Is Your Health Insurer Organization Future-Ready?

Technology in the hands of digital-savvy, mobile consumers opens a whole new world of opportunities in redefining how they actively monitor their own health care, personalize treatment and purchase insurance coverage. No longer are they limited to defined plans or services offered by their employers. The floodgates are opening where ‘choice’ is king and consumers will demand more control in building their own customized coverage and pricing that’s right for their diverse family needs. Information technology plays a key role in this shift.

A man sits at a desk using a Dell laptop and display monitor

Already, we are seeing people use online apps and social listening as gateways for choosing healthcare options that are right for them. Consumers are using smartphones and digital computing channels to purchase health plans. Mobile connectivity makes enrollment, billing and claims management a cinch. Gamification is driving better member engagements towards chronic illnesses management using simulated scenarios. Virtual clinical coaches are becoming employees’ best friend in motivating healthier lifestyles and behaviors.

The digital consumer revolution opens a renaissance for your health plan that’s both exciting as well as challenging. In the future, we’ll see such far-reaching technologies like nano-sensors, artificial intelligence, real-time data insights, the Internet of Things and end-to-end digitalization weave into every aspect of your health plan organization. With these unprecedented disruptions ahead, you will need to rethink how you bring value to your customers and make innovative, strategic use of information technology.

Health Plan 3.0 . . . the next wave of innovation

Health Plan 3.0 is a future-ready health insurance organization digitally equipped to provide a seamless experience to consumers in every aspect of the business. Your future enterprise will be driven by high-touch technologies and disruptive innovations across your entire value chain, bringing more structure and real-time visibility to your business and capabilities to quickly adapt to the nature, extent and velocity of the market changes.

Let’s briefly look at how some of the evolving technologies will transform the way your future-ready digital health plan might operate:

  • SMAC (interrelated social media, mobile, analytics, and cloud technologies) combined with the Internet of Things, big data and in-memory computing will enable your health plans to stay closely attuned to consumer demand and help you make better decisions grounded on real-time data and executed through a fast and agile IT environment.
  • Telehealth and intelligent wearables will enable your members to crowdsource a pool of rich clinical intellect by continuous and contextual monitoring of patient-generated health data for real-time member health management.
  • Genomics data coupled with member socio-economic and behavioral data will bring you more precise analytics to carve out personalized health coverage for members based on their individualized traits.
  • Artificial intelligence and machine learning technology will replace manual interventions with real-time automation for eligibility verification, prior authorizations, underwriting, clinical policy validation and claims adjudication.
  • Semantic Web 3.0, which is the third generation of the Web, will feature a more intelligent web emphasizing machine-facilitated understanding of information to provide a more productive and intuitive user experience. This will bring your members a seamless, optimal digital experience with an increased level of personalization while searching, shopping for health products, receiving communications, navigating through member coverage or managing disputes.
  • Service orientation will involve a suite of services with a modular approach to manage your health plan’s people, process and systems through the Internet. This will drive down the operational cost and bring increased speed, flexibility and agility to cater market need.

However, Health Plan 3.0 is not just about adopting new technology tools, solutions and intellectual property. It’s about having the expertise in place to imagine and bring to life the full potential of future possibilities within your business. For more than 25 years, Dell has been helping health plans reshape how they operate, serve customers and thrive in a world challenged by major disruptive forces. Let us help you rethink your health plan future and prepare a roadmap to undertake a digital transformation towards achieving the vision of Health Plan 3.0.

From June 3-5, we’ll be at the America’s Health Insurance Plans convention in Nashville. We invite you to come by our booth (#827) and join us at panel sessions.

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About the Author: Dr. Suman De