Payers focus IT investment on collaboration tools

June 1, 2005

Several for ces are causing changes in healthcare payer IT investment priorities.

Several for ces are causing changes in healthcare payer IT investment priorities. Among the most significant are:

In response, and beginning this year, healthcare payer organizations will begin to shift their IT focus and investment from internal operational improvements to exploiting technology to share information with key stakeholders.

Investment in business intelligence and enterprise analytics will soar. These collaboration tools will supplant administrative solutions as payers' IT investment focus.

Healthcare payers traditionally treated business intelligence and data management initiatives tactically. They're now acknowledging the strategic value of data and the potential value of better information to manage financial and clinical resources for greater customer satisfaction, efficiency and profitability. Enterprise analytics are needed that combine various analytics into one model that can gauge comprehensive performance and operational metrics.

To support stakeholder demands for information, payers must have an interface for each stakeholder-consumer, employer and provider.

Furthermore, the cornerstone of successful care management is knowledge of the characteristics of individual members and populations. Information is key to all aspects of care management. Availability of sophisticated algorithms to identify and stratify members to get them into the proper care management programs requires new sources of information in a shorter timeline than are available today.

INVESTMENTS EXTEND TO PHYSICIANS The consumer-defined business model embraced by healthcare purchasers and payers now raises the bar for healthcare operational performance. Consumers expect more efficient, effective transaction processing and information delivery. Investments just on the part of the business process owned by the healthcare payer can lead to incremental improvements. But to really improve overall business process and information exchange performance, IT investments must be made at all points of the business process, whether executed by the purchaser, the consumer, the provider or the healthcare payer organization.

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