Health Payers to Focus on Omni-Channel Strategies, Private HIX Solutions: IDC Health Insights for 2015

By CIOReview | Wednesday, January 14, 2015
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FRAMINGHAM, MA: International Data Corporation (IDC) Health Insight, provider of research and consulting services for health businesses and IT, has concluded in its report for ‘Top 10 Predictions’ that in 2015, the health payers will adopt Omni-Channel Strategies to attract consumers.

Deanne Primozic Kasim, Research Director of Payer Health IT Strategies at IDC Health Insights, states that there are IT-related challenges as well as business for payer organizations discovered by post-health reform environment that also adds key areas of opportunity for prepared plan leaders.

Below are the 10 predictions from IDC Health Insights for U.S. Payer Health IT 2015:

1. Omni-Channel understanding and delivery model tracks their consumers through multiple channels and provides more seamless experience that engage consumers. Payers will soon realize the potential of this model and start adopting it.

2. The partnership and relationship of payers with providers will be based on their multiple features such as support for Value-Based Reimbursement (VBR), Global Payments and Pay for Performance (P4P. Reimbursement Models.

3. Private Cloud solutions with feature Software-as-a-Services (SaaS) will play an important role to effectively manage data collection, aggregation and analytics efforts.

4. As the payers are more inclined to cloud-enabled solutions the threat of cyber attacks will be increased. To prevent from such attacks as well as secure their data, they will invest in multipronged security strategy.

5. Data management and warehousing strategies and related solutions will be of more concerned to address the challenge developed due to increasing amount of clinical, analytical and financial Data.

6. All the large organizations will prefer outsourced services for delivery of IT solutions that will cost them less.

7. Government-funded lines of business will be in more demand in near future including Medicare Advantage, Medicaid and Dual Eligibles.

8. Payers opt for population health management approach to care and disease management programs and soon selected IT vendors will look into this area and start investing.

9. Health payers will be keen to develop Non-Insurance Line of Business (LOB) including the investment in innovative health IT solutions. The LOB will deal with consumer communications and private Health Insurance Exchange (HIX) support.

10. The private HIX solution, set by organizations to let the citizen purchase health insurance in each state according to Patient Protection and Affordable Care Act (ACA), will be in demand.

“Payers are particularly challenged in 2015 to select and implement new processes and related analytical tools to better assess their operational performance, overall effectiveness, and understand their multifaceted consumer populations,” adds Kasim. “These 10 prediction areas provide a road map for payer decision makers to assess their related operational and technology areas and prepare their strategies and resources to leverage changing market conditions and create new opportunities, concluded Kasim.”