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Digital Transformation for Payers (Part 2 of 2) – Key Technology Enablers


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Shobhit Saran, AVP Health Plans, Vency Menezes, Payer Healthcare Consultant & Mamta Joshi, Payer Healthcare Consultant

June 14, 2021

In the previous blog, we shared the challenges faced by payer organizations due to evolving government regulations, technological innovations and member expectations. In part two, we highlight the technology enablers that would help payers overcome these challenges and start off on the right foot in their digital transformation journey.

Although the adoption of emerging technologies is growing steadily, organizations are still finding it difficult to identify the right technology that will solve challenges, or offer the highest ROI promise. Another challenge which organizations face is inertia in technology adoption. But payers will need to adopt next-gen technologies in the immediate future if they want to stay competitive and deliver a customer centric and advanced healthcare experience.

Key Technology Areas for Payers

1. Data Strategy

Correct data management strategies that include healthcare data ingestion pipeline, storage, computational and analytical needs will drive higher efficiencies across value-based programs. A scalable data strategy is crucial for health plans for improving rating scores and subsequently realize millions of dollars in savings.

2. Digital Modernization

The rise of on-demand healthcare has urged health plans to upgrade their operations by adopting technology capabilities such as automation engineering, microservices based architecture, cloud-based SaaS, etc. Digitization using deep learning with conversational AI, digital therapeutics, etc. have improved delivery of payer services.

3. Embedded Intelligence

Payer organizations can leverage embedded intelligence technologies such as MLOps, AI engineering to deliver a customer-centric experience. Automation and cognitive learning have contributed to reducing administration costs and improving the quality-of-care (member benefit enrollment, provider networking, claims management and care management).

In the past few years, the payer value chain has become more distributed and complex. And to manage this change, organizations will need to create a digital transformation ecosystem that’s sustainable, while ensuring immediate business benefits.

Impact of Next-Gen Technology on Payer Performance


Acquiring next-gen digital technologies will enable payers to create and advance an ecosystem that will not only satisfy consumer expectations, but build capabilities to effectively compete. Given the pace of technological advances, payers will need to drive digital transformation at the earliest or risk being left behind. Partnering with a healthcare technology partner will give payers access to comprehensive expertise and avoid any pitfalls, ensuring maximum returns on payers’ digital transformation efforts.



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