Gartner Research

U.S. Healthcare Payer CIOs Face Modernizing Core Administration or Risk Falling Behind

Published: 23 August 2013

ID: G00252437

Analyst(s): Christina Lucero

Summary

Current healthcare market trends and postreform regulations in the U.S. make current approaches to core administration obsolete. Payer CIOs and leaders who choose to defer multimillion-dollar investments in these systems risk seeing their enterprises become uncompetitive beginning in 2015.

Table Of Contents
  • Impacts

Analysis

  • A View of Core Administration and New Approaches

Impacts and Recommendations

  • Legacy systems will increasingly fail to address U.S. payers' needs in an era of rapidly growing regulatory demands and shifting markets, causing increased operations costs
  • Because of overburdened IT resources, payers are unable to sustain the level of attention legacy systems demand, much less meet the new business demands
  • High demand due to increased volumes of individual and small group member growth will stress fragile legacy systems and increasingly disrupt business for U.S. payers

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