Gartner Research

U.S. Healthcare Payer CIOs Optimize Government Program Enrollment and Reconciliation With Vendor Tools

Published: 01 August 2018

ID: G00363534

Analyst(s): Bryan Cole


Membership turnover and regulatory complexity are increasing in Medicare Advantage, Medicare Part D, managed Medicaid and ACA individual exchange. U.S. healthcare payer CIOs can optimize administration with a combination of vendors that facilitates member enrollment and file reconciliation.

Table Of Contents


  • Enrollment and Reconciliation Tools Optimize Member Administration
  • Buy an Enrollment and Reconciliation Tool to Close Operational, Financial and Compliance Gaps
  • Critical Capabilities Are Common, So Focus Purchase Decisions on Ease of Use, Critical Workflows and Error Reporting
  • Make a Long-Term Selection Since Vendor Turnover Is Low
  • Choose Best-in-Class Vendors to Improve Financial Performance in Each Business Line

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