THE 'EDGE REPORT BLOG

Why Agility Matters in the Age of Digital Health

When it comes to agility and speed, a successful health plan must have it all to please its stakeholders. Gone are the days of the traditional, slow, steady insurance business. Welcome the next generation of health insurance, where plans must be fast and agile to please their members.

Consumers across all industries are driving this change, and a reckoning is coming for health plans — the empowered, informed consumer who now demands more sophisticated, convenient, transparent, affordable, accountable, and personalized service. To meet demand, health plans must shift their business model to embrace the empowered consumer by consistently offering the best, most competitive services and benefits.

Findings from a recent survey of 73 health plan executives that HealthEdge completed with an independent research firm, Survata, show that the most important organizational goal health plans have for 2018 is to increase member satisfaction.

Consumer-centricity requires payers to invest in new services and products and do so at the speed of the consumer, in a manner that meets the needs of that consumer. Naturally, this means investing in new technology to support the introduction of new services and products.

In the world of legacy core administration system, when an organization needs to make plan/benefit changes and create new plans, it can take six to nine months to complete these changes in the system in time for enrollment. This means that for every new enrollment taking effect in January, you must lock down the plans no later than March of the previous year.

For today’s consumer, and tomorrow’s success, health plans need technology that will enable them to make changes to plans and benefits in a matter of hours. This capability will please consumers and providers alike by providing access to accurate information in a much timelier manner.

Baby Boomers, Gen Xer’s, and Millenials alike are demanding transparency and access to accurate real-time information available to them 24/7 via mobile, phone calls, and other avenues. This means layering the digital information era on top of the traditional health insurance infrastructure.

HealthEdge’s HealthRules® is a next-generation core administration solution, which empowers your health plan to offer the best coverage and service at the lowest costs and do so faster than your competitors. This is because HealthRules:

  • Speeds time to market, allowing your organization to quickly respond to market demand and be the first to offer the most up-to-date, innovative plans
  • Empowers your staff to accurately and quickly respond to member queries using a single source of truth
  • Eliminates man-months of IT’s time in the product development lifecycle
  • Further lowers costs by employing business analysts to make system changes to HealthRules and allowing IT to work on other value-add projects
  • Improves claims auto-adjudication rates by 10 to 25 percent and speeds up claims processing

Interested in learning more? Watch our recent webinar on the topic: "Agility & Flexibility: The Key to Growth in 2018," featuring HealthEdge customer John Janney, SVP of Transformation for AmeriHealth Administrators. Transforming their business using HealthRules, AmeriHealth Administrators was able to quickly bring new benefit plans to market while aligning operational processes and business goals -- all with the customer at top of mind. Watch the webinar here.

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