The hotly debated Affordable Care Act, fondly called Obamacare has started bringing in much needed reform in both the healthcare and health insurance sectors of America. Its goal, to increase access to healthcare and health insurance and curb healthcare spend. The law does not change how one can get insured; however, it does shake up how insurance can be purchased and accessed, as well as who accesses it.

This of course is good news for the customers, and opens up the playing field for healthcare companies and insurance providers. For the insurance companies in this current scenario, the question then becomes, “how do I expand my business and reduce costs, improve my customer’s experience, manage risks and still comply with the regulatory standards?”

The answer: Digital Innovation.

In the first place, most insurance companies have multiple isolated applications. These have to go, to be replaced by a powerful service-based system that offers enhanced user experience, boosts existing channels of distribution and offers new products to address gaps in the market.

So in building an integrated system, what are the elements that insurance companies need to prioritize?

So much expectation – so where does one start? A good place to start is with the customers – to focus on what the users need versus what they think they need. This is the era of anytime, anywhere transactions, and insurance companies need to facilitate that.

The essentials of a good integration programme are simplified processes, real time or near real-time processing and data strategy.

According to a report from Common Wealth Fund, the US scores well on patient centric healthcare and preventive measures. But the situation of coordinated processes needs a boost in scores, through utilisation of advanced integrated IT infrastructure, which will act as seamless bridge for stakeholders.

While we understand the trend predictions from PWC’s healthcare research institute, the whole experience of insurance processes can be leveraged with different solutions in this era.

SMALL SCALE AND LARGE SCALE INTEGRATION OF IT INFRASTRUCTURE

Real-time systems integration allows the insurer complete processes that have been initiated through varied channels, using core applications and data, whilst also providing a consistent experience that remains unaffected regardless of the channel used.

HEALTHCARE OPTIONS IN HAND

The customer, on the other end, could connect and transact via mobile devices, healthcare devices, or customer care lines. An integration strategy should therefore incorporate multiple points of integration to ensure that the customers enjoy a seamless experience and facilitate information exchange, to connect with insurance providers, doctors, hospitals and employers. So, the customers would get a simplified experience to store, share, synchronize & process their claims, get claim approvals and access healthcare data, care schedules, medical device data analysis & care reports.

BEHAVIOURAL ANALYTICS AND PATIENT CARE

Between insurance buyers, employers, and healthcare providers there is the need to lower costs, and efficiently process the claims while prioritizing the consumer’s health. Here lies the potential to integrating data of medical devices, diagnostic processes and hospitals.

The only way forward in the current highly competitive landscape is to change the current system of doing things. Replacing the old cumbersome, inflexible and expensive with more streamlined and flexible processes that meet new and emerging needs. ACA sought to address the problem of America’s uninsured millions. In doing so, it has also made it imperative that insurers look to improve efficiency, manage risk, provide value and safeguard opportunities for future growth!