Gartner Research

Healthcare Payer Administrative Systems Maturity Model

Published: 26 May 2016

ID: G00302699

Analyst(s): Constance Sjoquist

Summary

Healthcare payers need to modernize their administrative systems to manage the new and diverging interests of their stakeholders. They should use this maturity model to understand what investments in people and technology they will need to make to support impending industry transformation.

Table Of Contents

Analysis

  • A View of the Healthcare Payer Administrative Systems Maturity Model
  • Payer Administrative Modernization Attributes
  • Innovation Triggers
  • Operational Intelligence
  • The Mature Payer Administrative System
  • Assessing the Payer Administrative System Maturity Model
  • Attributes of Effective Payer Administration
    • Level 1 — Aware
    • Level 2 — Enabled
    • Level 3 — Managed
    • Level 4 — Intelligent
  • Payer Administrative Systems Modernization Is Inevitable

Gartner Recommended Reading

©2020 Gartner, Inc. and/or its affiliates. All rights reserved. Gartner is a registered trademark of Gartner, Inc. and its affiliates. This publication may not be reproduced or distributed in any form without Gartner’s prior written permission. It consists of the opinions of Gartner’s research organization, which should not be construed as statements of fact. While the information contained in this publication has been obtained from sources believed to be reliable, Gartner disclaims all warranties as to the accuracy, completeness or adequacy of such information. Although Gartner research may address legal and financial issues, Gartner does not provide legal or investment advice and its research should not be construed or used as such. Your access and use of this publication are governed by Gartner’s Usage Policy. Gartner prides itself on its reputation for independence and objectivity. Its research is produced independently by its research organization without input or influence from any third party. For further information, see Guiding Principles on Independence and Objectivity.

Already have a Gartner Account?

Become a client

Learn how to access this content as a Gartner client.