Cutting Costs and Complexity for Health Plans

Cutting Costs and Complexity for Health Plans

Helping health plans gain a competitive advantage and seize new market opportunities by cutting costs and complexity.

For the first time in history, cost cutting is identified as a top priority in analyst surveys of health plan executives, second only to business growth. In fact, America's Health Insurance Plans (AHIP) has recently estimated potential savings of $500 billion to $700 billion from administrative simplification and the cost of doing business.

Health plan CEOs are now asking their IT executives to answer this question: "How can we reduce costs and complexity and position the company for growth in the current economy?"

Microsoft believes that health plans can simultaneously be cutting costs and complexity and improving the productivity and innovative capacity of their teams to grow the business. The most successful health plans will be those that cut the complexities and costs of doing business by prioritizing and precisely applying their IT investments-many of which they already own-to the people-driven business processes with the highest impact.

Exceptional plans are leading the way by focusing on three themes. First, prioritizing and acting on those areas that will give them the greatest competitive advantage. Second, improving team productivity and people-driven processes to grow the business. Third, reducing overall IT spend.

Cutting costs and complexity: Prioritize and act on areas that give competitive advantage

The challenge of prioritizing and deciding where to cut costs and complexities without disrupting productivity is daunting even for the most seasoned IT executives. To cut complexity and costs and improve business performance at the same time, business capabilities, IT resources, and organizational culture must all be aligned to the company's short- and long-term strategic plans. Microsoft and our partners are uniquely able to help you realize a faster return on investment by helping you find, prioritize, and act on the highest-impact business processes without the usual lengthy and expensive consulting engagements.

Grow the business by improving team productivity

While integrating systems and automating transactions are essential to efficiently running your health payor organization, it's your people and teams - not transactions or line-of-business (LOB) applications - who have the greatest potential to innovate, improve member health, drive out inefficiencies, and reduce operational and medical costs. Your members, providers, and employees make decisions and take actions every day that affect health outcomes and the cost of care. By taking advantage of innovative technology tools to improve the right people-driven processes, your organization can cut costs and complexity and improve business performance.

Reduce spending on technology

Eliminate redundant applications

Redundancies in technology investments most often occur when common business applications serve slightly different purposes but share features. These features can include messaging and calendaring systems, collaboration tools, enterprise search applications, document management suites, social networking, web conferencing, databases, business intelligence dashboards and reporting tools, and custom-developed applications.

By standardizing on technology platforms that include many of these capabilities as built-in functions, you not only can eliminate redundancies, but also can drastically reduce IT complexity and support costs.

Respond quickly to business opportunities

To support new business initiatives, you need to free up people and operating capital, modernize core legacy systems, and leverage new technology investments to power a new, agile, and highly scalable set of business and care processes and services.

The Microsoft Connected Health Framework (CHF) for Health Plans is a service-oriented architecture solution that enables you to meet these challenges by aligning your business goals and imperatives with your IT organization. Microsoft CHF enables your IT organization to quickly respond to changing business demands by reducing the complexities of managing processes and connecting core systems, service channels, new applications, consumers, and partners. Unlike other solutions, which include a complex and costly configuration of multiple products and solutions, Microsoft CHF for Health Plans is a simple and pragmatic approach to enabling the critical capabilities needed to exploit new business opportunities and respond quickly to changing business needs. It's the next-generation platform to support direct-to-consumer connections, delivery of actionable information within the context of existing workflow and digital lifestyles, and end-to-end collaboration with providers and partners.

​Quickly prioritize and act on the areas that will give a competitive advantage

The challenge of prioritizing and deciding where to cut costs and complexities without disrupting productivity is daunting even for the most seasoned IT executives. The critical first step is finding the right opportunities to focus on and then prioritizing them, because not every cost-cutting measure will maximize your competitive advantage.

To cut complexity and costs and improve business performance at the same time, business capabilities, IT resources, and organizational culture must all be aligned to the company's short- and long-term strategic plans. Microsoft and our partners are uniquely able to help health plans realize a faster ROI by helping them find, prioritize, and act on the highest-impact business processes without the usual lengthy and expensive consulting engagements.

Grow the business by improving team productivity and reducing labor-intense, error-prone processes

While integrating systems and automating transactions are essential to efficiently running a health plan, it's your people and teams -- not transactions or line-of-business (LOB) applications --who have the greatest potential to innovate, improve member health, drive out inefficiencies, and reduce operational and medical costs. Your members, providers, and employees, not PCs and servers, make decisions and take actions every day that affect health outcomes and the cost of care. By taking advantage of innovative technology tools to improve the right people-driven processes, your health plan can cut costs and complexity and improve business performance.

The reason IT hasn't played a larger role in people-driven processes in the past is that, unlike administrative machine-to-machine transactions, most day-to-day work performed by people is beyond the reach of conventional LOB applications such as enterprise resource planning, customer relationship management, care management, and core administrative systems. These applications were originally designed for structured, routine tasks and transactional processes. Human workflow, on the other hand, is most often less structured and highly collaborative, and it runs end-to-end across the workplace, the home, and multiple company boundaries.

? Reduce overall IT spend

  • Eliminate redundant applications

    Redundancies in technology investments most often occur when common business applications serve slightly different purposes but share features. These features can include messaging and calendaring systems, collaboration tools, enterprise search applications, document management suites, social networking, Web conferencing, databases, business intelligence dashboards and reporting tools, and custom-developed applications.

    By standardizing on technology platforms that include many of these capabilities as built-in functions, health plans not only can eliminate redundancies, but also can drastically reduce IT complexity and support costs.

  •  Respond quickly to business opportunities

    To support new business initiatives, health plans must free up people and operating capital, modernize core legacy systems, and leverage new technology investments to power a new, agile, and highly scalable set of business and care processes and services.

    The Microsoft Connected Health Framework (CHF) for Health Plans is the "real-world," service-oriented architecture solution that enables health plans to meet these challenges by aligning their business goals and imperatives with the IT organization. Microsoft CHF enables your IT organization to quickly respond to changing business demands by reducing the complexities of managing processes and connecting core systems, service channels, new applications, consumers, and partners. Unlike its competitors, which offer a complex and costly configuration of multiple products and solutions, Microsoft CHF for Health Plans is a simple and pragmatic approach to enabling the critical capabilities needed to exploit new business opportunities and respond quickly to changing business needs. It's the next-generation platform to support direct-to-consumer connections, delivery of actionable information within the context of existing workflow and digital lifestyles, and end-to-end collaboration with providers and partners.
To find out more about the Microsoft portfolio of cost-cutting solutions, contact us today.

 

   

Microsoft solutions

Learn about these solutions for cutting costs and complexity in your organization.   
  • Office Business Applications

    Digitize and improve people-driven workflow and collaboration using Microsoft Office as an interface for your existing line-of-business applications.

  • HIPAA 5010 Compliance for Health Plans

    New government mandates can help you reduce costs while improving the quality of health care delivery using the richer data set inherent in the International Classification of Diseases (ICD-10) mandated for use in 2013.

  • Microsoft Unified Communications

    Microsoft Unified Communications offers a unified conferencing experience that integrates voice, video, Web conferencing, and desktop sharing to enable easy-to-use, real-time communication and collaboration right from the desktop.

  • Enterprise Content Management

    Microsoft offers a complete, familiar, and flexible ECM platform that can bridge the gap in people-driven processes left behind by line-of-business applications.

  • Business Intelligence for Health Plans

    Even the smallest improvement in everyday decision-making can improve corporate performance, member health, and profitability.

  • Connected Health Framework for Health Plans

    A collection of vendor-agnostic best practices and guidelines for building service- and standards-based, interoperable e-Health solutions.