Skip to main content
Get the latest EIS content instantly!
EIS Resources

A business case for digital transformation for health plans

“Digital transformation” is a term that’s talked about a lot by health insurers and by insurance software providers like us here at EIS. It’s discussed so often for good reason: because it can help health plans tackle some of their biggest operational challenges to save time and money while at the same time create engaging experiences their customers crave. 

Health plans know it’s imperative to transform to remain viable, and they’ve been doing what they can to implement incremental change. Constrained by legacy technology, most health plans haven’t been able to make the progress they’d like. Most believe it’s too risky to replace core systems, which is ironic for an industry that exists to accept risk! Having a solid business case is key to offsetting that risk and demonstrating value.

Three key drivers of value for digital transformation

While there are many benefits of digital transformation, there are three key outcomes and drivers of value to include in a business case: decrease total cost of ownership, increase operational efficiency and improve customer experience.

1. Decrease total cost of ownership by spending less to implement ongoing change.
Health insurance is complex and highly regulated, and yet health plans have typically lagged behind other industries in technology advancement. Most health plans have legacy systems that have been in place for ages which require ongoing investment to maintain. These systems have a monolithic architecture with deeply ingrained, complex business rules and expansive, disorganized integration patterns. These dependencies make it very difficult to change when needed, let alone change quickly.Through digital transformation, health plans can modernize their core platforms with solutions like those EIS offers that are open and flexible and expose rules in an organized and efficient manner. These low code solutions allow health plans to move much more quickly and with far less cost from idea to implementation, decreasing total cost of ownership and accelerating time to market.

2. Increase operational efficiency and decrease operational expense:
In addition to making IT delivery more efficient, digital transformation can help organizations greatly increase operational efficiency. Of course there’s the obvious benefit of task and process automation, but having truly modernized core platforms allows healthcare organizations to more easily redesign and continuously adapt their processes. So many of today’s operational processes are remnants from older, paper-based and manual processes, mimicked within technology solutions. With more flexible technology, processes can be designed around desired outcomes rather than around what the technology dictates. It becomes easier to streamline and eliminate unnecessary steps and whole processes which dramatically increases operational efficiency and reduces operational expense.

3. Improve consumer experience to increase reputation and revenue:
While saving money is great, most health plans are looking for ways to create new and unique consumer experiences as a means to differentiate themselves. Consumers expect the same level of transparency and immediacy with their health plan interactions as with everything else. They don’t care that health insurance is complicated and they don’t want to have to know how each function or department in a typical health plan works. They want relevant, easy-to-understand information that is personalized and timely. If their favorite department store can know what they want to buy before they do, surely their health plan can anticipate their needs and preferences and engage with them on their terms. Through digital transformation, with open and connected systems, health plans can innovate faster and provide the omni-channel experiences customers crave, attracting more customers and leading to higher customer satisfaction and perceived value. 

By breaking free from the legacy technology that has typically held the industry back, health plans can be better positioned to keep up with the rapidly changing needs of their consumers and reduce ongoing cost. Building a solid business case is a critical first step to any successful digital transformation.

Need help building your business case? We can help. Book a call today.

The post A business case for digital transformation for health plans appeared first on EIS.