|
Insights
|
Introduction
Today, interoperability has become essential for collaboration to take place seamlessly. However, traditional systems, with high maintenance costs, slower compliance rates, poor interoperability, siloed data centers, outdated security, and delayed go-to-market, continue to hinder these collaborations/partnerships. Future-proofing the approach to digital transformation demands the move towards cloud-native development, API-fication, containerisation, and microservices.
Benefits Driving the Payers Towards Cloud-based Digital Transformation
Industry trends indicate that payers are inclined toward a 100% cloud-based ecosystem. While the overarching benefits seem evident and domain-agnostic, cloud-based digital transformation yields different impacts in the eyes of a healthcare payer.
1. From the market view
As market dynamics keep changing, cloud technology facilitates rapid adaptation and scalability. A midsize payer could easily employ cloud platforms and gain a longitudinal view of members – thus quickly growing their member base with various strategies from insights derived from the 360-degree view. Speed and scalability, together, flourish with cloud operations.
2. From the operational view
A healthcare payer today can transition from traditional call centers to cloud-based omnichannel services – allowing seamless data collection, effortless collaborations, and smooth interoperability due to automation. The result? From remote working to a secure database, operations are maximised, efficiency is enhanced, and agility is amplified.
3. From the cost view
A shift from the traditional operating model will lead to substantial cost benefits. How? It’s done by adopting the SaaS (Software as a Service) model – a cloud computing service model where software applications are provided over the internet on a subscription basis. This realignment of resources from the traditional operating model to a subscription-based pricing model enables strategic investments in other aspects of the business. For instance, opting for a cloud-based customer relationship management solution with a subscription model will help the payers pan out yearly expenses.
With an entire series of benefits, tech and healthcare leaders have begun a movement towards an innovation- and integration-led approach to business. In such a dynamic ecosystem, the outcomes become multi-faceted.
Partnerships: Raising stakes and amplifying results
In the increasingly connected world driven by experiential economy and digitalisation, shared cloud solutions are a boon for health plans. The healthcare environment hinges on five principal results: better member experience, analytics and ML-led data platform, a resilient health platform, operational excellence, and robust security and compliance.
Enhanced consumer experience
Personalised experiences, AI-driven patient engagement, value-based care products, newer models like telemedicine, omnichannel engagement, and optimal care pathways enhance consumer satisfaction for members, providers, and brokers alike. Payers can improve the efficacy of growing their consumer base with longitudinal mining that identifies potential interventions and recommends the next best action. This results in improved health, reduced costs, and customised care plans driven by personalised content and engagement.
Analytics and ML-driven data platform
Ingesting expansive data is the biggest challenge of HIPAA-compliant data interoperability. In fact, 30% of the world’s stored data is health related. This is where analytics and ML-driven data platforms come in. Health plans can ensure the quality and consistency of data on cloud solutions. Additionally, automated and omnichannel data platforms can optimise member acquisition processes, elevate patient outcomes, and enhance interoperability by enabling informed and secure decision-making. Integrating ML and predictive analytics offers actionable insights for medical management, ultimately contributing to improved patient outcomes.
Robust health platform
Cloud can streamline clinical workflows and build omnichannel engagement capability, ensuring a scalable and flexible virtual health infrastructure. Thus, future-proofing operations, managing care coordination, and delivering services promptly are at the core of healthcare.
Operational excellence
The road to operational excellence can have its individual challenges. From cloud waste to excess cloud spend, the answer lies in multi-cloud operating models. Health plans, therefore, can utilise cloud platforms to enable intelligent automation and cost containment. The innate scalability and flexibility facilitate smooth operations, ensuring cost-effectiveness in the long term.
Uninterrupted security and compliance
When it comes to healthcare, security and regulatory standards become a pressing concern. Contemporary health plans demand compliance mechanisms and security practices that can adapt to evolving development models, such as containerisation and API reliance. Cloud solutions streamline compliance protocols and offer advanced security measures to protect against data breaches, ensuring continuous adherence to regulatory requirements.
Payer and hyperscaler partnerships
Hyperscalers are now strategically inclined toward industry-specific solutions rather than technology solutions. These solutions are often built in collaboration with payers and/or niche vendors to make them marketplace-ready. Recent partnerships between payer companies and leading cloud service providers emphasise the significant impact of cloud services on the healthcare sector.
Notable collaborations include:
- Through their Living Health strategy, Highmark Health and Google Cloud are collaborating using advanced analytics and artificial intelligence to provide personalised member care experiences.
- Cambia Health and AWS Cloud are combining NLP and machine learning models for prompt member insights.
Other instances include Blue Shield of California partnering with Google Cloud to develop a next-generation, real-time processing platform and Elevance Health teaming up with Google Cloud for an AI-driven synthetic data platform. Moreover, Humana, Microsoft, CVS Aetna, and Microsoft Cloud employ cloud, AI, and FHIR technologies for predictive and intelligent automation solutions.
Role of System Integrators
Today, cloud adoption has become increasingly vital in healthcare ecosystems, and payers are already joining this transformation. Recent market research found that the healthcare IT market will be valued at $1319.28 billion by 2030. In such a case, System Integrators (SIs) are crucial in establishing beneficial cloud alliances.
The road to a fruitful cloud transformation is through System Integrator (SI) partners teaming up with healthcare payers and hyperscalers. The complete understanding of cloud-based transformation benefits can be only when health plans and cloud service providers collaborate with IT service providers working in healthcare, like CitiusTech, who enhance care coordination, interoperability, and regulatory compliance.
Hyperscalers are swiftly advancing digital solutions through collaborative development and innovation. This is done by recognising the role of in-house System Integrator (SI) partner programs. Embracing initiatives such as the Google Cloud Partner Advantage, AWS Managed Service Provider (MSP) Programme, and Microsoft Cloud Partner Programme, they are proactively driving transformation. Holding distinguished titles such as Healthcare Competency Partner with AWS, Microsoft Certified Gold Partner with Microsoft Azure, and Google Cloud Partner with Google Cloud Platform, CitiusTech stands out as an SI partner for leading cloud service providers.
Our position as an SI partner to major cloud service providers like AWS, Microsoft Azure, and Google Cloud Platform positions us to bridge the gap between healthcare plans and cloud service providers. It goes beyond mere technical support; it’s about a comprehensive segue.
Conclusion
Strategic partnerships with cloud service providers and System Integrator (SI) are indispensable to the payer’s digital vision. They simplify creating state-of-the-art, scalable, system-agnostic, and secure architectural frameworks that adeptly respond to the evolving needs within healthcare.
Cloud-based solutions ensure that health plans are resilient and future-proofed for continuous growth. At the same time, they enhance interoperability, facilitate seamless data transfer, and improve the quality of patient care. Furthermore, payers can welcome improved outcomes and heightened efficiency while unravelling hidden possibilities for a better tomorrow.
Shobhit Saran, Vice President – Payer Consulting Lead, CitiusTech
