantifiable success expectations and goals to be realized from the investment
  2. Confirming that business requirements align with those goals
  3. Identifying transformation opportunities to leverage investment
    •  Foundational transformation (e.g., overall organizational structure, normalized contractual arrangements)
    • Transactional transformation (more efficient process flow, e.g., claims, enrollment, billing)
  4. Configuring and integrating the investment that supports the transformed environment
  5. Educating/training all key stakeholders

Competitive market forces and compliance and regulatory demands will continue unabated. The opportunity to effectively address these market challenges through enabling technical architecture and leveraged transformation is there for the taking.

About the Author

Mike Comick

Mike Comick
VP, Strategic Partnerships 

Mike Comick is a HealthEdge Vice-President, leading the company’s Strategic Partnership program.  Mike has over 35 years-experience in health insurance core systems and associated business transformation.  Prior to joining HealthEdge, Mike was co-founder of Healthcare Technology Management Services (which was later acquired by Emdeon), a partner with First Consulting Group, and Vice-President of the Core Claims/Administration practice at CJ Singer / Gartner Group.  Mike has published company profiles, market win/loss reports and health plan IT aggregate budget analysis.

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