Welcome
Health insurance has been revolutionized, altering not only the ways we conduct business, but also establishing a new set of regulations for which payers must abide. Driven also by consumerism and new open source, innovative technologies that support multiple initiatives, such as blockchain, the ability for payers to adapt has become a necessity.
Poised by our unbriefed knowledge of how healthcare will appear under President Donald Trump’s administration, new uncertainties are emerging. This provokes concerns over higher premiums, fewer insurance choices, efforts of addressing state-specific health care needs utilizing 1332 State Innovation Waivers and Section 1115 Waivers, and efforts to repeal and replace the Affordable Care Act. Read more
Simply put, while healthcare payers continue to take these changes in strides, to say that healthcare payers are amid a defining moment of our industry’s history is an understatement. In this newsletter, you will learn about the opportunities healthcare payers should engage in to reach greater operational efficiencies, realize more revenue opportunities, and gain access to greater data analytics for optimized decision making. Gartner’s research outlines the adoption of emerging technologies, which are intertwined with the digital payer transformation, including its contribution to consumer engagement.
At Softheon, we strive to create simple solutions to challenges such as these. Our turnkey Software-as-a-Service (SaaS) and Business Process as a Service (BPaaS) solutions provide end-to-end tracking, monitoring, and reporting of business activities for individual and small group enrollment, financial management, and customer relationship processes.
Understanding that healthcare is constantly evolving, our solutions can be deployed and configured within 90 days. This agile development process positions us to quickly adapt and adhere to the latest regulatory developments. Continuing our history of success, we are proud to be trusted by 37% of healthcare payers participating on the public exchanges and to manage 24% of their membership.
Eugene Sayan
Founder & CEO, Softheon, Inc.
Hype Cycle for U.S. Healthcare Payers, 2017
- B. Holmes| J. Cribbs | B. Cole
- 14 July 2017
This Hype Cycle tracks the maturity and adoption rates of emerging technologies that are important to healthcare payers' digital transformation. CIOs can use this note to prioritize, create roadmaps and coordinate initiatives with their peers and partners to enable critical business capabilities.
Analysis
What You Need to Know
Healthcare payers are facing a defining moment at the intersection of industry tumult and digital disruption. Gartner's health-value management business model lays out a rationale and architecture for transformation spanning business capabilities from intelligent administration to applied business intelligence (BI)/analytics, to provider and purchaser alignment, and to population health and consumer engagement management.
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