CIO Review: CSO and SVP of Consulting and Delivery at TriZetto, a Cognizant Company, Discusses Trends Impacting Health Plans

“Healthcare has undergone significant transformation, forcing stakeholders to find new and innovative ways to remain successful in an increasingly competitive market,” writes Cem Tanyel. “Previous practices and methodologies need to be reframed as health plans move quickly to adapt their technology infrastructures in order to accommodate changes spurred by the Affordable Care Act and the increasing consumerism of healthcare.” Excerpts:

“Organizations should focus on the following five trends that are significantly impacting today’s health plans.

- Mergers and acquisitions

- Convergence between health plans and providers

- The U.S. government as the world’s largest healthcare payer

- Consumer influence

- Health plans need to do more with less

To remain competitive in today’s market, health plans should capitalize on the benefits of SMAC as they navigate the turbulent waters of the sea-change occurring within the industry. The following SMAC technologies should be considered by CIOs within the health plan business model:

- Cloud technology: Conceptually, cloud-based deployments can support core system integration during health plan mergers or alternatively, provide a fast way to split systems in divestiture situations.

- Mobile reform: Mobile reform is at the heart of the healthcare consumerism trend. Many health plans are looking to add more value to their patient portals, as well as supplement these portals with mobile applications capable of linking directly to members and patients.

- Social networking: Healthcare enterprises capable of solving the conundrum between utilizing social networking platforms to deliver better care and protecting member/patient privacy can expect to see huge returns from their innovation.

- Analytics: Communication and interaction between organizations and their data is required, a mammoth task given the multitude of businesses, caregivers, applications, languages and data formats involved.

All stakeholders should expect to see exciting breakthrough innovations from our nation’s health plans in the near future. This can be accomplished by focusing on applying SMAC technology toward the major industry trends. As a result, health plan thought leaders will be driven to new heights of technological creativity to ensure their organizations remain both relevant and profitable.”  

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